The last six weeks have been packed with both new opportunities and challenges. You are helping to sustain me. Each team member of CBC sees that doors are opening in ways that were almost unthinkable even a year ago. Challenging cultural thought can be full of surprises. Be encouraged with us!

Here is a sampling of what has been going on:

The Stanford University showing of Eggsploitation on May 1 went really well. Often university settings like this can be openly hostile, but this showing and presentation exceeded my expectations. Judy Norsigian, author of Our Bodies Ourselves, joined me for this lively event. Regardless of our differing perspectives on many issues, we were in total agreement and spoke with one voice on this issue. We set the stage for an engaging Q & A at the end of the showing and presentation time. The room was packed with 75 very engaged students and faculty. Presenting truth makes a difference.

I had some exceptionally good meetings in April in both Washington, DC and New York City. These key appointments are opening new networks and opportunities. I am amazed in how one appointment often leads to totally unexpected open doors for honest dialogue. Taking the initiative to find common ground is critical.

Kathleen Sloan, my colleague from NOW, and I have co-authored an opinion piece which has been submitted to a publication for their consideration. We talk about the “War on Women” as it relates to reproductive technologies. We address the war on egg donors, war on poor women as surrogates, and war on unborn baby girls when people “prefer” boys rather than girls. We have become good friends over common concerns. When we join forces on things like this, it causes many to seriously consider serious implications. I will keep you informed. Defining reality is never easy.

I am a regular blogger for a new site called NewFeminism.co. My recent piece, “It’s Menopause—Not Infertility,” is making a big splash with women commenting from as far away as Japan. Speaking truth in new places has unexpected outcomes.

The spring edition of the journal Human Life Review includes an article I wrote entitled “Thank God Hippocrates was Pagan.” This is part of a symposium series where various authors are invited to discuss how to defend the sanctity of life in the public square. I build my position from a page out of the Hippocratic Oath (which is actually a pagan document that has served the medical profession for thousands of years): first, do no harm. Being willing to raise the bar is not always popular.

We have just completed hand selecting our first nine Paul Ramsey Fellows. They include bright and engaging students from Harvard, the University of Virginia School of Law, the University of Chicago, Stanford, The Graduate Theological Union, Fuller Seminary, Fordham, and Talbot. The first gathering of these exceptional students will be in August when all the students and Scholars will begin a journey together. The Paul Ramsey Scholars leading the Institute and serving as mentors include Dr. Gilbert Meilaender, Dr. William Hurlbut, Dr. Todd Daly, and Wesley J. Smith, J.D. Prior to the first gathering, each Paul Ramsey Fellow will be required to read Paul Ramsey’s The Patient As Person. Imagine the impact we will realize as young scholars are mentored and guided by some of the leading bioethics scholars! Raising up young thinkers to challenge the culture is vital to our future.

In June, I will be in Washington, DC again for a special showing of Anonymous Father’s Day. We plan to use this coming Father’s Day celebration to draw attention to the many thousands of children who have no clue who their father is.

CBC sincerely needs your financial partnership. We cannot do what we are doing without you! Your gift to the CBC today translates into an impact on our culture, challenging and changing views.

To keep moving forward I do need your help this month. Cash flow is critically low. Your special gift at this time is needed and most appreciated. I ask that you respond with a generous special gift.

Your gift is needed. Your generosity will make a difference! Thank you for your timely partnership.

Sincerely,

Jennifer

When the news broke that Mitt and Ann Romney welcomed grandchildren numbers 17 and 18 this past Friday via “gestational surrogacy,” those of us here at CBC central—who oppose commercialized conception—wondered where the bottom is in these murky waters of assisted reproduction.

Tagg Romney posted this on his facebook page after the twins were born:

Jen and I are happy to announce the birth of twin boys, David Mitt and William Ryder. Everyone is healthy and happy. They weighed in at 5 lbs 13 oz and 19-3/4 inches and 6 lbs. 13 oz and 19 inches. A special thanks to our gestational surrogate who made this possible for us. Life truly is a miracle, and we feel so blessed to be able to celebrate the arrival of these precious boys into our family. For those keeping score at home, these are grandchildren numbers 17 and 18 for my parents.

