Smart Mice, Not So Smart People An Interesting and
Amusing Guide to Bioethics
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ALSO BY ARTHUR L. CAPLAN
Am I My Brother’s Keeper?: The Ethical Frontiers of Biomedicine
Due Consideration: Controversy in the Age of Medical Miracles
If I Were a Rich Man Could I Buy a Pancreas?:
And Other Essays on the Ethics of Health Care
Moral Matters: Ethical Issues in Medicine and the Life Sciences
The Case of Terri Schiavo: Ethics at the End of Life
(coedited with James J. McCartney and Dominic A. Sisti)
Darwin, Marx and Freud: Their Influence on Moral Theory
(coedited with Bruce Jennings)
The Ethics of Organ Transplants: The Current Debate
(Contemporary Issues
(coedited with Daniel H. Coelho)
The Human Cloning Debate
(coedited with Glenn McGee)
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Copyright © 2007 by Rowman & Littlefield Publishers, Inc.
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British Library Cataloguing in Publication Information Available
Library of Congress Cataloging-in-Publication Data
Caplan, Arthur L.
Smart mice, not-so-smart people : an interesting and amusing guide to
bioethics / Arthur L. Caplan.
p. cm.
9781461734055
1. Medical ethics. I. Title.
R724.C344 2007
174.2—dc22
2006014275
Printed in the United States of America
™ The paper used in this publication meets the minimum requirements of
American National Standard for Information Sciences—Permanence of
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Table of Contents
ALSO BY ARTHUR L. CAPLAN
Title Page
Copyright Page
INTRODUCTION - Is America Going to Hell?
Part I - General Interest
Duty versus Conscience
The Ethics of Brain Imaging
Has Direct-to-Consumer Advertising Gone Too Far?
Ethical Lessons from the Flu Bug
The Colonel Kicks the Habit
Shame on Jeb Bush
Stark Raving Madness
Part II - End of Life
Million Dollar Baby
Physician-Assisted Suicide in Oregon
Lessons from Terri Schiavo
Part III - Engineering Ourselves
Is Cosmetic Surgery Always Vain?
Face-off over Gene Foods
Heightened Questions about Growth Hormone
Brain Enhancement
Seasonale: Medicine for the Sake of Convenience?
Raffy and the Trouble with Steroids
When Steroids and Politics Mix
ANDi the Fluorescent Monkey
PART IV - Engineering Plants, Microbes, and Animals
Are Genetically Modified Foods F it for a Dog?
Miss Cleo, Meet “CC,” the Kitty Clone
Whipping Up the Avian Flu
Should Scientists Create New Life?
Smart Mice, Not-So-Smart People
Part V - Experimentation Ethics
Testing Biological and Chemical Weapons: Any Volunteers?
Lawsuits Are Not the Answer
Commercial Concerns Should Take a Backseat to Public Awareness
Research Ban at Hopkins a Sign of Ethical Crisis
Research on the Newly Dead
Will We Ever Debunk Our Mythology about Human Subjects
Research?
Part VI - Health Reform
Cause Célèbre
Cheap Drugs Are Not the Answer to the African AIDS Crisis—Better
Infrastructure Is
Humility or Hubris?
Fiddling While the Health System Burns
No Coverage for Kids a Moral Failure
New World Calls for New Health Care
Our Dying Health Care System
The Moral Tragedy of Chronic Illness
Part VII - Human Cloning and Stem Cell Research
Cloning: Separating the Science from the Fiction
Cloning Flicks Offer a Moral Lesson
Embryonic Cloning Feat Points to Problems with Bush Policy
Korean Cloning Fraud
Media Bungled Clone Claim Coverage
Chutzpah
The End of the Embryonic Stem Cell Debate
Part VIII - Mapping Ourselves
Ethics First, Then Genetics
His Genes, Our Genome
Let’s Keep Our Genome in Perspective
“Darwin Vindicated!”
Ready for the Genomic Age?
Unethical Policies Undermine Value of Genetic Testing
Who Needs Bill Gates?
Part IX - Reproduction
Let’s Talk about Sex
Model Eggs
Soldier’s Sperm Offers Biological Insurance Policy
Taking Reproductive Responsibility
Test Tube Babies versus Clones
The Problem with “Embryo Adoption”
Are You Ever Too Old to Have a Baby?
Part X - The State of Science in the United States
Hullabaloo over MMR Risk Misses the Point
If Science Becomes Politicized, Where Do We Go for Truth?
