Map of life expectancy at birth from Global Education Project.

Thursday, June 16, 2005

Getting past Go

As medical technology continues to present with novel moral questions, we just aren't having the constructive public discussions that we really do need, because we don't get past this "anything with diploid human DNA is human life and all human life is sacred" crap.

Let us stipulate that we never saw the memo from God, so as far as we are concerned an embryonic stem cell is not Uncle Charlie and a human body without a functioning cerebral cortex is not telepathically crying out to be preserved. Nevertheless many problems remain concerning the boundary between life and death, human life and other life, and the moral demands placed on us by humans in various conditions.

Here are some problems that we need to think about, that don't have simple answers.

We can start with the allocation of resources. I've written before about the Rule of Rescue vs. utilitarian ethics and principles of justice. Terry Schiavo was not sentient, but there are plenty of perfectly sentient people who indeed do want to keep living whose lives are prolonged at a cost of hundreds of thousands or millions of dollars. Simultaneously, there are children in poor countries who are dying by the thousands every day, whose lives could be preserved at the cost of just a few dollars. Come to think of it, there are poor people right here in the United States who die every day from preventable or treatable causes. Why is this acceptable?

So take it a step further. Embryonic stem cell research could, many people hope, lead one day to replacement tissue, even whole replacement organs. Maybe we'll be able to regenerate spinal chords, cure Parkinson's disease, or even grow brand spanking new hearts, lungs, livers, arms and legs, you name it, in vats, with your personal DNA, and they'll be able to install the new parts in you like putting a new transmission in your old pickup truck. Sounds great! But, uhh, how much is it gonna cost and what percentage of the world's people will be financially eligible for the upgrades? How is that gonna make the rest of them feel?

Now here's something a lot of people worry about. Maybe you don't but you're gonna need to talk to the people who do. Why stop at fixing stuff that's broke? We could make improvements. Give you some extra lung capacity, a more powerful heart, stronger arms. Maybe we'll figure out a whole lot of detail about the development of the brain and find ways to make children smarter, or even add some IQ points to adults. Maybe we'll be able to give people equipment and capabilities that nobody ever had before.

Some people are horrified by that prospect. They have a moral revulsion at what they see as a violation of human nature or the opening of a future in which we won't know who's human and who isn't. Or they are concerned, once again, about a new and even more pernicious form of inequality, a two-tiered or multi-tiered human society in which some people are enhanced and others are just what we are now, which will then be inferior, because you can be absolutely certain that whatever the wizards of utopia come up with, it won't be available to everybody.

The main theme here (although there are others) is justice. Obviously, the idea that all aggregations of cells with human DNA are human life, and all human life is "sacred" and has an equal moral claim on the rest of us quickly reduces to the absurd. That's the position the Pope and James Dobson are stuck with, and it makes them self-evidently ridiculous. So get past that. Take the next step. What is right?

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