A foray into the new media

Prof. Russell Korobkin of UCLA School of Law was kind enough to ask me to review his new book Stem Cell Century: Law and Policy for a Breakthrough Technology (with Stephen R. Munzer, Yale University Press, 2007). I haven't done book reviews here before, and come to think of it, I don't know that I've ever seen a book review per se on a blog. People say things about books, of course, but making fun of Jonah Goldberg is not the same as writing for the Sunday Times.

So how to do this seriously in the blogging form? Fortunately, Prof. Korobkin's book is divided into chapters which neatly address a number of discreet issues, rather than constituting a single arc of argument. That makes it particularly suitable for the format because I can make some overall comments here, then take on various of the chapters, each reasonably within the limits of a single post. Unlike a typical book review, of course, this one will be interactive to the extent that readers want to comment. What will be most exciting, of course, is if Prof. Korobkin cares to join us. I have no idea whether he will, but it's worth noting that in the Web Century, that is possible. So here goes.

Stem Cell Century looks at various problems in the domain of biomedical technology from the perspectives of ethics, law and public policy, with just enough science thrown in to clarify the substrate of these problems. Prof. Korobkin doesn't just mean to inform us, he means to convince us. The book may be described as a series of ethical or policy puzzles, through which he walks us to the solution. Each subsection concludes with a succinct QED sentence.

The casual news reader or viewer thinks of the controversy over human embryonic stem cells as being all about whether blastocysts -- the small ball of cells constituting an early stage embryo, from which HESCs are derived, at least until very recently -- have the moral status of human beings. Prof. Korobkin addresses this problem very cogently, but it turns out that's just the beginning. He uses the emerging research program and potential technology based on human stem cells (it starts to open up a bit whether they are necessarily embryonic stem cells) as a frame to discuss cloning (a partly separate issue), biotechnology patents (with collaborator Stephen Munzer), issues pertaining to public financing of biomedical research, the ethics of human subjects research, people's ownership stake (if any) in the products and pieces of their own bodies, and the regulation of innovative medical treatments. You may recognize some of these subjects from Stayin' Alive, so the book is most welcome here.

I would say that Stem Cell Century is written with the comparatively sophisticated and highly engaged lay reader in mind. Korobkin doesn't assume much prior knowledge on the reader's part, whether of science, law, ethics or policy, beyond what one would hope a decently informed citizen would have. The style is lucid and accessible to people without specialized training or pre-loaded storehouse of jargon, although you will need to deal with a considerable list of acronyms. Those who find themselves acronymically challenged might want to have a paper and pencil handy.

It seems likely that most readers will in fact have a substantial background in one or another of the relevant disciplines or problem areas, so some passages will be review of familiar information. That won't do you any harm. However, not everybody will find that every chapter gets the juices flowing. The section on patent law, in particular, gets pretty deep into the weeds of legal sophistry while the payoff for the concerned citizen could probably be summarized very succinctly.

Indeed, I expect that for most readers the first issue addressed in depth -- what is a human being and is an embryo an example -- is going to be the most compelling, and that the rest of the book may seem something of an anticlimax. As I said, that's what the loudest public controversy has been all about, and it's obviously about the most important ethical question there is. What respect is due to human beings, and what entities are worthy of that respect? Most people are already fairly passionately involved in that debate, and it has deep connections to other problems people care about, such as abortion and the end of life. Once Korobkin has walked us through that -- as he does very cogently and enlighteningly -- how much rooting interest do we have left for property rights and regulatory theory?

Well, that's too bad, because these other issues do matter, quite a lot, to us as taxpayers and to potential beneficiaries (or victims) of biomedical advances. Where Prof. Korobkin has perhaps done himself a disservice is in framing all of these discussions in terms of stem cell research and/or therapy. In fact, the ongoing biomedical revolution is considerably broader than that, and offers compelling examples from other domains -- such as gene therapy, monoclonal antibodies and other bioengineered "large molecule" therapies, neuroscience, etc. -- that could help liven up much of this discussion and connect it to other controversies with which people are already engaged. The stem cell frame seems arbitrary, once we get beyond the embryo problem, and even a bit misleading.

Fortunately, we'll be free to pull in some of these other areas of biotechnology in upcoming posts. Of course, it turns out that Prof. Korobkin doesn't succeed in selling me every one of his QEDs; I agree with him mostly, but not entirely. So we'll take on those points as well. I'm looking forward to it.