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01/30/2017

Bioethics and the Problem of Silent Neutrality in the age of Trump

by Craig Klugman, Ph.D.

One of the most contentious of all issues in bioethics has been whether as a profession, we should take a stand against issues. Arguments have raged on both sides of the issue. The American Society for Bioethics & Humanities (ASBH) only takes stands on issues of academic freedom. The thinking, as I’ve seen it, is that bioethics has something to offer all political perspectives and by not taking stands on issues, we are more likely to help further conversations among people on  all parts of the political spectrum.

This stance has been tested: When as a nation we learned that torture was regularly being practice by our military some took offense, but only Steven Miles spoke out and resigned from the organization for not taking a stand. Bioethics in general has been criticized for its lack of participation in social justice issues. In Observing Bioethics, Renee Fox and Judith Swazey criticize the bioethical enterprise for this unwillingness to take a stand.

So are there extraordinary times and issues when we as a group should stand up either individually or en masse?

I have been personally struggling with how to respond to the mass upheaval currently taking place in the United States. Plans to re-open Guantanamo Bay, CIA black sites, and torture are violations of human rights and human decency. For example, banning refugees from our shores, keeping people from returning to their jobs/homes/families; even forcing residents at US hospitals to leave the country after returning from trips abroad. Also consider efforts to silence government scientists, health care providers in other countries receiving US aid, and the diplomatic corp. By the end of the week, the new administration is expected to release orders that permit discrimination against LGBQT people if their existence bothers someone’s “religious beliefs.” Can a doctor refuse to treat LGBQT patients in emergent situations?  Should we still stay silent? Can we still say silent?

Some academic and professional organizations are beginning to take a stand. The American Anthropological Association, the American Psychological Association the American Association of State Colleges and Universities, the Association of American Universities, and Association of International Educators have all taken positions against some of the executive orders such as the Dakota Access Pipeline and the ban on refugees and people from 7, predominantly Muslim countries.

Some individual bioethicists are also lending their voices and their expertise. Mark Kuczewski has openly spoke out in favor of Dreamers and DACA. Jonathan Moreno, Arthur Caplan, and Wesley Smith have conjectured whether Trump will form a new bioethics commission. Smith hopes that like Bush 43, a new commission will take a more conservative approach. However, given that Trump seems to only seek advice from his inner circle (note how he did not talk to agencies before issuing orders that affect them), I doubt a bioethics commission is forthcoming. Even if one were formed, its recommendations would likely go unheeded (look at how he has dealt with intelligence briefings) unless it followed the beliefs of the inner circle.

I know that ASBH and bioethics is an apolitical group—neither Republican nor  Democratic. But human rights are not a political issue—they are an ethical, moral and legal one. Both Caplan and Moreno have previously expressed concern about the “cultural wars” and any effect it might have on bioethics.  Moreno has said that we have reached a détente on these issues by “consciously ignor[ing]” them. If we truly are about autonomy, nonmaleficence, beneficence, justice, truthfulness, and empowerment, then it might be time to take a stand. It might be time to be talking to more than our institutions, more than to each other in our journals and meetings. It might be time for us to step up and put our theories into praxis. It is definitely time to re-consider the ASBH neutrality position.

As Aristotle said, reason is the function of humankind. As scholars in bioethics, we have trained our reason for critical thinking, reading and writing. Bioethics since its beginnings has been influential as expert resources in both government and the media. Isn’t it time that we use that influence to help others? Is it important to maintain objectivity so we can comment on the next three parent embryo or pig-human hybrid when we remain silent on people losing access to insurance and medical care?  When our collective voice is not heard about a US-created travel crisis that threatens the health of millions?

If bioethics is about studying the ethical issues of the life sciences, then certainly these gross violations of our inalienable rights that directly pose health harms to everyday people—religious-based bans on movement, throwing 20 million people off of health insurance, gag orders on health providers overseas, refusing physicians entry into the US, and an interest in torture—must move us to act. I, for one, have been calling my elected representatives on a near daily basis, writing on social media, knitting and handing out pink hats, and engaging in long dialogues. I plan to march more against what I see as injustice. But, I am only one small voice.

 

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