Is Biomedical Research Too Dangerous to Pursue?
Misusing the Nazi Analogy
How the President’s Council on Bioethics Lost Its Credibility
Pray It Ain’t So
Who Wins When Religion Squares Off against Science?
Why Are These Nuts Testifying?
Part XI - Donation and Transplantation of Organs
About Face
Restricting Blood Donations or Mad Cow the Deadlier Threat?
Jumping the Line
www.matchingdonors.com
Misguided Effort to Ease the Organ Shortage
No Excuse for Blood Donor Bias
Sperm Transplants Should Spur Debate
The Return of Fetal Tissue Transplants
AFTERWORD - What Is Bioethics?
About the Author
INTRODUCTION
Is America Going to Hell?
THE PAST FEW years could easily leave you with the distinct impression
that America is going straight to hell. We seem to be losing our moral
minds. Scandals, hypocrisy, duplicity, and vice are the daily fare of the
media. What is going on?
Hold on, you say. Things have been worse. Remember the sense of
ethical angst that engulfed the nation when a former president was revealed
to have dallied with an intern in the White House?
Admittedly, that was a dark time. President Clinton was rightly
condemned by a chorus of conservative congressional critics for his
immorality. But, some of those critics were quickly outed as having had an
illicit sexual dalliance or two of their own. The bottom line on Monicagate
was that we all understand that those involved were politicians, and
Americans really don’t expect much in the way of morals from that crowd.
These days things really are worse. Those from whom we do expect
virtue are letting us down.
Our most prestigious news organization, the New York Times, got
enmeshed in an ethics scandal of unprecedented proportion. A young
reporter filled the front pages of the paper with errors, lies, and stolen
material for months, maybe years. The coaches of our most prestigious
college sports (football and basketball)—men who are supposed to be icons
of morality in states such as Alabama and Iowa—confessed to such
indiscretions as spending time with strippers, drinking themselves to
oblivion, and trying to maul coeds at campus parties. And our athletes
themselves do no better, be it cheating with performance-enhancing drugs
or simply engaging in incredibly irresponsible behavior both in and out of
uniform.
They are joined in the ranks of the morally bereft by a bevy of titans of
American industry. Their ethical shenanigans have created a situation in
which a large number of prominent companies are bankrupt with their
leaders indicted. And millions of Americans are finding out that the
pensions and benefits they were promised by their bosses are nowhere to be
had.
Even the current president, who swore he would restore morality to the
Oval Office, is in deep ethical trouble. We went to Iraq for the express
purpose of ridding the world of a dictator and his weapons of mass
destruction, but the latter proved hard to find. And an administration that
promised it would not lie is watching some highly placed officials face the
wrath of special prosecutors and grand juries.
What about our ethicists themselves? Consider the fate of those who call
themselves our moral guides.
William Bennett styles himself as something of a national moralist.
Bennett built his career on wagging his finger at sin and encouraging young
kids to read snippets of wisdom about how to live that he thoughtfully
assembled and sold for great profit in various collections. But, Bill turns out
to have a huge gambling jones. The casinos know him so well that he is
referred to as a “whale”—good for millions of dollars of action. Our
national icon of moral priggishness can’t stay away from Vegas. An
aggressive effort to rehabilitate him in the public eye doesn’t change the
shame or irony of it all.
The same grim assessment can be offered of Pat Robertson, another self-
declared moralist, who spent a good part of last year defending his un-
Christian call to murder the head of state of Venezuela, Hugo Chavez. And
of the Reverend Franklin Graham, Billy Graham’s son, who heartlessly said
that the spate of hurricanes that pounded the Gulf area of the United States
were reflective of God’s wrath for sin in New Orleans. Either God has bad
aim, or he cannot distinguish the out-of-town gamblers and drinkers from
the local population.
So what are we to conclude? Is ethics just another name to describe the
values that the rich and powerful support? Is there a hypocrite lurking just
behind every moral pronouncement? I don’t think so.
What America needs is not a renewed effort to instill morality into the
hearts and minds of its citizens. Knowing what is right is no guarantee of
doing the right thing. What we need is a recognition that for ethics to work
in the real world, leaders must take their ethics very seriously. People need
not just to be told to do the right thing but rewarded and promoted when
they do.
Consider the case of dealing with unethical behavior on the part of
children.
Ethics and kids don’t seem to mix. I do not mean that kids cannot make
ethical judgments or that issues of right and wrong do not command the
attention of all kids from nursery school through high school. Anyone who
has talked to kindergarteners about their views of the kid who failed to
share knows that even very young children have a keen sense of injustice.