Those who are regular readers know I have mentioned in the past the list in Time magazine:
“The Ten Best Chores to Outsource.” Expecting to see housecleaning, landscaping, pool cleaning—you know, actual chores—I was shocked to see the number one best chore to outsource was pregnancy. As the Time article put it:

Outsourcing brings to mind big factories and call centers. But entrepreneurs around the globe now offer services—from tutoring to sculpting a bust of your grandpa—to regular folks for a fraction of the cost in the West. Thought the world was flat before? Well, now you can hire someone in India to carry your child.

Outsourcing pregnancy has become big business, transforming having a child into a “bits and pieces” brokered industry: sperm from a handsome Scandinavian stud; eggs from a smart, beautiful Ivy League woman; a womb-for-rent from a poor woman in India trying to provide food and education for her children; and brokers in the middle helping set up the legal transactions to build a better baby the 21st century way. Just this past week, London’s Daily Mail ran a story titled, “The Designer baby factory: Eggs from beautiful Eastern Europeans, sperm from wealthy Westerners and embryos implanted in desperate women.”

Sadly, the “gestational surrogates”—truly desperate women—in these stories are identified as “uneducated, bare-footed, dirt-poor Indian women from outlying villages.” The surrogacy consultants who run the WYZAX surrogacy clinic assure intended parents that the surrogates will not get attached to the babies.

The Romneys didn’t have to exploit a poor woman in India. They chose to exploit a woman, probably much less poor, right here in the U.S. And their surrogate might not have felt so exploited. She was just “helping a couple have a baby”—and being compensated for her help. Because of little regulation in the U.S., commercial surrogacy is legal and couples like the Romneys don’t have to outsource their pregnancies to India. Our Canadian neighbors got it right when the Supreme Court of Canada wrote, “allowing the purchase of human gametes and surrogacy services devalues human life and degrades those who choose to participate in such a commercial transaction” (emphasis mine).

Many of the news stories I’ve read over the weekend about Tagg and Jen Romney using a “gestational surrogate” state that this means the child is biologically theirs. I’m not sure how the press came to that conclusion because a gestational surrogate only provides the womb. Gestational surrogacy is just the derogatory term for the woman who carries and gives birth to the baby. They could have used an egg donor, which would mean the egg donor would be the genetic mother. They could have used a sperm donor too, meaning Tagg wouldn’t be the genetic father of the boys, if that was the case. And all this, apparently ignoring the Latter Day Saints’ position on surrogacy (the LDS church strongly discourages surrogate motherhood). Tagg and Jen have used this same surrogate in the past to give birth to their first son.

Outsourcing pregnancy. Wombs for rent. Commercialized Conception. Call me shocked and disgusted.

Event Information
May 1 @ 4:15pm

Bechtel International Center Assembly Room
584 Capistrano Way
Stanford, CA 94305

The Clayman Institute for Gender Research at Stanford University is presenting a screening and panel discussion of the documentary film, Eggsploitation, which blows the whistle on the deceptive practices of the infertility industry to exploit young women for their eggs. Profiling the harrowing testimonies of three egg donors, Eggsploitation reveals the shocking truths, hidden dangers and severe health risks associated with egg donation. The infertility industry today is a booming, multi-billion-dollar-per-year business; yet no regulation exists to protect vulnerable women from coercive marketing ploys and large monetary incentives to get their eggs.

This event comes at a crucial time. Stanford’s student newspaper, The Stanford Daily, recently carried a full-page ad seeking a “Genius Egg Donor,” and offering “excellent compensation.” (Click on the image to the right to read the full text of the advertisement.) Unfortunately, such ads are common on college campuses, particularly at elite institutions such as Stanford.

This event is free and open to all.

Speakers

Jennifer Lahl, President, The Center for Bioethics and Culture
Jennifer Lahl made her writing and directing debut, producing the documentary film, Eggsploitation, which has been awarded 2011 Best Documentary by the California Independent Film Festival. It has sold in over 20 countries. She is the founder and president of The Center for Bioethics and Culture Network.
 
