Who's right in the bioethics debates.
Tuesday afternoon, the Genetics and Public Policy Center holds a forum in Washington to talk about the next wave in sports: genetic enhancement. The final speaker, Tom Murray of the Hastings Center, ends with a scenario: Your loved one needs an operation. You're considering two surgeons. One offers to use a drug that improves the results of the operation. The other refuses to use the drug because it's unnatural. Which surgeon do you choose? Murray picks the first one, not because nature doesn't matter, but because the context is surgery. A surgeon's job is to heal, he says. An athlete's job is to excel through talent and training. A drug that's right in surgery might be wrong in sports. It depends on the context.
Every once in a while, somebody tells you something that makes other ideas click into place. This is one of those times. A few years ago, I got tired of hearing politicians spin, oversimplify, and shout past each other. After the 2004 election, I stopped watching politicians and started watching bioethicists. What the bioethicists talk about—the wonders and perils of cool new things we can do to ourselves—is more interesting. But the way they talk isn't much better. They spin, oversimplify, and shout past each other. The big shots play the same two-team game that bedevils politics: One team spouting half-truths of the left, the other spouting half-truths of the right. The lefties preach freedom and equality. The righties preach respect for life and nature. In the balance hang stem-cell research, assisted suicide, athletic doping, and other issues. Who's right?
I think I have an answer now: It depends on the context.
The lefties have trouble with the beginning of life. They're so in love with freedom that they sometimes forget the subject of freedom, the human being. They're so devoted to helping people that they sometimes forget the cost. At the beginning of life—stem cells and cloning—we're dealing with technologies that turn one human entity into a resource for another. You don't have to equate an embryo with a person (I don't) to recognize the underlying problem: We've caught ourselves by the tail. The more we erode the sanctity of human life—telling ourselves that the early embryo is fair game for a week, then two weeks, then four—the less it matters that the creatures we're helping are human beings.
The righties have trouble with the end of life. They revere nature. That works well at the beginning of life, when nature serves health. But toward the end, nature is basically trying to kill you. At Tuesday's forum, panelist Lee Sweeney recalls a conversation with Leon Kass, the former chairman of President Bush's bioethics council. Sweeney works on gene therapy for muscular degeneration. He says Kass told him that getting weaker as you grow old is part of life and should be embraced. I'll be happy to push your wheelchair, Sweeney told Kass, because I'll have taken genetic enhancement instead.
A month ago, I went to a meeting of Bush's council. I saw conservative ethicists belittle liberals and fumble mystically with end-of-life issues. Then, a week ago, I went to a meeting of progressive bioethicists. I saw liberals fire back, trampling the science and ethics of embryo research with all the subtlety of a political convention. That's what makes this week's meeting interesting. It isn't about the beginning or the end. It's about the peak years in the middle. The topic is sports, and the panel is liberal to moderate. Which side's ideas make more sense in this, uh, arena?
Right away, liberals have a problem: They worship equality and freedom, but in this case equality and freedom seem at odds. My freedom to inject myself with muscle-growth hormones denies you an equal chance of beating me. As the discussion unfolds, the liberals come up with a way around this problem. We're already unequal, they point out. Some kids can afford the best training and equipment; others can't. Melissa Mierke, a triathlon coach on the panel, condemns cheating but concedes that when you're racing for a scholarship that might even your odds against better-funded opponents, using a forbidden drug might not seem so unfair. And what about unequal genetic inheritance? Ron Green, a bioethicist from Dartmouth, jokes that he's one of the many "athletically challenged" people who would need gene doping to compete with Lance Armstrong. What's so fair about Yao Ming's height or Armstrong's absurdly efficient heart?
Murray makes a point that shoots down this argument. What disturbs athletes most about performance-enhancing drugs, he explains, is the fear that your opponent is getting a decisive advantage by doing something you aren't doing. Gene doping won't stop with genetic equality. It will aim next for genetic advantage. Nor will the struggle for advantage stop with gene doping. Native inequality will be replaced by purchased inequality, and the purchasing and fear will never end.
Conservatives have their own problems. Republicans in Congress are cracking down on steroids on the grounds that they're dangerous to athletes' health. But as Tuesday's discussion illustrates, this is actually a liberal argument. If a drug or gene treatment "improves health and is safe, there's no debate," Sweeney argues. Murray says steroids aren't nearly as dangerous as we were originally told, and anyway, we have no problem with athletes strapping boards onto their legs and flying down mountains at 70 miles per hour. Lots of sports are inherently dangerous. We designed them that way.
This last point turns out to be the key to Murray's approach. Conservative bioethicists aren't represented here, and Murray joins other panelists in criticizing Kass and the Bush council. But Murray's take sounds a lot like Kass'. He rejects the liberal-libertarian view that performance enhancement through drugs or gene therapy is just another phase of competition. Sport is supposed to test both physical excellence and refinement through training, he argues. That would be lost if performance-enhancement technology moved the contest, in effect, to the lab.
Kass and the Bush council make similar arguments in their report on enhancement technology. But Murray draws a distinction between his view and theirs. They rely on a theory of human nature, he says. He doesn't like that idea, because human nature is full of bad things like cruelty, treachery, and deception. Instead, he relies on a theory of the practice at hand. The difference is enormous. It's the difference between opposing enhancement in sports and opposing enhancement in humans generally.
Murray makes this point to separate himself from conservatives outside the room. But what's more striking is how it separates him from liberals inside. Sweeney keeps trying to broaden the discussion of performance enhancement to contexts beyond sports. He says society will accept muscle-building gene transfer for old folks, then for younger folks, and sports will have to follow. Sauce for the geezer is sauce for the Goose. When Murray draws the distinction between sports and surgery, Sweeney retorts, "Surgery isn't a sport. Neither is getting old."
But that's the point. If you don't want old age to be treated like a sport, don't treat sports like old age. Organized sports are a human invention. We set the stakes and can limit them at will. We make the rules and can change them at will. We have every right to restrict what the players can do to improve their chances. None of this is true in conception, gestation, aging, or death. Maybe we need to think less about how everything in life fits together, and more about how it doesn't.
Will Saletan covers science, technology, and politics for Slate and says a lot of things that get him in trouble.
Photograph of embryo on Slate's home page by BSIP Agency/Index Stock Imagery.