Bioethics is a moral imperative: a reply to Steven Pinker

Philosophy has a problem with expertise. The discipline is, at its heart, a form of questioning that struggles to provide for easy or definite answers. I think this is one of philosophy’s strengths, but it can provoke problems.

One such problem when those without philosophical training speak with authority on philosophical issues. The problem here is that the authority they hold in one domain - say, science - doesn’t translate in the way they imply.

Richard Dawkins is arguably the most prominent example, but others - such as Neil deGrasse Tyson - are also culpable. The most recent instance occurred in the Saturday edition of The Boston Globe, when psychologist Steven Pinker took aim at bioethicists.

Pinker lauds the opportunities offered by scientific advancement. These include increased lifespan, decreased rates of premature death, and curing disease. The greatest threat to increased advancement, he contends, is ethics.

Given this potential bonanza, the primary moral goal for today’s bioethics can be summarized in a single sentence.

Get out of the way.

A truly ethical bioethics should not bog down research in red tape, moratoria, or threats of prosecution based on nebulous but sweeping principles such as “dignity,” “sacredness,” or “social justice.”

The use of inverted commas as a form of written sarcasm has always interested me. It amounts to the conferral of tone such that the reader infers that the quoted phrases are inane or trivial. It’s particularly noteworthy when the disparaging tone targets dignity or justice. But this isn’t the most troubling aspect of Pinker’s claim.

Rather, it is the notion that scientific advancement would be best served by separating from ethics that concerns me.

Pinker gives several reasons why ethicists need to step back. These include:

1. Alarmist analogies and slippery slope arguments;
2. The ethical costs of slow development;
3. The inaccuracy of long-term predictions about scientific development; and,
4. Historical condemnation of certain scientific developments that we now know are useful to wellbeing.

Let’s deal with each in turn. My hope is that by the end I’ll have convinced you of two things. First, that ethical guidance is good for science. And second, that Pinker isn’t freeing himself from ethics so much as he is blind to his own ethical presumptions.

Alarmism and slippery slope arguments

Pinker charges ethicists with “thwart[ing] research that has likely benefits now or in the near future by sowing panic about speculative harms in the distant future.”

These include perverse analogies with nuclear weapons and Nazi atrocities, science-fiction dystopias like “Brave New World’’ and “Gattaca,’’ and freak-show scenarios like armies of cloned Hitlers, people selling their eyeballs on eBay, or warehouses of zombies to supply people with spare organs.

It’s true that science-fiction and popular culture can cause undue panic about scientific advancement. Jurassic World, for instance, subtley suggests that genetic research produces monsters. But I’ve worked with ethicists most of my professional life, and none work in Hollywood.

On occasion popular culture is demonstrative, and is useful for teaching. In those cases ethicists, like all academics, use them to prompt reflection.

The use of pop culture and other examples as thought experiments doesn’t strike me as perverse. Particularly not when bioethics emerged as a discipline in part as a response to the horrific human experiments performed during WWII. Perversion was a part of scientific advancement until ethical reflection checked its progress. Unethical studies like the Stanford Prison Experiment aren’t hypothetical. True, they don’t reach genocidal levels, but they do paint a picture about science experimenting in a vacuum that urges caution.

Delaying development has ethical costs

Pinker’s second argument is more compelling.

Slowing down research has a massive human cost. Even a one-year delay in implementing an effective treatment could spell death, suffering, or disability for millions of people.

Let’s put aside the fact that one paragraph later Pinker casts doubt on our ability to make accurate predictions at all. Because there is an interesting question here.

Let’s assume that hand-wringing ethicists slow progress that cures diseases. As a result, animals aren’t subjected to painful experiments, patients' autonomy is respected, and “justice” is upheld. At the same time, lots of people died who could otherwise have been saved. Surely, Pinker suggests, this is unethical.

Only under a certain framework, known as utilitarianism, in which the right action is the one that does the most good. And even then, only under certain conditions. For instance, although some research might have saved more lives without ethical constraints, Pinker wants all oversight removed.

Thus, even bad research will operate without ethical restraint. For each pioneering piece of research that saves lives there will be much more insignificant research. And each of these insignificant items will also entail ethical breaches. This makes Pinker’s utilitarian matrix much harder to compute.

Inaccurate predictions

Next up are Pinker’s thoughts about our limited predictive power.

Technological prediction beyond a horizon of a few years is so futile that any policy based on it is almost certain to do more harm than good […] Biomedical research in particular is defiantly unpredictable.

In many ways, I agree. Humans aren’t great at making predictions. It’s part of the reason why I’m not a utilitarian: it can be hard to know which action will maximise benefit.

Given the derision, it’s funny that Pinker would lean to consequentialism, or use a phrase like “almost certain”.

Furthermore, it attacks a straw man view of bioethics. It suggests that bioethics only offers guidance on the long-term consequences of research. If bioethics can offer guidance within the horizon of a few years (which, mostly, is what it does) then this argument falls on its face.

Most bioethicists aren’t pie-in-the-sky thinkers. Many have some scientific or medical training. Bioethicists work on imminent research, develop guiding principles for healthcare, and offer critique of current trends and new proposals. None of which requires much prediction.

Ethics has got it wrong before

Pinker’s final critique is an old one. That practices that ethical voices objected to in the past are beneficial and widely-accepted.

[…] treatments that were decried in their time as paving the road to hell, including vaccination, transfusions, anesthesia, artificial insemination, organ transplants, and in-vitro fertilization, have become unexceptional boons to human well-being.

For one thing, some bioethicists still object to artificial insemination and IVF. Many come from religious backgrounds, but the point is that not all the decrying has stopped. That’s part of the nature of ethical debate, and I think it’s a good thing. It invites us to refine arguments, reconsider assumptions, and establish principles.

Second, historical pitfalls of ethics only matter if you don’t believe in moral progress. Like science, discussion of ethics has (in general) improved over time. So, there’s no need to throw the ethical baby out with the bathwater.

Third, becoming “boons to human well-being” isn’t universally recognised as evidence of moral acceptability. For those concerned with rules, principles, or virtues, how something happens is as important as what happens. Lying, treating persons as objects, failing to respect life or humanity are morally dubious traits in themselves. They can’t be redeemed by the mere fact that they lead to good outcomes, unless you are a (pretty unrefined) consequentialist.

Closing thoughts

Bioethics and scientific development need to work hand-in-hand. Ethical guidance helps to protect test subjects and minimise harm. More importantly, though, ethical reflection helps direct scientific advancement toward the good.

Science is a progressive discipline. It aims to press boundaries, innovate, and discover what is new. Ethics helps to direct that progress, because progress for its own sake is pretty banal. As G.K. Chesterton once noted: “I have long ceased to argue with people who prefer Thursday to Wednesday simply because it is Thursday.”

I mentioned Jurassic World earlier. In the first film in the series the incomparable Ian Malcolm summarises its basic ethical message:

Your scientists were so preoccupied with whether they could that the didn’t stop to think whether they should.

I think this is even more pertinent when scientists' research is motivated by humanitarian goals. It makes it easier to justify dismissing important ethical goals. With apologies to Steven Pinker, we can’t sacrifice ethics on the altar of scientific progress.

@matthewtbeard