When president-elect Donald Trump reached the telling 270 electoral votes last week, questions of bioethics were far from the hopes, fears, and general concerns of the majority of the American population. Will “the Trump administration… create a bioethics body?” was not an issue on the minds of many voters [1]. These questions took a backseat for large parts of the heated election cycle, and they are certainly not to be found towards the upper end of Trump’s incoming agenda. To assume the American people look to bioethics issues with indifference, however, is a grave mistake. And yet, the current political approach to these disputes may prove to be an even greater source of error as scientific research begins its descent below the tip of such icebergs as genome editing, stem cells, and cancer.
While popular topics like abortion remain locked in the grip of the Supreme Court, a vast quantity of research regulation is directed through presidential commissions. Such commissions are “established by the president… to provide expert advice on topics related to bioethics” [2]. Criticism of these commissions is in abundance due to members’ alleged political inclinations and suspected use of the council’s advice as nothing more than justification for the implementation of science-related political agendas. The question must be asked: what role must politics play as the scientific frontier pushes into the unknown and new ethical questions arise from every direction?
The ideal goal of biomedical research is to “advance knowledge for the good of society” and “improve the health of people worldwide” [3]. It is undoubtedly unethical to oppose, absolutely, the progress of proper and productive biomedical research. To do so would be to oppose the improvement of people’s quality of life, or opportunity for life at all. Of course, it is therefore counterintuitive to allow the research itself to produce detrimental effects through its practice and inflict harm on its participants or audience. Scientists are tasked with operating within an acceptable medium of progress and protection, wherein biomedical advances are possible without causing injury in the process. Consequently, the necessity for regulatory bodies is blatantly obvious; we ought not to ask if we should form these bodies, but rather how we should form them.
Should Trump follow the roughly forty year precedent of establishing a presidential commission to deal with bioethics? The essence of this question delves into the core of bioethics’ nature – is it open to political, and therefore subjective, interpretation? Or is it composed of objective and empirical values? How can stem cell research be supported by one administration and opposed by another, and how does this process influence the utility of such research in the first place? Political inhibition of scientific research poses several risks. A conservative approach to issues involving stem cells not only limits the freedom of researchers within the field, but also threatens the health of those who could benefit from biomedical advances. Possible implications of inhibitory policies range from a devaluation of those people the research aims to help to a long-term inefficient investment of financial resources and scientific personnel. Likewise, a liberal approach can be detrimental due to its potentially dangerous and often risky dance along the border of ethical and unethical. This perspective is more susceptible to active mistreatment and damaging disregard. Both sides of the spectrum yield adverse consequences that may be in conflict with the original goal of biomedical research, so why is the spectrum applied to bioethics in the first place?
In order to maximize progress while maintaining protection, bioethics committees ought to operate independently of the political sphere of influence. So long as ethical support/disapproval comes from presidentially appointed groups, “instead of judging work in bioethics for the quality of its reasoning and arguments, the inclination will be to search for political commitments and leanings” [4]. Such an inclination detracts from the substance of bioethical issues and relegates legitimately formulated decisions to biased partisan beliefs. Thus bioethics, a discipline of intense deliberation and far-reaching consequences, is consigned to the political void. Instead, on the highest level of policy-making, a bioethics committee should be independent, consequential, and diverse. In the US, it could, on a smaller scale, mirror the organization and structure of the United Nations. Just as the UN “provides a forum for its members to express their views” and takes “action on the issues confronting humanity”, this bioethics council would support collaboration between members of assorted backgrounds and viewpoints in order to deliver concrete resolutions [5].
Of course, there are already numerous independent bioethics bodies across the US. I am proposing an organization that would directly provide advice to and demand action from the national government. It would replace any sort of presidential commission, but would retain authority in its relationship with the government. Through such an institution, biomedical research would finally have the opportunity to pursue its potential without the obstacles resulting from frequent fluctuation of party control over the presidency and Congress. Necessary ethical regulations would undoubtedly remain in place, authorized by the independent bioethics committee, but the consistency of those regulations over time would provide researchers with a reliable framework that does not change every four years. Consequently, promising areas of research could be advanced without political obstruction or unethical authorization – two potentially damaging costs of the conservative and liberal approaches, respectively, to biomedical research.
Upon his inauguration in January, Trump should avoid a presidential commission for a bioethics committee. Instead, he ought to appeal for the formation of an autonomous, independent bioethics body functioning outside the realm of government. Such an establishment will allow biomedical research to flourish by avoiding the detrimental effects of partisan interest in bioethics.
References:
[1] Jonathan D. Moreno. “A Trump Bioethics Commission?,” The Huffington Post, November 10, 2016, http://www.huffingtonpost.com/jonathan-d-moreno/a-trump-bioethics-commiss_b_12900660.html.
[2] “History of Bioethics Commissions,” Presidential Commission for the Study of Bioethical Issues, accessed November 15, 2016, http://bioethics.gov/history.
[3] “What is the Purpose of Medical Research?,” The Lancet, February 2, 2013, http://www.thelancet.com/journals/lancet/article/PIIS0140-6736(13)60149-X/fulltext.
[4] Jeffrey P. Kahn, “What Happens When Politics Discovers Bioethics?,” Project Muse, June, 2006, https://muse.jhu.edu/article/197657/pdf.
[5] “Overview,” United Nations, accessed November 16, 2016, http://www.un.org/en/sections/about-un/overview/index.html.