Leon Kass and the Challenge of Bioethics by William E. May

Leon R. Kass is chairman of President Bush’s committee on bioethics. He is also a remarkable person, a medical doctor and philosopher, who thinks deeply about the human condition and the profound philosophical questions posed by modern biotechnology. His recent book, Life, Liberty, and the Defense of Dignity: The Challenge for Bioethics (San Francisco: Encounter Books, 2002), is thus one of considerable significance.

In my opinion it is unquestionably one of the most important books on bioethics ever published. Although concerned with specific bioethical questions—in vitro fertilization, cloning, genetic engineering, the selling of human organs, euthanasia, and the like—Kass’s principal focus is on the profoundly deep questions about the meaning of our existence as embodied human beings underlying issues of this kind and the danger of dehumanization inextricably linked with the enormous powers over nature given by the “new biology.”

“The most fundamental challenge posed by the brave new biology,” Kass writes, “comes…from the underlying scientific thought. In order effectively to serve the needs of human life, modern biology reconstructed the nature of the organic body, representing it not as something animated, purposive and striving, but as dead matter-in-motion. This reductive science has given us enormous power, but it offers no standards to guide its use. Worse, it challenges our self-understanding as creatures of dignity, rendering us incapable of recognizing dangers to our humanity that arise from the very triumphs biology has made” (20).

Moreover, precisely because the reductivist science underlying the new biotechnology recognizes no standards to determine whether its proposed uses are good or bad, modern technology is not so much a “problem” as a “tragedy”: the master becomes more of a slave “not only through the unintended consequences of technology but from its victories [which] transform the souls and lives of the victors, preventing them from tasting triumph as success” (46).

Kass believes that the kind of human “dignity” associated with the new biology and its underlying anthropology is “inhuman,” because it “dualistically sets up the concept of ‘personhood’ in opposition to nature and the body” and thus “fails to do justice to the concrete reality of our embodied lives…and pays no respect at all to the dignity we have through our loves and longings—central aspects of human life understood as a grown togetherness of body and soul” (17, cf. 20).

Kass thus seeks a notion of human dignity rooted in a “proper anthropology” that “goes beyond the said dignity of ‘persons,’ to reflect and embrace the worthiness of embodied human life.” The dignity he seeks is that of a “life that will use our awareness of need, limitation, and mortality to craft a way of being that has engagement, depth, beauty, virtue and meaning—not despite our embodiment but because of it” (18).

Unfortunately, mainstream bioethicists today are blind to the signs of dehumanization. Kass believes that, far from questioning the human meaning of the proposed uses of the new technology, they have rather “entered in large numbers into the employ of the biotechnology companies, bestowing their moral blessings on the latest innovations—assuredly not for love, but for money” (9-10).

Kass believes that an opportune moment ”to seize the initiative and gain some control of the biotechnical project” is presented by the fierce debate now going on over the cloning of human embryos (141). Now, by firmly saying “No!” to cloning, whether for reproduction or for research, “may be as good a chance as we will ever have to get our hand on the wheel of the runaway train now headed for a posthuman world and to steer it toward a more dignified human nature” (147).

Kass regards cloning or “asexual reproduction” “a profound defilement of our given nature as procreative beings and of the social relations built on this natural ground” and as “a radical form of child abuse” (150). Asexual reproduction, he continues, “is a radical departure from the natural human way, confounding all normal understandings of father, mother, sibling, grandparent and the like, and all moral relations tied thereto” (154). Noting that asexual reproduction is found only in the lowest forms of life and that sexuality “brings with it a new and enriched relationship to the world” (156), he reflects on the Genesis accounts of human origins, sex, and marriage, and eloquently proclaims: “Human procreation…is not simply an activity of our rational wills. It is a more complex activity precisely because it engages us bodily, erotically, and even spiritually, as well as rationally. There is wisdom in the mystery of nature that has joined the pleasure of sex, the inarticulate longing for union, the communication of the loving embrace, and the deep-seated and only partly articulated desire for children in the very activity by which we continue the chain of human existence and participate in the renewal of human possibility” (157).

