Bioethics, Science, and Politics
http://www.100md.com
《新英格兰医药杂志》
To the Editor: In the pursuit of scientific truth, one of the most basic principles is the rigorous exclusion of preexisting bias. Without such exclusion, scientific investigation and experimentation have no validity. Blackburn's account of the recent restructuring of the President's Council on Bioethics (April 1 issue)1 raises the question of why this council, when dealing with an issue of such enormous scientific importance as the future of stem-cell research, is not held to the same standard. If Blackburn is correct, the council's ability to render unbiased recommendations is fatally compromised. Medical research conducted with the same bias would be summarily rejected by the scientific community as irrelevant and worthless.
In his analysis of this topic in the same issue of the Journal, Steinbrook2 writes that "advocates insist that the appointment process and subsequent committee deliberations should emphasize relevant scientific or clinical expertise and be free of ideological, political, and economic bias." The inherent correctness of this statement is self-evident. When we allow political and religious ideology to supersede science, we allow prejudice and demagoguery to supersede truth.
David S. Huckins, M.D.
Newton–Wellesley Hospital
Newton, MA 02462
References
Blackburn E. Bioethics and the political distortion of biomedical science. N Engl J Med 2004;350:1379-1380.
Steinbrook R. Science, politics, and federal advisory committees. N Engl J Med 2004;350:1454-1460.
To the Editor: In a recent open letter to President George W. Bush, bioethicist Arthur Caplan and colleagues state that the credibility of the President's Council on Bioethics was "severely compromised" by the replacement of two members of the council.1 More than 170 scholars, physicians, and researchers signed this letter in protest of the recent replacements, which reportedly skew the views of the council toward a more uniform position against stem-cell research.
The council is a creation of the executive branch. It lives and dies by the will of the President. His motives for appointments, though perhaps biased, are legal by executive order.2 Just as the presidential appointment of a Supreme Court justice would most likely reveal political and ideological bias, so might the makeup of his ethics council. How do we deal with this problem? We must view this council with healthy skepticism and with politics in mind. Most important, the medical field must look away from such political distractions and reflect on truly objective findings in science and ethics. We must publicly, independently, and objectively address such issues before political forums muddy the waters.
Darren P. Mareiniss, M.D.
University of Pennsylvania
Philadelphia, PA 19104
dpmmd@earthlink.net
References
Caplan A, Dworkin G, Feudtner C, et al. Open letter to President Bush regarding Council on Bioethics, Bioethics.net, April 10, 2004. (Accessed June 23, 2004, at http://www.bioethics.net/openletter.php.)
Executive Order 13237, 66 Fed Regist 59851:(November 30, 2001):66.
To the Editor: In her essay, Blackburn describes her departure from the President's Council on Bioethics and her belief that science is being misused by politics. What she fails to mention is that a substantial number of Americans, including both medical professionals and members of the general public, believe embryonic stem-cell research to be wrong. The task of the council is "to undertake fundamental inquiry into the human and moral significance of developments in biomedical and behavioral science and technology."1 Therefore, it is not surprising that the council may decide that some forms of technology violate the moral and ethical principles that guide our nation. In fact, I am encouraged that the council is asking difficult questions about the seemingly endless promises being made about future uses of embryonic stem cells. Recognizing the potential of stem cells and understanding that medical research has yet to describe adult stem cells completely, I raise the following question: Why not exhaust the potential of adult stem cells first and thereby avoid some large moral issues?
Derek W. Meeks, M.S.
University of Texas Medical School at Houston
Houston, TX 77030
dmeeks@uth.tmc.edu
References
Creation of the President's Council on Bioethics. (Accessed June 23, 2004, at http://www.bioethics.gov/reports/executive.html.)
To the Editor: Blackburn suggests that "Monitoring Stem Cell Research,"1 a report of the President's Council on Bioethics, rests on biased scientific information. The report contains review essays by leading scientists, including some who use human embryonic stem cells. The report identifies the scientific arguments for pursuing studies that involve the use of these cells.
