A sermon by Jaco B. ten Hove — Paint Branch UU Church, Adelphi, MD — Sept. 24, 2006
READING
from “Stuck in the Middle” by David H. Smith
(Hastings Center Report 36, no. 1, 2006, pg. 32-33)
INTRODUCTION: The author of our reading, David H. Smith, is Professor Emeritus in the Department of Religious Studies at Indiana University, where he taught for 36 years [1967-2003] until his recent retirement. He was also Adjunct Professor of Medicine.
But most pertinent, for the last 20 years of his tenure Smith directed the Poynter Center for the Study of Ethics and American Institutions, an interdisciplinary group that focuses on medical ethics, the teaching of ethics, and the relationship of religion and ethics. Which is all to say that he is well versed in the intersection of three demanding fields: medicine, religion and ethics.
One would expect that such a studied academician would have strong and well- grounded opinions about bio-ethics, and indeed he does. But not the way you might assume. Here he takes aim at some other strong opinions, which he generously calls “crisp positions” but that actually weaken our ability to set important public policy about bioethics.
...that debate could well begin with some caveats: that religion need not lead to political dogmatism, and that no religious card should be trump. In the United States religion is an important part of the discussion, but only a part.
One subject on which the crisp views are at loggerheads is the question of the status and use of human embryos. The claims are familiar: from the moment of conception or existence…the embryo has the moral status of the writer and reader of this prose. Or, the earliest embryo is simply a resource for advancement of the human prospect, and quibbles about its creation or preservation reflect ignorance of embryology and perhaps superstition.
The clash results in argument conducted as war, reminding me of the…story of the minister preaching in a small church with the windows open: A spring breeze refreshes the room, blowing notes off the pulpit. Someone sitting in the first pew picks them up to see that the minister had written in the margin, “Weak point, yell like hell.”
…I contend that both these crisp positions are wrong. The fact is that none of us knows just what embryos are, but additional facts are not going to resolve the question. Uncertainty fuels this passion of argument. Thus our problem is what to do in the face of frightening ontological uncertainty. A dogmatic position of any kind isn’t much help in this kind of situation, for it leads to…a conclusion when none is fully credible.
I think we can draw some provisional moral conclusions from the fact of uncertainty: that it is unreasonable to pretend that the early embryo either has full personal status or is nothing special—but I don’t expect many people to agree. What is most important for us to grasp is the fact of uncertainty.
Admitting uncertainty doesn’t come easily, especially in public argument. Standing up for ambiguity doesn’t win many elections, but it’s what persons who write and teach about bioethics should do when the moral stakes are in doubt…
Why? Because the most important work we can do as students of ethics is pre- political. We can’t stand above our culture announcing what forms of argument are legitimate or just what the status of the early embryo is.
That’s what the Christian theological tradition has called pride, and others have called bad faith. And forgetting that fact is what’s wrong with the crisp positions I have found I can’t hold.
SERMON: TO LIFE! (MORE OR LESS) — Jaco ten Hove
I found David H. Smith’s piece, “Stuck in the Middle” among the 66 solid pages of a recent journal called the Hastings Center Report, which was entirely dedicated to “The Next Set of Questions about Stem Cells.” I worked my way through it—with no advertising, either—and while it’s all well-written, I don’t expect it’ll be on very many nightstands, although it might do well as a sleep inducer—unless “uncertainty” gives you anxiety nightmares.
But I’m sure glad someone is pursuing this important field with depth and integrity, even if that means “standing up for ambiguity,” because there’s an awful lot of smoke amassing around the scene of biotechnology these days. This arena that inspires both dogmatism and ambiguity includes embryo research, abortion, euthanasia, uses of medical and reproductive technology, genetic manipulation, etc. And some of the louder voices in these discussions produce more heat than illumination.
As Smith, might remind us: despite all the fire spouted by extreme—or “crisp”— dragons at war with each other, “the fact of uncertainty” remains, even after the dragons have blown themselves out.
It’s mighty satisfying, for instance, to get all righteous for the “total sanctity of life” and claim that every particle of every “embryo has the moral status of the writer and reader of this prose” and deserves to be legally treated as such. But to my mind, this broad brush ignores the larger reality of how frequently death is a natural part of life, even in the early stages thereof.