 

Judy Norsigian, Executive Director, Our Bodies Ourselves
A co-founder of the Boston Women’s Health Book Collective (BWHBC) and co-author of all editions of Our Bodies, Ourselves, Judy is a graduate of Radcliffe College and an internationally renowned speaker and writer on a wide range of women’s health concerns. She has appeared on numerous television and radio programs including Oprah, Donahue, The Today Show, Good Morning America, and NBC Nightly News with Tom Brokaw.

Recently, Dr. Summer Johnson McGee, Co-Editor-in-Chief of the American Journal of Bioethics, posted on the journal’s blog a very brief and highly dismissive review of / comment on our film, Anonymous Father’s Day. The substance of her criticism, entitled “Are ‘Anonymous Fathers’ Really A Problem?” is that our organization, The Center for Bioethics and Culture, is on a “crusade against artificial reproduction,” and that our film is simply another entry in our greater efforts at opposing anything and everything that involves biotechnology.

She concludes:

Ironically, the CBC folks don’t decry adoption, which results in the same lack of knowledge about biological parents, nor do they denounce adopting embryos to prevent them from being incinerated. Why is sperm donation so exceptional and problematic? Other than, of course, that it involves biotechnology?

I await an answer.

It is difficult to know exactly how to respond to this criticism, since it so utterly fails to engage with the substance of the film or with our larger work. Indeed, we cannot determine whether Dr. Johnson McGee has even seen the film, since the only section of the film she (mis)references—”a ‘secret’ akin to a time bomb waiting to go off” (Barry actually says “land mines”)—appears in the film’s trailer, which is available on YouTube and on the film’s website.

The implication of her conclusion is that, of course, we are uncritically enthusiastic about adoption and embryo adoption; we are simply opposed to anything and everything that has to do with biotechnology. The truth of the matter, though, is that while adoption is and has been a tremendously good thing in the lives of many, its history is not without problems. Some mothers were coerced and even forced into giving up their children; some children grew up with secrets and lies, and with questions of identity and place that bear many similarities to the stories of the donor-conceived women and men in Anonymous Father’s Day.

Embryo adoption, too, does not leave us untroubled. First and foremost, we stand with many others in being concerned about the creation and long-term storage of so-called “spare” or “surplus” embryos. In addition, it seems reasonable to expect that those who were adopted as embryos will have some of the same questions about identity, place, and family that donor-conceived persons face.

Ultimately, however, there is a stark contrast between adoption (and embryo adoption), which seek to address existing situations, and reproductive technologies that involve spending thousands and thousands of dollars to create situations that need remedying.

To criticize our work as simply an opposition to biotechnology is to misunderstand, or worse misrepresent, our fundamental concerns about the protection of human life and our views on the importance of bodily existence and its implications for sex and procreation. While we do not delve into all of these topics in this film, our views on these issues are not hidden as both of us have written and spoken on these and other topics for several years. Often these concerns are bound up with various biotechnology, and more to the point, specific uses of biotechnologies, especially within fertility medicine, but to assert that we are simply opposed to biotechnology is to caricature our views and our work.

This film is not a distillation of all our concerns. Rather it is but one example of the ways in which our fundamental concerns impact the lives of ordinary people. Anonymous Father’s Day is an attempt to bring the perspective of the very people who were conceived via sperm donation into conversations about the use of sperm donation. As Diane Allen says in the film, “If we are going to have these technologies, then they need to work first and foremost for the people they directly affect. And although that can seem like it’s the patient, in reality it’s really the children who are being born.”

We are not alone in our concerns about anonymous fathers and about donor conception. In addition to the donor-conceived people, researchers, and activists interviewed in the film, many other donor-conceived persons have concerns about anonymous sperm donation and about donor conception, several of whom blog about their perspectives and their concerns. We have also been contacted by mothers who used donor sperm to conceive children as well as by sperm donors who resonate with the concerns raised in our film. It is also worth noting that the donor-conceived people in our film do not all agree with one another about the proper response to anonymous fathers.

