Get Ready for a Busy 2014 in Bioethics

Original Article

My taskmasters at the CBC never allow me to rest on my laurels. Fresh off several years of stellar prognosticating, I am now forced to answer the question: “But what have you predicted, lately?”

Okay, let’s take a look. Oh! Oh my. Please remember, the following predictions are what I see happening. They do not reflect what I want to happen.

Affordable Care Act, aka Obamacare

Too much precious predicting time over the last few years has been taken up with the soap opera known as Obamacare, officially, the Affordable Care Act. Enough! Just know the law will be the cause of more health care system turmoil and political tugs of war in 2014. Next case.

Assisted Suicide/Euthanasia

Euthanasia advocates are utterly committed to the cause of transforming killing into an accepted medical act. Accordingly,they will probe for areas of societal weakness to their killing agenda. Here is what the field will look like this time next year:

  • Belgium will legalize euthanasia for children: As I have described in these pages, Belgium has jumped off a vertical moral cliff in its broad license for medicalized killing. Now, the Belgian Parliament will make child euthanasia legal with no age limits. More, a child will have to ask to be killed under the law. Can you imagine? You’d better, because it this radical expansion of euthanasia is going to be very real.
  • Quebec will legalize euthanasia: The Canadian province of Quebec will enact one of the world’s most radical euthanasia laws, renamed “aid in dying.” Among its provisions: a requirement that doctors morally opposed to euthanasia either terminate a legally qualified patient who asks to die or refer to a doctor they know will be willing to kill.
  • The Canadian Supreme Court will Create a Constitutional Right to Assisted Suicide: In a related development, the Canadian Supreme Court accepted a case out of British Columbia that rejected a right to assisted suicide. Since the Court already ruled consistently with that decision years ago, I predict it took the case as a way of changing its mind and bringing assisted suicide to the entire nation of Canada.
  • No U.S. State will Legalize Assisted Suicide: There will be many attempts in state legislatures throughout the country to legalize assisted suicide. None will succeed.
  • A New Mexico Trial Court Ruling Legalizing “Aid in Dying” Will be Reversed: A trial judge in New Mexico redefined assisted suicide as “aid in dying” when done to a terminally ill patient by a doctor, and then claimed that access to the life-ending act is a fundamental liberty right. The decision will not stand.


It will be a relatively uncontroversial year in biotechnology. Advances in the ethically uncontentious adult stem cell research and induced pluripotent stem cells—in which skin cells are “reprogrammed” into stem cells—will continue at an exciting pace. Human trials and animal experiments will continue to demonstrate the tremendous potential for this form of regenerative medicine. Human cloning, already achieved, will not advance due to the shortage of eggs. Embryonic stem cell research will continue to lose its grip on the public’s consciousness as the above advances proceed.

Reproductive Technology

The notion that people have a fundamental right to reproduce by any means they desire or believe necessary will continue to expand. IVF will increasingly be considered a necessary covered benefit under health insurance—already the case in the United Kingdom. California’s new law creating a right for LGBT people to have their group health insurance pay for reproductive technology in the same manner as actually infertile heterosexual couples will spread to other states.

The drive to permit universities and biotechnology companies to buy eggs for use in cloning and other research will be renewed, with California passing a bill as it did last year (AB 926). That legislation was vetoed. But I predict that Governor Jerry Brown will sign the new, perhaps slightly modified bill, opening the door to Big Biotech’s exploitation of poor women for their eggs. Other states, hoping to lure biotech companies, will see legislation introduced to permit egg buying, but they will probably not pass in 2014.

The use of “gestational carriers” (surrogates) will continue to increase as more gay couples marry and decide they want children, and more older women decide they want children past usual childbearing age. In this regard, the CBC’s documentary expose on commercial surrogacy—Breeders: A Subclass of Women?—will generate intense controversy as criticism of IVF is increasingly castigated by the industry and its apologists as a cruel form of “infertility shaming.”

More evidence that children born from IVF procedures have worse health outcomes will not slow down the growth of the industry or the yearning of people to have children through technological means.


There are some important issues in bioethics that are receiving inadequate media attention. Here is what will happen:

Legislation will be introduced to permit paying for organs: The organ shortage has bioethicists scrambling to expand the donor pool. Look for legislation to be introduced to allow the families of organ donors to receive compensation. This will not pass in any state, but the pressure will increase in coming years.

The Jahi McMath “brain dead” controversy will continue: Readers may recall the tragic case of teenager Jahi McMath, who suffered cardiac arrest after surgery to correct sleep apnea. She was later declared “brain dead,” leading to international headlines as her family fought in court to continue her life support. She is currently maintained at an undisclosed location. If her body does not give out as predicted, it will raise significant questions in the public’s mind about the reality of “brain death,” leading to intense controversy and legislative battles.

Bioethics is one of the most consequential fields in society today with the potential to impact—for better or worse—the lives of each and every one of us. As such, it is always wise to expect the unexpected. But this much is sure: The CBC will continue to strive for bioethics policies that honor the unique dignity and sanctity of human life.

Wesley J. Smith

Chair and Senior Fellow, Center on Human Exceptionalism
Wesley J. Smith is Chair and Senior Fellow at the Discovery Institute’s Center on Human Exceptionalism. Wesley is a contributor to National Review and is the author of 14 books, in recent years focusing on human dignity, liberty, and equality. Wesley has been recognized as one of America’s premier public intellectuals on bioethics by National Journal and has been honored by the Human Life Foundation as a “Great Defender of Life” for his work against suicide and euthanasia. Wesley’s most recent book is Culture of Death: The Age of “Do Harm” Medicine, a warning about the dangers to patients of the modern bioethics movement.