Nature itself is rather ambiguous about life, often promoting in many species a very large number of births because only a percentage of them actually survive. This seems to be more of the natural order of things, which economist and parson Thomas Malthus noticed rather famously way back at the tail end of the 18th century.
Meanwhile, on the other side of the opinion spectrum, some among us completely discount experience of the ineffable human spirit in favor of a scientism that “sees science as the absolute and only justifiable access to the truth.” [Wikipedia] This can also be a self-satisfying posture that flattens out the universe’s wrinkles quite nicely, without allowing for the intrusion of mystery or miracle. Birth, ho hum.
Now, I caricature both positions unfairly, of course, knowing there are certainly many softer gradations of thought, which is my point. However, once we admit to exceptions, qualifications, and adjustments to any extreme position, we have to also submit to the grueling task of public policy-making, a challenge which may be expanding as fast as the technology.
Another writer in the Hastings Center Report [Ruth Macklin], describes a rather distressing recent trend in this field, the politicization of bioethics [“The New Conservatives in Bioethics,” p.34-43]. She pines for an apparently bygone era when useful discussion could happen between intelligent people of divergent viewpoints without the fierce labeling of themselves and each other as “conservative” or “liberal,” the latter posture often including an additional tinge of “permissive.”
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This partisan development seems to have coincided with the rise in power of the right wing of the Republican Party, which has emboldened its representatives in many fields to consolidate political leverage to achieve their other agendas. Here, they “seem to think they have a handle on the ‘one, true bioethics,’ akin to religious believers who assert that theirs is the ‘one, true religion’” [Macklin].
Conservative bioethicists also often unfairly paint those who do not share their views as lacking in moral seriousness, thus conveniently dismissing out of hand all the arguments they might find difficult to counter. [“Taking Stem Cells Seriously” by Jonathan D. Moreno & Sam Berger. The American Journal of Bioethics July/August, 2006]
In actuality, it may be hard to get more serious than the 1994 Report of the Human Embryo Research Panel (HERP) for the National Institutes of Health (NIH). That very formative report, now a dozen years old but still referenced, declared embryonic stem cell research “morally permissible because, although embryos deserve respect, they are not morally equivalent to human beings” [Moreno/Berger]. Panel called this the pluralistic approach, which they recommended over its alternative: to find one single aspect that would determine when and how embryos can be considered morally equivalent to full personhood.
Such a decision point might be the “holy grail” for conservative bioethicists. But these attempts too frequently “create paradoxes in logic and run counter to many widely accepted practices” [HERP], such as the generally unchallenged interventions of contraception and in vitro fertilization.
In contrast, the pluralistic approach suggests that this “is not an all-or-nothing matter but results from a being’s increasing possession of qualities that make respecting it more compelling” [HERP].
Note that this view does not categorically dismiss the inherent life contained in embryos. It does however, put it in perspective, rationally, in kind of a middle ground way. This reflects the view that “People do have respect for embryos, which is why they want to ensure that research using them proceeds carefully, ethically and with clear regulations and oversight” [Moreno/Berger].
And so we end up back in the public policy-making realm, where the “fight “may get too ugly,’” as described by a sub-headline in a St Louis Dispatch article this past summer. Evidently citizens of Missouri are right now considering how to vote on a November ballot proposal that would protect I that state any stem-cell research that is also legal under federal law. [“Churches joining stem cell showdown” by Jo Mannies and Tim Townsend, ST. LOUIS POST-DISPATCH, Saturday, Jul. 29 2006]
Not surprisingly, religious groups are galvanized on both sides and dishing out rhetoric, including my colleague, minister of the large First Unitarian Church of St. Louis, Suzanne Meyer, who has been known to use strong language.
“We can think,” she is quoted as saying, “about the notion that disease was God’s punishment for sin, or even when the Pilgrims saw smallpox as God’s way of eradicating the Native American population. We now regard those concepts as ludicrous.” Decades from now, “We’ll look back at the theological arguments against embryonic stem cell research and regard them as reprehensible.”
In the opposing camp, a leader of the Lutheran Church-Missouri Synod [Maggie Karner, director of life ministries], declared unequivocally, “It is ethically and theologically unacceptable to destroy the life of one innocent human being for the life of another.” Rather “crisp” positions.
An even more polarized arena in bioethics might well be abortion, where labels abound. Ferocious “pro-life” voices try to degrade those they disagree with by calling them “pro-abortion” or “anti-life,” while some of those folks self-describe as “pro-choice” and label their opponents “anti-choice.” The claims are familiar.
