Public bioethics and publics: consensus, boundaries, and participation in biomedical science policy

Public bioethics bodies are used internationally as institutions with the declared aims of facilitating societal debate and providing policy advice in certain areas of scientific inquiry raising questions of values and legitimate science. In the United States, bioethical experts in these institutions use the language of consensus building to justify and define the outcome of the enterprise. However, the implications of public bioethics at science-policy boundaries are underexamined. Political interest in such bodies continues while their influence on societal consensus, public debate, and science policy remains ambiguous. This article presents a theoretical discussion of public bioethics bodies as boundary organizations and examines them in terms of relationship to the moral and cognitive authority of science and other forms of expertise, mechanisms for public participation in controversial science policy, and the deployment of consensus models. The theoretical discussion is examined in the case of the U.S. Human Embryo Research Panel.

Stem cell research: a target article collection: Part III--determining moral status

In this chapter, I review some of the background thinking concerning matters of moral status that I had developed in previous years and that I would now bring to the work of the Human Embryo Research Panel. Two ideas were at the forefront of my thinking. First, that biology usually offers not decisive "events" but only continuous processes of development. Second, in making status determinations we do not so much "identify" a point on a developmental continuum where moral respect should be accorded as "choose" that point. These choices are "balancing decisions" in which the community of moral agents weighs its interests in protecting an entity against the burdens of doing so. After illustrating these two contentions, I consider some of the reasons why thinkers on the "right" and "left" of our bioethics debates have resisted or missed this basic insight.

Stem cell policies in the United States and in Germany

The article compares policymaking in the field of human embryonic stem cell research in the United States and Germany. Although experimental research with human stem cells is controversial in both countries, restrictions on research are much more strict in Germany than in the United States. In order to explain the contrast between the United States and Germany in dealing with human embryonic stem cell research and to predict possible future developments, we need to look carefully at a number of important differences in the interpretations and discourses of embryonic stem cell research and their consequences for the strategies of institutions and actors in the political-regulatory realm.

Human embryonic stem cells and respect for life

The purpose of this essay is to stimulate academic discussion about the ethical justification of using human primordial stem cells for tissue transplantation, cell replacement, and gene therapy. There are intriguing alternatives to using embryos obtained from elective abortions and in vitro fertilisation to reconstitute damaged or dysfunctional human organs. These include the expansion and transplantation of latent adult progenitor cells.

Ethics and policy in embryonic stem cell research

Embryonic stem cells, which have the potential to save many lives, must be recovered from aborted fetuses or live embyros. Although tissue from aborted fetuses can be used without moral complicity in the underlying abortion, obtaining stem cells from embryos necessarily kills them, thus raising difficult questions about the use of embryonic human material to save others. This article draws on previous controversies over embryo research and distinctions between intrinsic and symbolic moral status to analyze these issues. It argues that stem cell research with spare embryos produced during infertility treatment, or even embryos created specifically for research or therapeutic purposes, is ethically acceptable and should receive federal funding.

Embryo research: the ethical geography of the debate

Three basic political positions on embryo research will be identified as libertarian, conservative, and social-democratic. The Human Embryo Research Panel will be regarded as an expression of the social-democratic position. A taxonomy of the ethical issues addressed by the Panel will then be developed at the juncture of political and ethical modes of reflection. Among the arguments considered will be those for the separability of the abortion and embryo research debates; arguments against the possibility of the preembryo being a person, especially arguments associated with totipotency and the significance of the primitive streak; and the various reasons for regulating embryo research, including those associated with respect for the preembryo, the protection of traditional views of human procreation, and the prevention of commercialization.

Embryo research and public policy: a philosopher's appraisal

The development of public policy on bioethical issues can be approached through substantive moral and philosophic reasoning, or through balancing perceived societal views as to what is ethically acceptable. The Human Embryo Research Panel had to apply the first approach to the question of the moral status of the preimplantation embryo. Only after concluding that the preimplantation embryo was not a full human subject could the panel consider the conditions under which embryo research was ethically acceptable, given a range of societal views, concerns, and interests.

Fetal subjects and maternal objects: reproductive technology and the new fetal/maternal relation

This essay examines three tendencies nurtured in the practices of reproductive technology - tendencies with profoundly disturbing implications for us as individuals and as social beings. They are: 1) the increasing subjectification of the fetus (that is, the increasing tendency to posit a fetal subject), 2) the increasing objectification of the gestating woman, leading to her representation as interchangeable object rather than unique subject, and 3) the increasing tendency to conceive of the fetus and the mother as social, medical, and legal antagonists. Considering the construction of fetus, mother, and the fetal/maternal relation in earlier (Western) historical periods, a contemporary work of literature, a government report, and the popular press, I argue that as the fetus is increasingly being understood as a subject, the mother is increasingly being reduced to an antagonist, an obstacle to fetal health, and an object. The essay concludes by offering some tentative conclusions about the general process of fetal subjectification in the United States and Europe.

Arguing along the slippery slope of human embryo research

One frequent argument in the debate over federal funding of human embryo research is the slippery slope argument. Slope arguments can be of several types: either logical, empirical, or full (a combination of logical and empirical slope arguments, with an additional psychological premise). A full slope argument against human embryo research suggests that funding embryo research could undermine current protections for human subjects research, erode respect for persons with disabilities, and encourage eugenics practices. While the Panel commissioned by the National Institutes of Health to issue funding guidelines regarding human embryo research acknowledges some slippery slope concerns, the Panel's final report fails to address such concerns in any depth. Given this failure seriously to address these valid concerns, federal funding of embryo research should not proceed at this time.

Washington politics and genetic engineering research: when worlds collide

In earlier research, I developed a notion of "biopolitics" to help explain, first, the recombinant DNA debate of the 1970-1980s, and, second, the human gene transfer-therapy debate of the 1980-1990s. Drawing upon results gleaned from two recent meetings of high moment in the nation's capital, I expand upon the theoretical and empirical parameters of the biopolitical argument to elucidate the clash of policy preferences arising from two new areas of genetic experimentation: (i) human embryo research and (ii) the creation of commercially viable therapeutics to combat disease. I show the manner in which members of the biological science community and their policy allies are forced to cope with the realities of the "Washington political game," and why it is necessary for them to develop a sophisticated sense of what that "game" is.

Embryos created for research purposes

The creation of embryos for research use has drawn a great deal of criticism. It is difficult to defend an ethical distinction between what one can do to "spare" embryos and what one can do to "research" embryos. The strongest ground on which to argue against the creation of embryos for research is a symbolic one, having to do with respect for human life. Ronald Dworkin's work in Life's Dominion on the symbolic meaning of the abortion debate throws a helpful light on this dispute. By understanding the basic question to be, Does the creation of research embryos weaken or insult our communal respect for the sanctity of human life in some way that in vitro fertilization (IVF) or the experimental use of "spare" embryos does not?, the debate can move in a more constructive direction.

Ethics

For the first time, a National Institutes of Health advisory panel approved funding for the production of human embryos for research purposes. Oregon voters approved a Death With Dignity Act that empowers physicians to prescribe lethal doses of medication to terminally ill patients.

The Human Embryo Research Panel: lessons for public ethics

On the morning of December 2, 1994, after a preceding afternoon of discussion, the Advisory Committee to the Director of the National Institutes of Health (NIH) unanimously voted to approve the recommendations of the Report of the Human Embryo Research Panel. Panel members like myself who were present were elated. The vote marked the culmination of nearly a year of work. Approval of the report also represented a decisive step forward in bringing an end to a 15-year long moratorium on federally funded research on the preimplantation human embryo and techniques ofin vitrofertilization.