Thursday, November 5, 2009

Book Review: "Life, Liberty, and the Defense of Dignity" by Leon R. Kass, MD

This was a heavy and rich work. I found Dr. Kass to have a profoundly well-thought out explanation of his philosophical perspectives in many areas of bioethics. One complaint I had overall, however, was the tedious nature of his writing, and sometimes I wished he had more specific examples or practical applications for the points he was making. Granted, I agree with him that the defense of dignity is a hard thing, seeing as it is a value he describes as a “soft”, even “symbolic” (p15).

One strength of his writing for the Christian bioethicist is that the defense that he makes for human dignity is frequently made through moral reasoning rather than from Biblical sources, which makes for usefulness in conversation with those who have no belief in divine inspiration of Scripture. Also I appreciated the challenge he makes to Christian bioethicists who becomes “just like everybody else” in their discussion of the issues. (p61)

From his discussion in “The Meaning of Life-in the Laboratory,” I appreciated his pointing out the new beginning that occurs in fertilization, which is entirely different from the separate sperm and egg, that there is a new individual after fertilization is complete. I found his comparison of the in vitro blastocyst with the aborted fetuses (p89), to be painfully obvious—of course a live blastocyst is more viable than a dead fetus! Also I would have liked more elaboration on his mention that the thin-edge-of-the-wedge argument as being faulty or weak (p104). I also liked his approach in regard to legislation, that “not every folly can or should be legislated against.” It seems like there are areas of biotechnology that shouldn’t be funded by taxpayers but also can’t be legislated against (for instance because some would be impossible to regulate), though certainly experimentation on human embryos and human cloning are not among those areas. He provided very clear reasons to object to federal funding of embryonic stem cell research, in response to each of the major arguments in favor of it. He made the excellent point that funding should first go to preventing the causes of infertility (i.e. blocked oviducts from STDs) rather than to expensive high-tech/low-yeild treatments (IVF) (pg 111). Also I believe this is the only place I’ve read that stated that actual cost of funding all these IVF treatments if the government were to pick up the tab, and it is sobering. He ends this chapter with a candid summary of how difficult this discussion has been to him, and I appreciated and felt his honesty.

In his section on genetic technology, he discussed the concerns of having too much knowledge of our own genome and genetic disposition, and it’s dangers. I hadn’t considered this aspect of the matter, but rather had thought only of privacy issues. But the idea of people living life with the knowledge of their genetic future (dementia, etc.) is concerning.

While reading the chapter on cloning, it struck me several times how much has developed even in the seven years since Kass wrote this volume. This was in my opinion one of his best chapters, and the basis of his arguments against cloning was strong. Toward the end of the chapter he pointed out that scientists whose names we don’t know and in places we don’t know are currently working behind closed doors and in secrecy to clone humans. This is a chilling but certainly valid concern. Equally chilling was the discussion on the next chapter on maintain perfusion and respiration mechanically in the newly dead in order to maintain an organ supply.

One of the strengths of Kass’ writing is the candid way in which he admits his personal difficulty with some of the arguments he makes, yet his honestly only serves to strengthen his perspective. For instance, on page 210, he points out his “weakening on the subject of euthanasia is precisely this: I would confess a strong temptation to remove myself from life to spare my children the anguish of years of attending my demented self and the horrible likelihood that they will come, hatefully to themselves, to resent my continued existence.” He notes these reasons might lead him to think he might have a duty to die, but argues against this thought in that “What principle of family life am I enacting and endorsing with my ‘altruistic suicide’?” and also points to another article for further discussion of this concern (210). Later he has a very balanced view as he states he “defends the practice of allowing to die while opposing the practice of deliberately killing.” (p227)

One argument that did appear weak which he used in regard to several issues was that deep within us we find the idea of certain things (i.e. cloning) repugnant, and that this feeling should be taken into consideration and even have possible moral value. This seems a stretch; since there are a lot of things which we may find repugnant but certainly have no moral opposition to.

Overall this is a book I will frequently refer to as I work through these issues, and the insight and candor with which Dr. Kass examined the issues is a rich resource to any who would read it.