British philosophy professor David S. Oderberg and Australian Supreme Court barrister Jacqueline A. Laing agree, writing, “It is plain that bioethics has been dominated by a certain way of doing moral philosophy,” what they call an “establishment view.”19 In this regard, Fox and her co-author, Judith P. Swazey, president of the College of the Atlantic in Bar Harbor, Maine, have written, “Bioethics is prone to reify its own logic and to formulate absolutist, self-confirming principles and insights,” as bioethicists “have established themselves, and their approach to matters of right and wrong, as the ‘dominant force’ in the field.”20 Those are pretty good descriptions of the mind-set of ideologues.
Sociologist Howard L. Kaye, PhD, author of The Social Meaning of Modern Biology,21 believes that this bioethics establishment view conceives of itself “less as an attempt to arrive at an ethical regulation of biomedical developments” and more as a system in which “biology [is] transforming ethics.” Kaye observes that many bioethicists “believe fervently that there needs to be a radical transformation in how we live and how we think based on new biological knowledge because our values, our ethical principles, our self conception are based on outmoded religious ideas or philosophical ideas that they think have been discredited.”22 If Kaye is correct—and there is abundant evidence that he is—the ultimate bioethics agenda is startlingly radical: dismantling the values and mores of our culture and forging a new ethical consensus in its own self-created image. There’s a word for such a breathtaking agenda: ideology.
Adding heft to my claim was the adverse reaction within the field generally to the appointment of Leon Kass by President George W. Bush to head the relatively conservative President’s Council on Bioethics in 2001. Never had a bioethics council received such a high profile. Moreover, as a prominent ethics professor at the University of Chicago and elsewhere, no one questioned Kass’s academic or intellectual credentials. But rather than being pleased that the field’s prominence had been recognized by the president of the United States, the attacks on Kass from prominent bioethicists and policy advocates flew fast and furious.
Liberal science writer Chris Mooney interviewed several prominent bioethicists for his piece “Irrationalist in Chief,” published in the American Prospect, which concluded that Kass brings “a sixteenth-century sensibility to guide us through twenty-first-century [bioethical] conundrums.”23 In a similar vein, bioethicist James Hughes castigated Kass as a “bio-Luddite,” while cloning-advocate Gregory E. Pence branded him as a “false prophet of doom.”
The torrent of criticism jumped the shark when (then) University of Pennsylvania bioethics professor and editor in chief of the American Journal of Bioethics Glenn McGee editorially attacked Kass for advocating the moral concept of intrinsic human dignity into ongoing bioethical debates:
It has become the era of Leon Kass, brought back to scholarly life by a call from President George W. Bush. It was a call to become a Presidential bioethics advisor [as head of the President’s Council] in the service of putting a stop to embryonic stem cell research, and if possible, putting a stop to a number of other scientific and clinical projects objectionable to the far right wing of the Republican Party, and in particular, Southern Baptists.24
Bioethicists pride themselves on rational discourse, but this was rank diatribe from the head of an influential bioethics journal. Kass is Jewish, not Southern Baptist (and for that matter, neither is former President Bush nor, as far as I know, were any council members.) Claiming his approach to be in the service of the “far right” of the Republican Party did an injustice to Kass’s nuanced and meticulous approach to bioethics. Moreover, demonstrating how politicized bioethics has become, McGee and his equally chagrined colleagues would have surely cheered if Kass had worked to “put a stop” to clinical projects held to be “objectionable” by the far left of the Democratic Party.
Why is this important? “Bioethics is a phenomenon of great social importance that extends far beyond medicine”25 and, as Dr. Kaye noted, many leading bioethicists are generally dismissive of Western values and traditions and indeed seek to dismantle them. That would be of little consequence if the movement were relegated to the cultural fringe. But mainstream bioethicists are among society’s most influential members. They serve on influential federal and state government public policy commissions, influencing the evolution of public policy. They are public advocates influencing popular views. They write health policy legislation. They consult in medical controversies at the clinical level, often influencing life and death decisions. They testify as expert witnesses in court cases and submit “friend of the court” briefs in legal cases of major significance. They appear on television and in the print media as “expert” commentators. Behind the scenes, they advise politicians from the local level all the way to the federal bureaucracies and, indeed, the president of the United States.
Every medical school teaches bioethics to every student, significantly influencing the attitudes of our doctors of tomorrow toward the health care system generally and their future patients specifically. Bioethics instruction is also provided to other university and postgraduate students studying to become lawyers, business executives, government policy makers, nurses, and educators. For those who wish to make a career in bioethics, many of our leading universities provide postgraduate degrees in the field, with graduates becoming consultants to nursing homes, HMOs, hospital organ procurement centers, and as scholars in think tanks.
Moreover, the influence of bioethicists has grown in the years since this book’s first edition. Bioethics is now an international movement, its advocacy pursued in virtually every developed country.
I was certainly not the first critic of the movement. Years before I entered the fray, the late philosopher and theologian Richard John Neuhaus succinctly described this oozing of bioethics into every nook and cranny of the West’s institutions when he wrote: “Thousands of ethicists and bioethicists, as they are called, professionally guide the unthinkable on its passage through the debatable on its way to becoming the justifiable, until it is finally established as the unexceptional.”26
It is worth reflecting upon what has become unexceptional in contemporary medicine and public policy since Neuhaus wrote those words in 1988. Then, most people would have found it unthinkable to dehydrate cognitively devastated people to death by removing their feeding tubes. It might even have been criminal. Today, due in large part to vigorous advocacy by bioethicists, which in turn led to court cases27 and then to new laws permitting the practice, withholding “artificial nutrition and hydration” has become routine—and not just for those diagnosed as unconscious.
In 1988, assisted suicide was illegal in every country. Today, euthanasia is administered to an ever-widening cohort in the Netherlands, Belgium, and Luxembourg. It is legal in Quebec and was transformed by the Canadian Supreme Court into a Charter right in 2015. In the USA, assisted suicide has been legalized by statute in California, Oregon, Washington, and Vermont—with new legislative proposals pouring forth with the start of every state legislative session.
It was once unthinkable to procure organs from someone in a persistent vegetative state. Although that is not being done—yet—some of the most mainstream bioethicists and physicians in the organ transplant community dispassionately debate doing just that, in essence advocacy to permit killing for organs.28
Ironically, the medical ethics, public policies, and philosophical beliefs that mainstream bioethics espouses are being imposed on a public that does not share many of the underlying values upon which they are based. This results in a distinct and oppressive disconnection between the medical protocols and public policies forged by bioethics advocacy and the people impacted directly by them. Kass explains: “There is a kind of condescension toward the views of the general public [within bioethics] and a considerable divide about core moral views. The American people, as a whole, are a religiously affiliated or God believing people and it is on the basis of the wisdom of these traditions that they express their