Further, these concerns are not limited to our own shores. The London-based Nuffield Council on Bioethics currently has a project underway to “explore the ethical issues that arise around the disclosure of information in connection with donor-conceived people.” In the Australian state of Victoria, a parliamentary committee has recommended that donor-conceived persons should be told the identity of their biological parent, even if the sperm donor was originally promised anonymity. And, as we highlight in the film, a case regarding sperm-donor anonymity is currently working its way through Canadian court system, and will likely end up before the Supreme Court of Canada.

In answer to the question, “Are ‘Anonymous Fathers’ Really a Problem?” our response is “yes, and we are only beginning to find out just how much of a problem.”

We have been very encouraged this week to read the dialogue between Slate’s William Saletan and the New York Times’ Ross Douthat. It is an example of a substantive, civil, and even cheerful exchange between two people who have very different views. Such exchanges are possible only when all parties are willing to do the difficult work of seeking to understand fully the positions of others. Unfortunately, Dr. Johnson McGee’s post shows no evidence that she has made any effort at all to understand our position. Instead, she criticizes a caricature of our work.

Finally, we would like to give Dr. Johnson McGee the benefit of the doubt regarding her use of the term “crusade” to describe our work. Perhaps it was a poorly considered word choice in a hastily written blog post. If so, then we would like to bring to her attention that its connotations are not helpful to a substantial discussion of important ideas.

At the same time, however, we do not want to be passive-aggressive with regard to this matter, making some subtle dig by simply bringing up the use of the word “crusade.” We will state it plainly: if you wish to criticize our work because we are Christians, then please do so directly. We make no secret of the fact that we are Christians, nor do we make any apologies for addressing the issues of bioethics from a perspective that is informed by one of the world’s great religious traditions.

To criticize a caricature of our views or to mock and dismiss our work because we are Christians is to demonstrate an intellectual indolence that is beneath the standards of the American Journal of Bioethics and that is in direct opposition to the character of the entire history of the field of bioethics.

Jennifer Lahl is the executive producer, director, and co-writer of Anonymous Father’s Day and the founder and president of The Center for Bioethics and Culture.

Matthew Eppinette is the associate producer and co-writer of Anonymous Father’s Day and new media manager at The Center for Bioethics and Culture.

Just when you think you have heard it all, someone pushes the envelope. According to three ethicists writing in the journal Ethics, Policy and the Environment, because geoengineering might be too risky a way to combat global climate change, we should alter the human species instead.

Here is the argument offered by Matthew Liao, Anders Sandberg, and Rebecca Roache. Climate change is the result of human corruption of the environment—so-called anthropogenic causes. Climate change affects food production, access to water, health, and the environment. Since, in their view, millions could suffer from the consequences of climate change something radical must be done. Recycling, tax-incentives, and large-scale manipulation of the environment are, according to the authors, either too negligible or too grand to be effective. Geoengineering, in particular, is disadvantageous because “in many cases, we lack the necessary scientific knowledge to devise and implement geoengineering without significant risk to ourselves and to future generations” (p. 4). So, in one breathtaking leap, the authors argue that we ought to consider “biomedical modification of humans to make them better at mitigating climate change.”

To be fair, they do offer a caveat: “Our central aim [in the paper] is to show that human engineering deserves consideration alongside other solutions in the debate about how to solve the problem of climate change. Also, as we envisage it, human engineering would be a voluntary activity—possibly supported by incentives such as tax breaks or sponsored health care—rather than a coerced, mandatory activity.”

The suggestion that we ought to modify the human species as a means of mitigating climate change is at once both naive and hubristic. If they think modifying the environment may be difficult, successfully modifying the extraordinarily intricate balance of human homeostasis is a pipedream at best. Here is what they think might be desirable.