In a sound-bite world, it seems to matter most what “side” you’re on, as if there were only two camps and no reasonable center place from which to see the subtleties of complex arguments, let alone find any compromised solution. Yes, I suppose “standing up for ambiguity doesn’t win many elections,” but what if it’s the most responsible position?
Personally, I’m anti-abortion and pro-choice—a posture that requires a degree of nuance. Nuance—hey, now there’s a label that I’m willing to be associated with. So maybe I’ll start a new campaign to advocate the “pro-nuance” position. Yeah, that’s it: I’m for nuance. Vote for Nuance! (Hmmm. Fat chance.)
But am I imagining it or has this word “nuance” gotten more play lately, even in political discourse, like when someone needs to explain something more complicated than a sound bite can handle, and perhaps more often in election season? It also, however, often crops up as a liability, as in this recent statement from a critical pundit:
“Today’s Democratic leaders are all about talk, all about appearances, all about nuanced positions…”
[J.B. Williams, “Democrats Recruit God to Advance Morally Bankrupt Agenda,” Canadafreepress.com, 9/21/06]
—as if articulating nuances was a superficial activity and a problem. Better to be “crisp,” I guess. Well, when it comes to bioethics, at least, I think nuance reigns, but it makes lots of people uncomfortable —given “the fact of uncertainty” and ambiguity.
People are also ill at ease because of true statements like this one from Lori Andrews, who is a professor and director of the Institute for Science, Law and Technology at Illinois Institute of Technology. She is not an extremist, just a careful observer of what’s happening, and offers this historical reality check:
Each step along the way, from sperm donation to in vitro fertilization to surrogate mothers to embryo research, we have gradually yet inexorably moved closer and closer toward engineering human life to fulfill individual desire.
This indeed gives me pause, as it invokes the specter of a slippery slope, down which we are sliding into immoral manipulation of the human genome and ultimately cloning ourselves. This is a very easy bogeyman to call upon to foment fear and resistance to the advancement of genetic science. Makes me at least a little fearful.
It also reminds me of a memorable old TV commercial for a margarine product that was supposedly better than pure butter. A kindly feminine goddess figure appears interested but then turns rather sour (and violent) when she discovers it’s not butter, scolding, “It’s not nice to fool Mother Nature!”
Well, how much are we going to “fool” with Nature? And who exactly gets to decide what is or isn’t “nice” about biogenetics? Or how far we go how fast? There will always be strong opinions tossed around, especially from those who are over- cautious and those who throw caution to the wind and rush headlong forward. Both claim value to their positions.
And what about the increasingly obvious and possible opportunities for “engineering human life to fulfill individual desire” by gene-splicing that is less about healing and more about enhancement? Just because we can do it, technologically, should we fool with Nature at deep fundamental life levels?
I suppose we should not be surprised that there is a considerable commercial market for elective genetic manipulation. But have we truly come to grips with what this already looks like and will look like?
Seductive voices among us are promoting the concept of “designer babies” created by genetic manipulation to have greater intelligence or resistance to diseases, certain heights and weights, etc. These enhancements, of course, would be most available to people who could pay for them, which adds another specter to the impending scenario: greater and greater divisions between the haves and have-nots, the former now spending their increasing riches on achieving genetic superiority as well.
All this provides a rather serious urge toward some kind of reasonable regulation that might straighten out the slippery slope a bit, even if not quite leveling the playing field, as it were. We must make distinctions. For instance, as one author put it: “The right to terminate an unwanted pregnancy is very different than the ‘right’ to modify the genetic makeup of future children” [Tom Athanasiou & Marcy Darnovsky, “The Genome as Commons.” WorldWatch, July/August, 02]
But are we even up to the task of regulating ourselves? Evidently there are forces aligned against regulation from both extremes. We know there are researchers who want to plow ahead without obstacles. But some fierce opponents of biogenetics take a more strategic, if cynical approach, believing it’ll be easier to prevent progress if there are no rules. Why? Because people will be easier to scare. So they actually block regulation.
Consider this impression from the very reputable director of the University of Pennsylvania School of Medicine’s Center for Bioethics:
“Rather than argue about how best to control the rapidly evolving technology of cloning for stem cell research, they know that you will be more opposed if you worry that the technology will get out of control. If there are no rules at all then you have a reason to keep worrying. So the critics prefer to continue to leave cloning research unregulated so that you will stay scared and cloning will stay banned.”
