Jonathan D. Moreno, a senior fellow at the Center for American Progress (CAP) and professor at the University of Pennsylvania's Center for Bioethics, and Sam Berger, JD and former fellow at the CAP, have edited a thoughtful collection of essays entitled Progress in Bioethics: Science, Policy, and Politics. The purpose of Moreno and Berger's volume is twofold: First, the collection is intended to address the issue of defining progressive bioethics; second, it is designed to identify the key principles and values that progressive bioethicists endorse.
As the field of bioethics has become increasingly more politicized, conservative values have increasingly been a dominant force in the public arena—perhaps because their views are vociferously expressed and, in many cases, unified. This has not been the case, however, for more liberal perspectives in bioethics, apart from those belonging to the Academy and the annual conferences held by professional scientific organizations—two sorts of venues that are, arguably, some distance from the public eye. Progress in Bioethics contributes to the greater bioethical discussion by spelling out the principles that guide progressive thinking on bioethical issues. I think the hope of its editors is that this pursuit of clarity will be instrumental in securing a place for progressive bioethicists to have greater presence in public policy formation. The book also provides an alternative perspective for thinking through bioethical issues, which may appeal to a morally pluralistic society.
The book is divided into five parts. Part one is aimed at clarifying the values that unify progressive bioethics, values that endorse what Moreno and Berger have termed a critical optimism with respect to biotechnology. Progressives embrace the possibility of science improving the human condition and reducing suffering, but they still remain cognizant of the reality that such technologies can also cause harm. Relatedly, science appeals to progressive bioethicists in terms of their reliance on the actual science in the development of robust, ethical argumentation—that is, good ethics first start with good facts.
It makes sense, then, that progressives are pragmatically oriented to bioethical problems of the actual world, rather than those of some imagined world of the future. Progressives are more inclined to spend their time deliberating, for example, on how conscientious refusals may impinge individuals' autonomy (autonomy being an integral value of progressives) as opposed to being overly concerned with designer children of the future.
Equality and justice are also key values of progressives. Contributor Richard Lempert writes that “morality requires that people be treated more or less equally, particularly with fundamental goods such as health care. Progressives are wary of distinctions in treatment, research, and the availability of health services that disadvantage the less powerful, particularly minorities and women” (p. 33).
In part two of Progress in Bioethics, R. Alta Charo provides a framework for understanding the fundamental division between conservative and progressive bioethics. Charo argues that conservatives have an aversion to science's being used to improve the human condition, coupled with an affinity for their morality to be enforced by government, whereas progressives welcome scientific advances and find legislation of morality to be problematic. Kathryn Hinsch traces the development and rise of conservative bioethics to a prominent presence in politics and explains how this movement has gained momentum and what progressives might learn from its trajectory. What is not clear from this chapter, however, is whether the funding data that Hinsch provides from different conservative bioethics organizations is intended to do more than just draw attention to the kind of mobility available to conservatives, given such generous funding. Finally, Laurie Zoloth asserts that conservative bioethics has an incorrect moral focus. She is critical in her chapter of the kinds of bioethical questions on which conservatives concentrate, and this focus, in Zoloth's view, displays a disregard for the present pain and suffering replete in this world.
Part three of this collection contains Paul Root Wolpe's discussion on how the biotechnology industry supports the need for bioethics. John H. Evans provides an interesting hypothesis on the division between religion-based bioethics and secular bioethics. In his view, this division originates from different intellectual concerns. Evans writes that “us participants… were increasingly marginalized as the debate… moved from… ‘ends we adopt’ to ‘a set of assumed ends, which means will maximize these assumed ends’” (p. 121). Finally, Eric M. Meslin identifies the progressive character of national bioethics commissions.
Part four demonstrates nicely that progressives, although they are committed to several core principles as was indicated above, do not have a univocal position on bioethical issues. James J. Hughes argues that progressive values support the use of biotechnology:
A technoprogressive approach to human enhancement is merely the consistent application of the values that have been at the core of progressive political movements since the Enlightenment—the right of individuals to be free to control their own bodies, brains, and reproduction according to their own conscience.
p. 186
Although it is not explicitly a response to Hughes's piece, Marcy Darnovsky's contribution is one in which she concedes that although progressives welcome the benefits of biotechnology, they should also employ a precautionary principle, lest such unrestrained enthusiasm obscure the potential harm of such technology.
The final section addresses the general question of whether the politicization of bioethics necessarily results in an impasse between progressive bioethics and conservative bioethics. Michael Rugnetta puts forward a very provocative hypothesis in which Catholicism's teaching on conscience is supported by progressive values. In Rugnetta's view, this allows the Catholic Church and its faithful to be able to participate in pluralistic public discourse on bioethical dilemmas. This contention provides some hope for meaningful bioethical discussion to occur between religious-minded conservatives and secular progressives—a hope made all the more relevant by Arthur Caplan's contribution that the ascension of bioethics to a powerful position of social prominence cannot be sustained or operate effectively without ideological perspective. Caplan asserts that
Bioethics has power and can serve political purposes. It has made a difference, and now it wields power. No power exists in a political vacuum. The key to navigating the new world that bioethics finds itself in—the public arena, which is a stormy, unpredictable, and even dangerous place to be—is to admit these facts. Once it has conceded, there is no turning away from them. Bioethics will, like economics, political theory, and sociology before it, have to learn to live with power. One way to do so is to operate from explicitly ideological perspectives.
p. 223
Progress in Bioethics provides an important contribution to the movement, profession, and industry of bioethics. This volume accurately identifies progressive values and progressive bioethical commitments in a systematic way. Such systematization, I think, will be instrumental in mounting a more organized and persuasive progressive voice in policy debates and in the political arena, which is mostly dominated by conservative voices. My hope—and also my concern—is that such systematization of progressive values will not hinder meaningful thought about bioethical issues by these very voices. It would be a shame if thoughtful reflection were replaced by less-than-rational adherence to core principles—a criticism often lodged against conservatives.