First, humans might be altered to be meat aversive. All one would have to do is stimulate the immune system so as to “induce mild intolerance (akin, e.g., to milk intolerance)” to meat. Or, since the “human ecological footprints are partly correlated to our size,” we can just make humans smaller! “Reducing the average US height by 15 cm would mean a mass reduction of 23% for men and 25% for women, with a corresponding reduction of metabolic rate (15%/18%), since less tissue means lower nutrients and energy needs.” One way to produce these tiny people would be through pre-implantation genetic diagnosis, say the authors. Just select the embryos for transfer to a woman’s womb that have the genes for compactness; toss the embryos will tall genes. Smaller humans could also be produced through hormone therapy and reduction of birth-weight.

Second, the number of humans could be modified through cognitive enhancement. Why cognitive enhancement? Because apparently only stupid people have more than two children per family. “There seems to be a link,” the authors maintain, “between cognition itself and lower birth-rates.” Since two children per family is lower than the replacement rate (of roughly 2.1 per family in industrialized countries), population would decline.

Third, pharmacological enhancements could increase altruism and empathy. The result: generous and happy people through chemistry. Modifying altruism and empathy “by human engineering could be promising.” Testosterone, by the way, “appears to decrease aspects of empathy,” according to the authors. So, to follow their logic, since testosterone prepares both males and female for reproduction, reducing its levels in every human body would both reduce the number of people on the earth and, at the same time, make them more compliant.

Why undertake the re-engineering of the human species? Because, say the authors, “human engineering is potentially less risky than geoengineering. Second, human engineering could make behavior and market solutions more likely to succeed.” In other words, we would be far more likely to create tiny, happy people than we would be to modify the environment or create incentives that would encourage environmental stewardship.

Most readers will find the suggestion that re-engineering the species to control climate change is simply ludicrous on the face of it. But it is worse than ludicrous, it is dangerous. Although the authors say these alterations will come about voluntarily, it would, in fact, be parents who would make these decisions for the next generation without consent. Our children would become guinea pigs in a massive genetic and pharmacological engineering experiment—which, in many cases, we would be unable to reverse.

In an interview with Ross Andersen in The Atlantic, one of the authors, Matthew Liao, a professor of philosophy at New York University, said that making these sorts of modifications in our children is not morally problematic. After all, the tiny, happy child will thank you for making him smaller and more altruistic. And why shouldn’t he? You modified him to be generous and altruistic.

Well, what about an individual’s free will? Wouldn’t giving a child behavior modifying drugs to make her detest meat violate her freedom? Says Liao, ” . . . in some sense your inability to control yourself is a limit on the will, or a limit on your liberty. A meat patch would allow you to truly decide whether you want to have a steak or not, and that could be quite liberty enhancing.” So, by extension, a little doping of the water supply would help people truly express their will. The logic is simply perverse.

In this paper we see another example of the human self-loathing that is so much a part of both the environmentalist and transhumanist movements. For environmentalists, human beings are parasitic threats. For the transhumanists, human beings are maladaptive and need re-engineering. Instead of seeing human creativity, innovation, and market forces applied in stewardly ways for the sake of the truly human good, the technologist (the human) becomes the technological artifact (the modified post-human). Human re-engineering, it seems to me, is a far greater threat to our humanity than climate change.

 
C. Ben Mitchell, Ph.D., is Graves Professor of Moral Philosophy at Union University, a member of the Board of Directors of the Center for Bioethics and Culture Network, and Chair of the Paul Ramsey Award Nominating Committee.

This article originally appeared at First Things’ “On The Square.” Reprinted by permission

The last few weeks have been filled with a whirlwind of activity for the Center for Bioethics and Culture. So much is going on that it is sometimes difficult to catch my breath. Pacing is everything. There is far more to do than the small, dedicated team of CBC can undertake.

Here is a sampling of a few of the highpoints of the last couple of weeks:

We are beginning to work on our fourth documentary film. More on the topic and focus later, but I can assure you that this next film (like the others we have produced) will address life issues that grab the heart.

On March 23, CBC hosted the 9th Annual Paul Ramsey Award Dinner in San Francisco. This year the award was given to Mary Ann Glendon, Learned Head Professor of Law at Harvard Law School and a member of the President’s Council on Bioethics from 2002 to 2005. You can read and hear her acceptance remarks on our website. Bestselling author and editor of the Weekly Standard, Joseph Bottum, delivered the keynote address entitled, "Why Life and Death Matters." You can also hear the audio of his message on our website.

