Daniel
Callahan & Bioethics
Where
the Best Arguments Take Him
Paul
Lauritzen
http://www.commonwealmagazine.org/article.php3?id_article=1951&var_recherche=...Callahan
Daniel
Callahan & Bioethics
Where
the Best Arguments Take Him
Paul
Lauritzen
In the
summer of 2003, the renowned bioethicist Daniel Callahan testified before
President George W. Bush’s Council on Bioethics, which was gathering material
for a report on stem-cell research. Stem-cell research holds a therapeutic
promise so enormous that even some prolife advocates support it, despite its
use and destruction of embryos. The scientists on the council, like most of the
researchers who testified that day, seemed to feel an obligation to move ahead
with it. Would Callahan, one of the founders of the field of bioethics, go
against the grain of this consensus?
The
seventy-three-year-old Callahan was emphatic: It is a mistake, he told the
council, to think that we have an obligation to pursue stem-cell work-or
medical research generally, for that matter. Medical progress is certainly an
important social good, but it must be weighed against competing social goods,
such as education or decent housing. What’s more, Callahan insisted, many of
the diseases that stem-cell research might address, like cancer and heart
disease, are illnesses of the old, and we must ask whether extending the human
life span by a few more years through new treatments for these diseases is
worth the cost.
Some of
the scientists on the council seemed fairly stunned that Callahan would suggest
fixing public education instead of attempting to cure cancer, or would
de-prioritize research on treatments for diseases afflicting the elderly. After
all, here was a founding father of bioethics, an elected fellow of the American
Association for the Advancement of Science, and a member of the Institute of
Medicine of the National Academy of Science, the recipient of numerous honorary
degrees, a finalist for a Pulitzer Prize-in short, someone who should be able
to understand how crucial their research is-and he was calling it comparatively
unimportant.
Yet, no
one who has followed Daniel Callahan’s long and distinguished career would be
surprised at his comments. Indeed, for nearly forty years Callahan has been
writing and lecturing about medicine’s need to accept human finitude and
recognize competing moral and social-justice claims. Almost every one of the
shelfful of books he has published since the early 1970s has explored these
themes in one way or another. Whether he is stressing the social implications
of bioethical decision making, the need to emphasize caring rather than curing,
or the importance of foundational questions of meaning over questions of
procedural justice, Callahan has sought to explore the folly of what he calls
the “gospel of medical progress”-namely, the idea that medicine brings the good
news of liberation from death and dying. If it is possible to speak of modern
idolatry, Callahan says, medicine’s spurious promise of an infinitely postponed
mortality is it.
Callahan’s
1990 critique of the American health-care system, What Kind of Life, sets out
systematically to demythologize medicine by showing how, distracted by the
“glamour” of curing patients, medicine has lost sight of the surpassing
importance of caring for the sick and vulnerable. Callahan reminds us that the
suffering caused by sickness and death can be reduced but never overcome, and
that the best that medicine can do is to be committed unequivocally to care. He
is eloquent about what caring requires. “At the center of caring,” he writes,
“should be a commitment never to avert its eyes from, or wash its hands of, someone
who is in pain or is suffering, who is disabled or incompetent, who is retarded
or demented; that is the most fundamental demand made upon us.”
There
is an irony in the fact that this language of uncompromising concern for the
weak and the vulnerable-language that has a decidedly Catholic feel-comes from
a self-described agnostic.
When we
do not confront the proper place of illness, suffering, and death in human
life, we too easily succumb to the dangerous illusion that, through technology,
we can become as gods. It was precisely this conversation that Callahan was
trying to spark in his testimony before the President’s Council in 2003. To
assume that if we do not conduct stem-cell research, then the blood of those
who die will be on our hands-an argument, he told the council, that molecular
biologist and Nobel laureate Joshua Lederberg had made to him about medical
research generally-is to surrender to the fantasy that we are god-like in our
powers. This danger was what he was urging the President’s Council to discuss,
and what the scientists in the room seemed not to comprehend.
Perhaps
their incomprehension reflected a discomfort at the religious implications of
what they were hearing. The fact is, though Callahan understands himself as a
secular ethicist, others may not.