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2009…A Not So Dark Year in Bioethics After All

Original Article

Each year, the CBC asks me to predict what will happen in bioethics/biotechnology in the coming year. In November 2008, I saw a “dark year” coming, caused by what I perceived to be a “cultural earthquake” caused by the election of President Obama and the legalization of assisted suicide in Washington State. Indeed, I worried that “the people now in power have views that are inimical to the sanctity and equality of human life.”

I still believe that is true. But I underestimated the resiliency and determination of those who oppose the development of what is sometimes called a culture of death. Thus, the year didn’t go nearly as badly as I feared.

Biotechnology

Biotechnology was a hot flash point during the entirety of the Bush Presidency. But it has been almost a non-existent controversy in the ten months since President Obama was inaugurated, partly because the Bush funding policy was rescinded (as I predicted), and partly because of the incredible successes of the induced pluripotent stem cells (IPSC), that do not require embryo destruction. Still, predictions were made and an accounting must be made.

Predictions I Got Right

  • “The Bush Embryonic Stem Cell Funding Policy is Toast.” That was an easy call, and indeed it came to pass quickly. Today, all embryonic stem cell lines already in existence – and those that will be manufactured from “leftover embryos” during the Obama presidency – qualify for federal funding.
  • The Amount of Federal Funding of Human ESCR Will Remain Roughly the Same. Right again. The number of stem cell lines eligible for federal funding expanded, but the amount of money available for that research remains roughly the same.
  • The Federal Government Will Not Fund Human Cloning Research in 2009. The real goal for the brave new world crowd human cloning research. And while agitation began immediately after the rescission of the Bush funding policy to have the Feds also fund human cloning research – such as in the New York Times and in science journals – I correctly predicted that the campaign to do so would not succeed in 2009.

Predictions I Got Wrong

  • New Federal Law Will Explicitly Legalize Therapeutic Cloning. During the Bush years, Senators Feinstein and Hatch repeatedly tried to explicitly legalize therapeutic cloning. I thought that drive would finally succeed in 2009. But perhaps because human cloning has proved very difficult to accomplish – and because of the dramatic success in the ethical induced pluripotent stem cell field – no moves were made to push this particular ball forward.

Prediction I Missed Altogether

  • Special Federal Funding for Ethical Pluripotent Stem Cell Research Rescinded. Candidate Obama ran on the promise that he would create policies bridging the ideological/political divides that roil this country. No policy epitomized that approach more than President Bush’s 2007 executive order requiring the NIH to fund research into finding non embryonic alternatives to researching with pluripotent stem cells. Despite the great success in that very field with the IPSCs, Obama quietly rescinded the Bush Order.

Assisted Suicide

There were two big news stories about assisted suicide in 2008 – Washington voters legalized Oregon-style assisted suicide by ballot initiative (I-1000), and a Montana trial judge declared a constitutional right for the terminally ill to “die with dignity.” I thought those successes would be built upon in 2009. I was wrong. The field remains mostly unchanged.

Miscellaneous

I made several predictions in other bioethical fields, and proved pretty prescient, but not infallible.

  • Abortion. I predicted that the Freedom of Choice Act (FOCA) – which would erase all state laws limiting abortion – would not pass. Not only did the bill not pass, no efforts were made to move the bill. However, I was wrong that federal funding for abortion would be permitted by the end of the year. That remains a goal of the Administration and the leaders of Congress, but as of now, it remains an unrealized goal.
  • Conscience Clauses. A great bioethical battle is coming over whether medical professionals who do not wish to be complicit in life-ending activities – such as abortion or assisted suicide – will be driven out of health care. I predicted that the “Bush Conscience Clause” protecting such dissenting health care workers would be overturned by the Obama Administration. I was certainly right that the effort would be made. Indeed, the effort was one of Obama’s first official acts. But bureaucracy being what it is, as of this writing, the revocation has not been published in the Federal Register. Meanwhile, a Ninth Circuit Court of Appeals ruled in a contraception case that a Washington regulation requiring all legal prescriptions to be filled did not violate the right to freedom of religion. If this case sticks, not only would Washington pharmacists with a religious objection to contraception be required to dispense birth control, but also to provide lethal prescriptions for use in assisted suicide.
  • Human Exceptionalism. While acknowledging that “timing is uncertain,” I worried that the European Court of Human Rights would declare chimpanzees to be legal persons in Europe. No decision has yet been made. But I was right that Spain would fully adopt the Great Ape Project making great apes part of the “community of equals” with the Spanish people. However, Nepal has yet to follow Ecuador in granting “rights” to nature, not because it won’t, but because the process has not been completed.
  • Futile Care. Alas, I was right that Texas would not rescind its law legalizing medical futility in 2009. I was wrong that a major lawsuit in the field would make big news. Other than a temporarily stalled attempt to legalize futile care in Idaho, the field was generally quiet in 2009.
  • Biological Colonialism. I worried that despite legal attempts to restrict the exploitation of the world’s destitute for their body parts, biological colonialism (such as buying organs), would increase in 2009. While there were no reliable studies published about this, it is clear that at the very least, the problem remained undiminished.

Missing the Story of the Year

My greatest failure – and it’s a whopper – was missing the entire brouhaha over Obamacare. I expected health care reform to be introduced. But I never anticipated it would bloat to a 2000-page bill or that Congressional leaders would try and push the behemoth through with such scant opportunity for democratic debate. And because I missed the ruthlessness of Obamacare’s pushers, I also failed to predict the commitment and resiliency of the resistance. In other words, I wrote not a word about what turned out to be the biggest story in bioethics of the year. Why I still have this predictor gig is beyond me.

The year 2009 turned out not to as dark as I feared. Rather than an 8.2 on the cultural Richter scale, the elections of 2008 turned out to be a 3.3. But that didn’t happen by accident. The lines generally held because people across the nation and the world worked energetically to prevent the worst from coming to pass. The CBC was an important part of that struggle, just as I predicted it would be.

Next month, assuming Jennifer Lahl is still interested in my predications after my Obamacare debacle, I will tell you what I think will happen in 2010.