On March 24, CBC formally launched the Paul Ramsey Institute. Scholarly engagement is a necessity if we are going to impact lives. This is a long-term project, and the official launch is an important and long-awaited step. The organizing members include Dr. William Hurlbut, Wesley J. Smith, J.D., and Dr. Gilbert Meilaender.

In the spirit of Paul Ramsey, this Institute will seek to support current leaders working in the area of bioethics, engage and positively change the culture, have a life-affirming impact on the gatekeepers of society, and mentor and equip the next generation of the brightest minds who will boldly speak out about issues of bioethics. This launch will be a game-changer.

Breakthroughs have been realized over the last 12 months because of partners like you. You are involved in work that is operating on the edge. What we are doing puts us in the crosshairs of many who oppose our core beliefs. Our unwillingness to be silent is creating numerous hostile challenges.

We have a clear, strategic initiative that drives our activities. We aim to be in front of strategic audiences and engage today’s gatekeepers with a message that touches the emotional hurts and hearts of people who are often ignorant of the far-reaching impact of seemingly simple life decisions.

In order to get our message out through thought-provoking films, various media exposures, writings, speaking engagements, and launching new initiatives like the Paul Ramsey Institute, your generous financial support is sincerely needed. I can’t do this by myself — your support is critical to our success.

At the Paul Ramsey Award Dinner, I asked those present to consider how they might join in partnership with us. Now I am asking you as well.

Perhaps you could commit to giving a specific sum by the end of 2012. Perhaps you could become a monthly partner by contributing a set amount — $25, $50, $100, or more — each month to the work of the Center for Bioethics and Culture. Perhaps you could make a special gift right now.

Your personal participation is so needed at this time!

Can I count on you to help us take advantage of the doors that are opening to us? I do look forward to receiving your response.

Thank you for joining hands with me at this time. Your partnership means a great deal to me.

Most sincerely,

Jennifer

By Matthew Eppinette, CBC New Media Manager

I am happy to report that three months after its release, Anonymous Father’s Day has now sold in nearly a dozen countries. I suppose this isn’t surprising given the international scope of anonymous sperm donation.

For example, in the Australian state of Victoria, a parliamentary committee has recommended that donor-conceived persons should be told the identity of their biological parent, even if the sperm donor was originally promised anonymity. Current law, according to The Australian,

prohibits donor-conceived children before July 1, 1988, from having access to any information about their donor parent. But people conceived after January 1, 1998, have unconditional access to this information. Those conceived between 1988 and 1997 can only access information with the donor’s consent.

In anticipation of a backlash from donors who wish to remain anonymous, the committee also recommended that donors be given an enforceable option to not be contacted by their donor-conceived children. The thinking seems to be that at least people will have access to important medical information, even if they are not able to meet their donor parent.

The ultimate concern driving the committee’s unanimous recommendation is “the rights of the child.”

Such retrospective access would be a first. This recommendation applies only to the state of Victoria, but there is much hope that the recommendation will become law in the whole of the country. The government must respond to the committee’s recommendation and report in six months, and we will be closely monitoring events there.

Meanwhile, in the Netherlands, a couple is using the sperm of the husband’s father to create their child. An MSNBC article points out:

The child produced from this union of egg and sperm would have a “father” who was his biological half-brother, and a “grandfather” who was his biological father.

The opinions of ethicists who have weighed in range from “ethically high-risk” to “too bizarre for the child’s sake.” For its part, the almost-anything-goes American Society for Reproductive Medicine (ASRM) indicates that arrangements like this are generally, but not always, acceptable. Typical.

Finally, Olivia Pratten’s lawsuit in British Columbia continues to work its way through the Canadian court system. While Olivia’s records have been destroyed, she is working to give donor-conceived persons access to their birth records on par with the access adoptees have under Canada’s 1996 Adoption Act.

In reading about these international cases, I couldn’t help but think of the key insight that Diane Allen offers in Anonymous Father’s Day: “If we are going to have these technologies, then they need to work first and foremost for the people they directly affect. And although that can seem like it’s the patient, in reality it’s really the children who are being born.”

