Steven Pinker is right about biotech and wrong about bioethics

Steven Pinker published an editorial in the Boston Globe that scorned the profession of bioethics, telling them to “Get out of the way” of biomedical research. Ironically, he made this point with a poor bioethical argument. Despite that, he made a valid point about how we should evaluate novel biotechnologies. In short: this is a mess, but it’s worth straightening it out.

Pinker’s topic is bioethical arguments about biotechnological innnovations. Pinker chastises bioethicists:

A truly ethical bioethics should not bog down research in red tape, moratoria, or threats of prosecution based on nebulous but sweeping principles such as “dignity,” “sacredness,” or “social justice.” Nor should it thwart research that has likely benefits now or in the near future by sowing panic about speculative harms in the distant future. These include perverse analogies with nuclear weapons and Nazi atrocities, science-fiction dystopias like “Brave New World’’ and “Gattaca,’’ and freak-show scenarios like armies of cloned Hitlers, people selling their eyeballs on eBay, or warehouses of zombies to supply people with spare organs.

There’s a lot here, so I’ll start with the good point that Pinker made. Biomedical research has produced extraordinary benefits and there’s every reason to expect more in the future. Unnecessary delays in that research are paid for in lives. It’s true that many treatment innovations have unanticipated harms—e.g., thalidomide—but biomedical science has procedures to detect and correct for them. To my knowledge no biomedical innovation has led to the kinds of existential risks created by physics research, such as thermonuclear weapons. Moveover, our ability to predict the future consequences of research is extremely limited. All this taken into account, the burden of proof for limiting biomedical research that does not have clearly identifiable harms should fall on the critic, and the standard of proof should be high.

In short, I largely agree with the standard Pinker advocates for evaluating whether concerns about long-term social consequences of a biomedical research program should be grounds for delaying biomedical research. So what’s wrong with his argument?

First, even by newspaper op-ed standards this is lazily argued. Pinker attributes a host of opinions to bioethicists without quoting any bioethicist. He does not cite any cases to document that bioethicists’ concerns about long term consequences have impeded research and caused harms. There likely are such cases, but he writes as if they are common. I served for years on the University of Pittsburgh IRB. For better or worse, the long term risks of biomedical research were never even discussed.

Worse, Pinker brackets “dignity” and “social justice”* in sneer quotes, as if it were self-evident that affronts to these values do not fall into the class of “identifiable harms” and as if these concerns can be dismissed without any actual argument. The only normative framework that has weight, by his lights, are the mortality and morbidity of disease. Of course mortality and morbidity are exceptionally important. But if that is the only framework that matters to Pinker he is in a very small minority.

To see this, consider Pinker’s dismissal of concerns about trafficking in human body parts (“people selling their eyeballs on eBay, or warehouses of zombies to supply people with spare organs”). There are markets in human organs, but they are illegal almost everywhere. I’ve read thoughtful arguments both for and against the legalization of such markets. However, I find it hard to imagine that Pinker thinks we could decide whether to permit such trade without thinking through whether permitting such trades would degrade human dignity or cause injustice. Consider the current dispute about the disposal of fetal body parts by Planned Parenthood. Is it permissible to sell parts of dead fetuses?** I haven’t read anyone who thinks that question is morally trivial.

Pinker might respond that the biotechnical research he seeks to advance have no adverse consequences for human dignity and social justice. Again, I largely agree. But you have to make that argument, not just wave the concerns away.

In summary, Pinker is making a bioethical argument for a conclusion I support. But he argues his case badly and starts from defective premises. The evaluation of biomedical research cannot rest on any single normative framework—morbidity/mortality, cost-effectiveness, whatever—because the values we hold are more complex than that. So ethics, where we argue about what we should value, can’t be dismissed. Pinker’s right that some bioethicists make weak arguments, but the proper response to that is to make strong ones.

*Pinker also derides concerns about “sacredness.” While I don’t dismiss this concern, for reasons developed by Rawls I don’t think sacredness has a place in bioethical policy in a secular republic.

**Whether it would be legitimate to sell fetal body parts is separate from the question of whether Planned Parenthood was selling them, which Planned Parenthood denies.


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