What I mean in saying that ethics and kids don’t mix is that there are a lot
of kids who behave in unethical ways. Surveys of college students show
that more than two-thirds admit to having engaged in serious cheating in
high school. Rates of stealing, drug use, violence, and nonconsensual sexual
contact are depressingly high among adolescents and even younger
children.
There is a lot of bad behavior out there. Does this mean that parents
should be beating themselves up over their failure to teach ethics to their
children? Are parents failing, as many conservative pundits suggest, or is
something else going on? I think something else is going on—we are
confused about what to expect when ethics is taught.
I have one son, Zach. He went to Germantown Friends, a school with
deep Quaker roots in Philadelphia. Trust me, Quaker schools yield to no
others when it comes to caring about ethics. And I suspect that having a dad
who is involved in ethics on a daily basis has made ethics a rather central
issue in my son’s upbringing as well. So, if there are kids out there who got
more in the way of ethics at school and at home, I am not sure who they
are!
That said, Zach, like any young person, has his share of ethical flaws and
weaknesses. He is sometimes willing to lie to get out of a tough situation.
He was known to skimp on a homework assignment or two in high school.
Once he took credit for work he really did not do. He was not truthful about
using alcohol to excess.
So what is going on? Did his dad, a full-time bioethicist, fail him with
respect to moral instruction? Should the Quakers give up their teaching
efforts if one of their best students engages in unethical behavior? I don’t
think so.
If you talked with Zach, you would quickly realize that he thinks hard
about his conduct, his choices, and how others behave toward him. If he
sometimes skirts out on the edge of immorality, it would be hard to argue
that he does so simply because he did not know any better or lacked the
ability to think through what he was doing.
Zach, like any moral agent (including his father) is tempted by all of the
short-term rewards that bad behavior can bring. As some wag long ago
noted, if sin wasn’t so much fun, we would not engage in so much of it. No
one ever said ethics was easy. And that is the point.
The test of an “ethical” child is not simply the child’s behavior.
What parents need to understand is something that ethicists from
Socrates and Jesus and Aquinas to Martin Luther King and Gandhi have
long understood: always acting ethically is hard. That is no less true of us
than it is of our children. Lapses and failures are consistent with good
ethical teaching.
If we measure parental success in teaching about ethics simply by
expecting perfection, we will always be disappointed. Few people, adults or
kids, always behave ethically. Those who do are known as saints. For the
rest of us, ethical conduct is an aspiration but not always a reality.
What a parent needs to do is to teach their kids enough about ethics to
know right from wrong and then to strive to use that knowledge in a world
where it is sometimes hard to do so. Kids need the tools to feel remorse
when they err, to correct self-indulgence, to feel guilt about doing wrong,
and to retrospectively realize that what looked like a good decision
yesterday was in actuality a lousy one when seen in the light of ethical
reflection today.
If parents or society expect perfection from those they teach ethics to,
they will be disappointed. If instead they create the basis for remorse,
reflection, self-correction, and a striving to do better, then they will have
done a great job transmitting the tools of ethical character and conduct.
There is still too much immorality out there to say that we are doing enough
to teach our kids. But what should make us truly worried is when we do not
hear much in the way of apology, self-criticism, or remorse on the part of
our children, our civic and business leaders, and our moral leaders.
Ethics will only flourish when checks and balances are in place. If an
organization lets an individual plagiarize or cook the books either because
no one asks or no one tells, then they are as much to blame as the person
himself for ethical failure. At the end of the day, ethics is as much a social
activity as a matter of individual choice. If it is failing in our nation, then
we have to bear some of the blame ourselves, but we also have to blame a
community that is long on talk but short on accountability.
So what needs to be done? We need to be sure that editors and publishers
are held accountable along with reporters who do wrong. We need to tell
boosters and alums that their gifts are no longer welcome if those they
support bring discredit to their university. We need to hold to account the
stockholders and investors who put up with the unethical practices that have
made a joke out of the notion of business ethics. We need to make sure that
no one gets a golden parachute from a company where the retirement
benefits have been depleted. We need to be sure that those who lead our
military training institutions are held accountable for the behavior of those
in charge.
We need a political reckoning for politicians who say one thing but then
deliver nothing. And we must not believe that the only thing that matters in
morality is what each individual chooses to do. What matters just as much
is what happens in the wake of immorality both in the heart of the person
and in the behavior of the community.
Part I
General Interest
