13 August 2015
Steven Pinker, the noted Harvard professor of psychology, recently published in the Boston Globe an opinion piece on the subject of bioethics. This was followed up by an interview published on the Knoepfler Lab Stem Cell Blog. The common (and perhaps restrained) view of the first piece is that it is ’provocative’.
Setting the cat among the pigeons
Pinker’s specific topic was, as Julian Savulescu puts it, questioning the contribution of bioethics to the safe and efficient regulation of research. The fact Savulescu has commented – in some detail – on Pinker’s thoughts might clue you in to how provocative was the original piece.
And it wasn’t just Savulescu. It was a Nature editorial. And Richard Ashcroft. And Daniel Sokol. And Alice Dreger ; Russell Blackford; Christopher Mayes; Stuart Rennie; Alexandra Ossola; and so on. When someone like Steven Pinker speaks, people listen. And when he attempts to provoke a reaction, a reaction he will get. By the bucket load – questioning the contribution of an entire discipline is pretty provocative, as far as academia goes.
What was he getting at? That depends on to whom you listen – the commentators above are varied in their analysis, to put it mildly. People have picked up on different things: the claim that “we already have ample safeguards for the safety and informed consent of patients and research subjects”, that the obvious main point of his essay is that ethicists get their predictions wrong, or that pretty much everyone can agree that irrespective of whether one thinks there are enough regulatory safeguards, those safeguards could be better executed – ethics oversight can be painful and sometimes seemingly wilfully difficult to navigate. However, Pinker’s key claim is:
“Biomedical research, then, promises vast increases in life, health, and flourishing. Just imagine how much happier you would be if a prematurely deceased loved one were alive, or a debilitated one were vigorous — and multiply that good by several billion, in perpetuity. Given this potential bo nanza, the primary moral goal for today’s bioethics can be summarized in a single sentence.
Get out of the way.”
A grain of truth?
The internet doesn’t need another long analysis of Pinker’s comments. There are enough of them already. I broadly agree with Richard Ashcroft’s position – crudely paraphrased, that the essay was a deliberately provocative genre piece but does contain some decent points. The most important, from my perspective, being that the ways some regulatory systems are used to implement the principles of bioethics are not fit for purpose and may be actively harmful to beneficial research.
But the claim that bioethics should ‘get out of the way’ is needlessly provocative and frankly unhelpful. I wonder: had this not been Steven Pinker, would anyone be bothering to write about these responses? This seems unlikely. The claims are a strange combination of the morally obvious (“A truly ethical bioethics should not bog down research in red tape, moratoria, or threats of prosecution based on nebulous but sweeping principles…”) and the bizarrely selective in their view of what bioethics actually is (as Eric Meslin is quoted as saying, bioethics might slow progress sometimes, but it isn’t the only thing it does).
A (fair) criticism often levelled at me by my colleagues is that I can become too easily caught up in definitions and categorisation schemes – but here it actually is important. It may be that ‘bioethicists’ do sometimes irresponsibly retard important and beneficial research but, as Meslin pointed out, it is not the only thing they do and not the only thing that bioethics as a field seeks to achieve. Even the term ‘bioethics’ can be something of a blunt instrument, incorporating as it does so many different philosophical, cultural, historical, and theological (and probably geographic) differences. Lumping it all together seems reasonable at first – we need easily used terms – but the clash between my experience of bioethics and Pinker’s understanding of the same discipline is so great that we seem to be conceiving of entirely different things. Pinker reasonably, given the context, notes the work of Leon Kass – but this is the bioethics of 14 years ago and many thousands of miles away.
The broad church of bioethics
It is important not to get caught up in ‘no true Scotsman’-type arguments, as they are ultimately pretty vapid and unhelpful, but it is worth reflecting on the fact that ‘bioethics’ is a broad church indeed, with space for the sensible and the foolish, for technophobes and for technophiles. Which leads us to the obvious and oft-made criticism about bioethics ‘getting in the way’, and the equally oft-made response, as typified by Savulescu’s closing point with which I entirely agree: “the moral imperative for bioethics is to get out of the way when it should get out of the way (even stronger, it has a duty to facilitate and support ethical and beneficial research); but it is also imperative to stand up when it should stand up”.