Indeed.

The 2012 Paul Ramsey Keynote
Speaker: Joseph Bottum

Author of the national bestseller Dakota Christmas, an e-book memoir of his childhood on the prairie, Joseph Bottum is a contributing editor to the Weekly Standard and one of the nation’s most widely published essayists—with work appearing in journals from the Atlantic Monthly to the Wall Street Journal, Commentary, and the Washington Post. The former literary editor of the Weekly Standard and former editor in chief of First Things, he holds a Ph.D. in medieval philosophy and has done television commentary for networks from the BBC to EWTN, including appearances on NBC’s Meet the Press and the PBS NewsHour. His books include his latest poetry collection, The Second Spring, and he lives with his family far off in the Black Hills of South Dakota.

Prof. Glendon’s Acceptance Speech: Video

Prof. Glendon’s Acceptance Speech: Text

I am deeply honored by the award you have chosen to confer on me this evening and very regretful that I am not able to accept it in person.

At the same time, I am humbled to find myself in the company of persons I admire so much as your previous honorees. Unlike most of them, I never knew Paul Ramsey personally. Rather, I first encountered his vision and his work through the Ramsey Colloquia, a series of seminars where the late Richard John Neuhaus presided and where Leon Kass and Gil Meilander were among the most brilliant participants. As a result, I am keenly aware that in honoring me this evening you are also celebrating the way that Ramsey’s inspiration and insights live on through those whose lives he touched.

My path crossed again with those of Leon Kass and Gil Meilander when we served together on the President’s Bioethics Council under Kass’s chairmanship. What a privilege it was to be a part of that great work! My eyes were opened and my horizons expanded in ways I could never have imagined.

My introduction to the world of bioethics had begun many years earlier, when the Supreme Court’s decision in Roe v. Wade caused me to become alarmed about the threat to human life and dignity posed by the growing normalization of abortion. I remember that many people scoffed when some of us predicted that disrespect for the lives of the unborn would lead someday to treating disabled newborns and the frail elderly as disposable too. They said that would never happen.

Today, however, as we all know, the legalization of various forms of assisted suicide is no longer a remote possibility. With health care and social welfare systems under increasing strain, the pressures to turn a blind eye to euthanasia can only be expected to build.

Meanwhile, advances in bio-medicine are occurring with such speed that they have outpaced reflection on their moral implications. Experiments that involve the destruction of human embryos inevitably take us further along the path of treating some human lives as less worthy than others. They foster a mentality that accepts treating the lives of the weak as means to the ends of the strong.

As Paul Ramsey understood, the way a society handles such challenges has a transformative effect on the moral texture of our culture. Nations and persons, at any given moment, are continually being shaped, for better or worse, by our actions and decisions. Each time we make policy on abortion, euthanasia, and human experimentation, we are either helping to build a civilization that promotes human flourishing, or we are making the world more dangerous, especially for the weakest and most vulnerable.

If what Leon Kass has called “the party of dignity” is to make headway in confronting those challenges, we need to move forward simultaneously on three fronts—legal, political, and cultural. Even though I am a lawyer, I have no doubt that the most important of these fronts is cultural. Neither legal nor political advances can be sustained without winning the hearts and minds of our fellow citizens. And, make no mistake, that task has become progressively harder. For when protections for life and dignity disappear one by one, even decent men and women get used to their absence. Minds close and hearts harden.

That’s why we need prophetic truth-tellers like Paul Ramsey, Leon Kass, and Gil Meilander. And that’s why the work of the Center for Bioethics and Culture is so important. You are making the case for morally responsible science, using all the resources of modern media. And you are making that case as it must be made in our pluralistic society—with reasons that are intelligible to all men and women of good will, to persons of all faiths, and to persons of no faith.

Sometimes it seems as though we are not making much progress, or even falling behind. But we all know that that we are in it for the long run. And we can all hope that by playing our part—with Ramsey, his students, and those whose lives they have touched—we are helping to keep alive the flame of truth about the human person. No one, of course, knows that better than those of you who are here this evening to support the work of the Center for Bioethics and Culture. For allowing me to have a share in this evening’s celebration, and for the great work you are doing, I thank you from the bottom of my heart.