[Arthur L. Caplan, Chair, dept. of medical ethics and Director, Center for Bioethics, Univ. of Penn. School of Medicine: “Stem cell research needs regulation.” Posted on MSNBC, 5/20/05.]
This makes me want to ask who’s in charge of the regulation process, anyway? From my scattered research for this sermon, I couldn’t tell you, really. Maybe it will be fought out in the media and through ballot measures, as in Missouri. I did find that the first public national body to help shape bioethics policy in the U.S issued its report in 1975 and since then there have been a succession of commissions addressing related concerns, leading up to the current group called the President’s Council on Bioethics. Whether they—or anyone else for that matter—can keep up with, let alone stay ahead of the science is a very good question.
I admit to some skepticism that our federal government, at least as currently construed, will be able to effectively guide this realm, but I’m equally suspicious of “the market,” with its lack of conscience and reliance on a bottom line of profit. But some kind of oversight is called for, or else we clearly risk unleashing biotechnology on a scale that is, at a minimum, daunting. News items appear almost daily that portray the particulars, as we try to comprehend and adjust to incremental movement down one slippery slope or another.
A rule that I think should be considered more often is the law of unintended consequences, which no doubt grows in importance as complexity increases. Have we learned anything from examples like the malaria outbreak in Borneo in the 1950s? At that time the World Health Organization (WHO) sprayed DDT to kill mosquitoes, an action which also killed wasps that were keeping down the population of thatch-eating caterpillars. Suddenly, without the wasps around, the thatched roofs on homes were disappearing en masse.
Meanwhile, the DDT-laden mosquitoes and wasps were gobbled up by little lizards called geckoes, which were in turn eaten by cats, who then perished from the poison passed along. The absence of felines allowed the multiplication of rodents, which then had its own negative effects. Finally, to slow down this destructive chain of events, officials had to parachute 150,000 live felines into the area to control the rats. [From “Notes on the Ecological Dimension” by Mitchel Cohen, www.zmag.org, August 31, 2006]
Horror stories like that are still unfolding around the globe, as we too often use misguided and near-sighted techniques to address single symptoms of our declining environmental system without considering larger, wider implications.
Entering and altering genetic patterns seems like asking for similar trouble, and yet… and yet, the promise of biotechnology to serve the good is seductive. But how can we know what we’re doing, or at least improve the odds that we won’t actually slip and fall headlong into a very ugly future?
To move forward equitably and safely, we are called to learn a better, more inclusive method for how to make important distinctions together. And any religious, political or secular dogmatism that attempts to trump the discussion should be a red flag that instead signals greater need for more open conversation.
What makes the most sense to me is to steadily increase our application of holistic thinking. My Unitarian Universalist faith is in our interconnections, which are most visible when one pauses occasionally to look up from the immediate and out into the ultimate. There is wisdom embedded in the web of all life, of which we are just a part.
If we step back and take a larger look at how biogenetics is meshing with other forms of planetary evolution, we might see paths that lead us to a more peaceful future, with less war—of both the verbal and military kinds.
This heavily nuanced realm in which we muck around with genetic make-ups—for humanitarian or commercial purposes—is not all good or all bad, but it does seem like a dangerous capacity that should have some reasonable safeguards on it. — Wait a minute; what’s this in my margin? “Weak point. Yell like hell!” Okay: Vote for Nuance!
Begging for more nuanced holistic thinking is not likely to win elections, alas. Nonetheless, the welfare of our children and theirs and theirs may well depend on our collective ability to make very important distinctions in public policy today. Can we touch together the “group mind” of a planetary consciousness, and move effectively toward a sustainable future?
Perhaps the dilemmas we face belong to the throes of an older paradigm giving way to whatever is going to carry us forward into this new millennium. Of course, the perhaps glorious irony is that while we are pressing on into uncharted regions of technology, we are also rediscovering the power of very ancient wisdom that grounds us, literally, in the eternal, elemental Earth.
Let us hear the call to ever more holistic perception, nuanced as that may be. Let our great strengths as a people of passion serve a greater good and help us to make the important distinctions that will guide our culture into a more peaceful tomorrow. May it be so!