The United States and other countries are debating whether limits on research that destroys human embryos are warranted and, if so, what those limits ought to be. Persons who regard the embryo as a stage of human life that merits protection want the research prohibited, despite the knowledge it could generate. Persons who regard the embryo as a less morally significant organism think that potential gains in knowledge justify its destruction. Some of the latter group believe that the human embryo has an intermediate moral status that supports at least some limits on research. Because each position has many adherents, the government's funding policy is inevitably a contentious matter. Civility and tolerance are essential to deliberating these questions.
"Monitoring Stem Cell Research" explores an array of ethical considerations relevant to the research. The report acknowledges competing claims and shows respect for differing viewpoints. Scientists and physicians should read the report and make their own judgments about its quality and about the larger issues bearing on this important area of science and policy.
Rebecca Dresser, J.D.
Washington University
St. Louis, MO 63130
dresser@wulaw.wustl.edu
Editor's note: The writer is a member of the President's Council on Bioethics. The opinions expressed are her personal views.
References
President's Council on Bioethics. Monitoring stem cell research. (Accessed June 23, 2004, at http://www.bioethics.gov/reports/stemcell/index.html.)
Dr. Blackburn replies: Mr. Meeks is mistaken in suggesting that I do not take into account the fact that many Americans do not currently approve of stem-cell research. The problem I have with the reports of the President's Council on Bioethics is one of scientific completeness and balance in the presentation of the scientific facts, as best we know them. The specifics of my and council member Dr. Janet Rowley's concern with two of the council's reports are clarified elsewhere.1 As I state in my Perspective article, I am not concerned about the council's taking up these important matters, which I agree remain under debate. My concern, rather, is that any policy recommendations about biomedicine should be based on all the available scientific information.
I agree with Professor Dresser's view that civility and tolerance are conducive to good policymaking. I would therefore like to reemphasize that my concern about the President's Council on Bioethics report entitled "Monitoring Stem Cell Research" is that, despite my efforts to have the most recent and most complete input from scientific experts included in the scientific descriptions in the report, these efforts were only partially followed up in the preparation of this report. As a result, coverage of key scientific knowledge in this rapidly moving scientific field was incomplete and hence its scientific content was imbalanced.
Elizabeth H. Blackburn, Ph.D.
University of California, San Francisco
San Francisco, CA 94143-2200
telomer@itsa.ucsf.edu
References
Blackburn EH, Rowley JD. Reason as our guide. PLOS Biology 2004;2:E116. (Web only.) (Available at http://www.plosbiology.org/plosonline/?request=get-document&doi=10.1371/journal.pbio.0020116.)
In his analysis of this topic in the same issue of the Journal, Steinbrook2 writes that "advocates insist that the appointment process and subsequent committee deliberations should emphasize relevant scientific or clinical expertise and be free of ideological, political, and economic bias." The inherent correctness of this statement is self-evident. When we allow political and religious ideology to supersede science, we allow prejudice and demagoguery to supersede truth.
David S. Huckins, M.D.
Newton–Wellesley Hospital
Newton, MA 02462
References
Blackburn E. Bioethics and the political distortion of biomedical science. N Engl J Med 2004;350:1379-1380.
Steinbrook R. Science, politics, and federal advisory committees. N Engl J Med 2004;350:1454-1460.
To the Editor: In a recent open letter to President George W. Bush, bioethicist Arthur Caplan and colleagues state that the credibility of the President's Council on Bioethics was "severely compromised" by the replacement of two members of the council.1 More than 170 scholars, physicians, and researchers signed this letter in protest of the recent replacements, which reportedly skew the views of the council toward a more uniform position against stem-cell research.
The council is a creation of the executive branch. It lives and dies by the will of the President. His motives for appointments, though perhaps biased, are legal by executive order.2 Just as the presidential appointment of a Supreme Court justice would most likely reveal political and ideological bias, so might the makeup of his ethics council. How do we deal with this problem? We must view this council with healthy skepticism and with politics in mind. Most important, the medical field must look away from such political distractions and reflect on truly objective findings in science and ethics. We must publicly, independently, and objectively address such issues before political forums muddy the waters.
Darren P. Mareiniss, M.D.
University of Pennsylvania
Philadelphia, PA 19104
dpmmd@earthlink.net
References
Caplan A, Dworkin G, Feudtner C, et al. Open letter to President Bush regarding Council on Bioethics, Bioethics.net, April 10, 2004. (Accessed June 23, 2004, at http://www.bioethics.net/openletter.php.)