Bioethics exploded into the headlines over the last few weeks after the Journal of Medical Ethics published an article promoting “after-birth abortion,” that is, the right of parents to have infants killed if the child’s presence in life did not serve their (or society’s) interests.

But hidden by the sturm und drang over infanticide, Bioethics published another radical proposal that received virtually no attention—but which, if adopted, could result in thousands of persistent vegetative state (PVS) patients being dehydrated to death.

The question concerns whether or not to provide such patients with food and water. Tube-supplied sustenance—called artificial nutrition and hydration (ANH)—is considered a form of medical treatment that can be withdrawn or withheld like any other medical care, such as antibiotics, chemotherapy, and indeed, aspirin. Of course, unlike withdrawing other treatments, ceasing to provide ANH results in the patient’s death in every case—usually over a 10-14 day period.

(Withdrawing such medically efficacious sustenance should not be confused with situations in which a patient’s body is actively shutting down during the dying process and the body can’t assimilate food or water. In such cases, ANH is medically inappropriate. The patient dies of their disease, not dehydration.)

Currently, in the absence of an advance directive to the contrary, benefit is given to life in PVS and other catastrophic brain injury cases—with surrogate decision makers able to order that such treatment cease if they think it is in the patient’s best interests. But that would change if Catherine Constable, the author of the Bioethics article, gets her way.

She argues for a policy in which ANH must be withdrawn once a patient is diagnosed to be permanently unconscious unless the family orders otherwise. In other words, dehydration would become the default position for patients diagnosed in PVS.

How does she justify such a harsh measure? First, she denies PVS patients have an “interest” in living because (quoting Princeton bioethicist Peter Singer) “life cannot benefit them.” That being so, money rules:

We need not label these patients as already ‘dead’ or claim that withdrawing care is not the same as ‘taking life’ in order to find that it is difficult to apply any sort of ‘right to life’ argument to a patient who would not now or ever choose to exercise that right. In view of this conclusion, other considerations, such as the cost to the health care system . . . would seem poised to be deciding factors.

Of course, such an argument could also be voiced in support of killing these helpless patients by harvesting their organs. Indeed, it already is—as I have discussed previously.

But what about the people who unexpectedly wake up? Constable says most of these weren’t truly PVS—even though some had been so diagnosed. (In fact, studies show that PVS is misdiagnosed about 40% of the time.)

But that doesn’t matter because “the new life gained” by the “miracle patient” is “far less likely to resemble what he lost than to be some state of middle consciousness;” a life “quite possibly, worse than non-existence.” Moreover, the potential benefit of living to be a miracle patient “is not sufficient to trump the public interest in allocating resources to patients more likely to benefit.”

In typical bioethics style, Constable then puts in a hedge, allowing that families of PVS patients should “be given the last word.” That would still put at immediate risk of dehydration the thousands of existing PVS patients without families.

But even Constable’s bow to family intimacy seems political and hollow. Thus even though she states that families “should be encouraged to consider whatever factors they deem useful,” families would be made to believe that dehydration is right:

We should discontinue the practice of putting families in the position of having to justify a decision to withdraw ANH by making assertions about what the patient would have wanted . . . To put the onus on a family to justify the decision to withdraw ANH is to effectively treat them as would-be executioners who need to be checked . . . In the case of PVS, when in doubt as to a patient’s wishes, it is better to discontinue life-sustaining treatment.

But if it is true that families now have to justify choosing to dehydrate, this radical shift would put families in the position of having to justify the continuance of food and fluids in the face of potentially hostile doctors, bioethicists, and the public policy of society.

Families often already face too many such pressures. Creating a “default for death” policy would not only make matters worse, it would establish the foundation for a veritable duty to die.

 
CBC special consultant Wesley J. Smith is a senior fellow at the Discovery Institute’s Center on Human Exceptionalism and a consultant for the Patients Rights Council.