It’s that time of year when the CBC asks me to look back on my annual predictions in the world of bioethics to see how I did. The answer? Quite well. In fact, I think it was my best year ever.
First, I predicted that what has come to be known generically as Obamacare—actually the Patient Protection and Affordable Care Act—would pass into law. Right. But as I noted at the time, that was the easy part. The real question was what the new law would look like. Here is what I foresaw:
- The “public option” would not become law. Right.
- Cost/benefit boards would be authorized that could become the foundation for health care rationing.Right.
- The law would permit regulators to permit indirect public funding of abortion by permitting policies for which people receive government financial assistance to cover abortion. Right.
- The law would permit “end of life counseling” to be specifically compensated. Wrong.
- The law would not cover illegal aliens, but there would be no requirement to prove legality before buying insurance from exchange-authorized company, meaning that those not legally in the country can theoretically buy coverage. Right.
Stem Cell Research
I next turned to stem cell and cloning issues. First, I predicted that adult stem cell human trials would continue to scant media interest, and that the first embryonic stem cell human trial would commence to great media acclaim: Right.
Next, I predicted that attempts would be made in Congress to block passage of the Dickey-Wicker Amendment—a policy passed annually as part of the budget process that forbids the Feds from funding destructive embryo research—but that Dickey would survive. Right. The DeGette/Castle/Specter bill, which did not pass, would have authorized full federal funding of embryonic stem cell and human cloning research, thus exempting those fields from Dickey.
I also predicted that advances would be made in human cloning but that the issue would remain quiescent. Wrong and Right. I know of no major advances in human SCNT, although primate SCNT has moved forward. Because of that, as I predicted, the issue has raised barely a ripple.
I predicted induced pluripotent stem cell research—which turns normal cells into pluripotent stem cells—would advance quickly, but that they would not be used in human trials. Right.
I predicted that no new states would legalize assisted suicide. Right.
I predicted the Connecticut lawsuit to exempt “aid in dying” (assisted suicide for the terminally ill) from the state’s law outlawing assisted suicide, would fail. Right.
I predicted Scotland would legally permit restricted access to assisted suicide. Thankfully, Wrong.
Health Care Provider Rights of Conscience
I was completely wrong in everything I predicted about this issue, and I am glad of it. First, I predicted that President Bush’s conscience clause regulations, which prohibit employment discrimination against medical professionals who refuse to participate in a medical procedure that violates their religious or moral beliefs, would be revoked. Wrong.Revocation has been started, but remains mired in the bureaucratic process.
I thought that lawsuits over conscience rights would proliferate. Wrong. The issue was very quiescent.
I predicted that a few states would pass stronger conscience laws protecting doctors, nurses, and others from participating in abortion or assisted suicide. Wrong. If they did, I am unaware of them.
I also predicted that pharmacists would be prohibited from refusing to dispense contraception. Wrong, again.
I prophesied that the Freedom of Choice Act—which would have eliminated state and federal statutory restrictions on abortion—would not pass. Right.
I predicted Idaho would pass a limited law permitting futile care theory to be imposed, e.g., allowing hospitals to unilaterally refuse wanted life-sustaining treatment. Wrong.
I thought there might be a sleeper bioethics story that I had not predicted and which would take us by complete surprise. Right. A federal judge unexpectedly ruled that President Obama’s embryonic stem cell funding policy violates the Dickey-Wicker Amendment. I knew about the lawsuit, but did not expect it to succeed. The case is on appeal.
Total: Right 13, Wrong 7, or 8—if you count my mistake about the stem cell lawsuit. That’s almost a 2-1 margin. Not bad, if I don’t say so myself.
The most interesting thing about 2010 was how much oxygen the fight over Obamacare took from other bioethical issues. Indeed, with that very notable exception, 2010 was a relatively low key year in the field.
That doesn’t mean it will stay that way. Bioethics will remain a highly contentious field for many years to come. The question is, what will happen next. Will attempts to repeal Obamacare succeed? Will assisted suicide advance? What about other issues of concern to the CBC in 2011 such as the exploitation of young women for their eggs and other biotechnological issues?
I know (I think). Like Scrooge’s last ghost, I’ll take you on a trip into the future in a few weeks so you can prepare yourselves for Bioethics 2011. Stay tuned.
CBC Special consultant Wesley J. Smith is a Senior Fellow in Human Rights and Bioethics for the Discovery Institute. His latest book is A Rat is a Pig is a Dog is a Boy: The Human Cost of the Animal Rights Movement (Encounter Books).