Executive Order 13237, 66 Fed Regist 59851:(November 30, 2001):66.
To the Editor: In her essay, Blackburn describes her departure from the President's Council on Bioethics and her belief that science is being misused by politics. What she fails to mention is that a substantial number of Americans, including both medical professionals and members of the general public, believe embryonic stem-cell research to be wrong. The task of the council is "to undertake fundamental inquiry into the human and moral significance of developments in biomedical and behavioral science and technology."1 Therefore, it is not surprising that the council may decide that some forms of technology violate the moral and ethical principles that guide our nation. In fact, I am encouraged that the council is asking difficult questions about the seemingly endless promises being made about future uses of embryonic stem cells. Recognizing the potential of stem cells and understanding that medical research has yet to describe adult stem cells completely, I raise the following question: Why not exhaust the potential of adult stem cells first and thereby avoid some large moral issues?
Derek W. Meeks, M.S.
University of Texas Medical School at Houston
Houston, TX 77030
dmeeks@uth.tmc.edu
References
Creation of the President's Council on Bioethics. (Accessed June 23, 2004, at http://www.bioethics.gov/reports/executive.html.)
To the Editor: Blackburn suggests that "Monitoring Stem Cell Research,"1 a report of the President's Council on Bioethics, rests on biased scientific information. The report contains review essays by leading scientists, including some who use human embryonic stem cells. The report identifies the scientific arguments for pursuing studies that involve the use of these cells.
The United States and other countries are debating whether limits on research that destroys human embryos are warranted and, if so, what those limits ought to be. Persons who regard the embryo as a stage of human life that merits protection want the research prohibited, despite the knowledge it could generate. Persons who regard the embryo as a less morally significant organism think that potential gains in knowledge justify its destruction. Some of the latter group believe that the human embryo has an intermediate moral status that supports at least some limits on research. Because each position has many adherents, the government's funding policy is inevitably a contentious matter. Civility and tolerance are essential to deliberating these questions.
"Monitoring Stem Cell Research" explores an array of ethical considerations relevant to the research. The report acknowledges competing claims and shows respect for differing viewpoints. Scientists and physicians should read the report and make their own judgments about its quality and about the larger issues bearing on this important area of science and policy.
Rebecca Dresser, J.D.
Washington University
St. Louis, MO 63130
dresser@wulaw.wustl.edu
Editor's note: The writer is a member of the President's Council on Bioethics. The opinions expressed are her personal views.
References
President's Council on Bioethics. Monitoring stem cell research. (Accessed June 23, 2004, at http://www.bioethics.gov/reports/stemcell/index.html.)
Dr. Blackburn replies: Mr. Meeks is mistaken in suggesting that I do not take into account the fact that many Americans do not currently approve of stem-cell research. The problem I have with the reports of the President's Council on Bioethics is one of scientific completeness and balance in the presentation of the scientific facts, as best we know them. The specifics of my and council member Dr. Janet Rowley's concern with two of the council's reports are clarified elsewhere.1 As I state in my Perspective article, I am not concerned about the council's taking up these important matters, which I agree remain under debate. My concern, rather, is that any policy recommendations about biomedicine should be based on all the available scientific information.
I agree with Professor Dresser's view that civility and tolerance are conducive to good policymaking. I would therefore like to reemphasize that my concern about the President's Council on Bioethics report entitled "Monitoring Stem Cell Research" is that, despite my efforts to have the most recent and most complete input from scientific experts included in the scientific descriptions in the report, these efforts were only partially followed up in the preparation of this report. As a result, coverage of key scientific knowledge in this rapidly moving scientific field was incomplete and hence its scientific content was imbalanced.
Elizabeth H. Blackburn, Ph.D.
University of California, San Francisco
San Francisco, CA 94143-2200
telomer@itsa.ucsf.edu
References
Blackburn EH, Rowley JD. Reason as our guide. PLOS Biology 2004;2:E116. (Web only.) (Available at http://www.plosbiology.org/plosonline/?request=get-document&doi=10.1371/journal.pbio.0020116.)