Cloning is “perverse.” Any attempt to clone a human being “would constitute an unethical experiment upon the resulting child-to-be” (158); [1] it also perverts the whole meaning of having children and the parent-child relation (161). Kass argues that cloning for research is even more perverse than cloning for children. If a human being is cloned for reproduction, it at least has a chance to continue life, whereas if one is cloned for research it is doomed to death. To ban the former and allow the latter “is blatantly anti-life, making it an offense to keep the baby alive and bring it to birth” (168).[2]

Kass also notes, “cloning represents a giant step (though not the first one) toward transforming procreation into manufacture [and depersonalization]” (155, emphasis added). The “first step”, of course, was in vitro fertilization, a topic considered earlier in the book, in Chapter Three, which to me was the most disappointing chapter in the book. In it Kass discusses the status of the embryo, including the extracorporeal embryo engendered in vitro. Here Kass seems to me to be in contradiction to himself. On the one hand he acknowledges that “any honest biologist must…be inclined, at least at first glance, to the view that a human life begins at fertilization” (88). While agreeing that a blastocyst is not, “in a full sense, a human being—or what current fashion calls, somewhat arbitrarily and without clear definition, a person,” Kass nonetheless says, “One could [even say] the in vitro blastocyst is exactly what a human being is at that stage of human development. Only its extracorporeal location is different” (88).

So is the human blastocyst a human being or not? From what Kass has thus far said one could conclude that it is. But nonetheless he goes on to say: “We are right to consider the human blastocyst in vitro as potentially [emphasis added] a human being…”(89); and that “it is at least potential humanity” (89; emphasis in original). But if the blastocyst, whether in vitro or in vivo, is only “potentially” a human being, it is not actually a human being. I hold that it is actually a human being, with the potential to become a mature human being; Kass here seems to consider it only potentially a human being.

Moeover, Kass clearly approves in this chapter of in vitro fertilization and embryo transfer as a legitimate way to treat the infertility of married coupled, as in the case of Louise Brown’s parents (93). Kass thus seems here clearly to approve of what is called “homologous” in vitro fertilization. This procedure he claims is “compatible with the respect due human life.”

But paradoxically, in this chapter Kass also examines the meaning of extracorporeal fertilization as such and finds it depersonalizing and dehumanizing. In a beautiful passage he writes: “What is the significance of divorcing human generation from human sexuality, precisely for the meaning of our bodily natures as male and female, as both gendered and engendering? To be male or female derives its deepest meaning only in relation to the other, and therewith in the gender-mated prospects for generation through union. Our separated embodiment prevents us as lovers from attaining that complete fusion of souls that we as lovers seek; but the complementarity of gender provides a bodily means for transcending separateness through the children born of sexual union. As the navel is our bodily mark of lineage, pointing back to our ancestors, so our genitalia are the bodily mark of lineage, pointing ultimately forward to our descendants. Can these aspects of our being be fulfilled through the rationalized techniques of laboratory sexuality and fertilization…when technique comes merely to the aid of our sexual natures and our marital hopes, could we be paying in coin of our humanity…for electing to generate sexlessly?” (101).

In short, I was disappointed by Kass’s discussion of “making babies” by the use of in vitro fertilization. He seems in it to “fudge” on the status of the human embryo and fails to repudiate the “making” of babies involved in in vitro fertilization, even when done to help “overcome” the infertility of a married couple while at the same time acknowledging that this way of generating human life is depersonalizing and dehumanizing. In vitro fertilization was a major step in transforming procreation into re-production and is utterly incompatible with respect for human life because it treats this life, at least initially, as a “product” inferior to its producers and not, as it truly is, a being equal in dignity to its progenitors.

Discussing the age of genetic technology and possibilities of genetic engineering Kass believes that threats to human dignity will probably arise even with the most humane and “enlightened” use of the new technology. Ultimately, “the price to be paid for producing optimum or even only genetically sound babies will be the transfer of procreation from the home to the laboratory. Increasing control over the product can only be purchased by the increasing depersonalization of the entire process and its coincident transformation into manufacture. Such an arrangement will be profoundly dehumanizing” (131).

Since Kass rightly regards a “human being as largely, if not wholly, self-identical with his enlivened body” (181-182), he argues that it is not only wrong but foolish to treat the body as a mere instrument and to consider one’s bodily organs as commodities one owns or possesses. Kass thinks that we sense that the human body “belongs to that category of things that defy or resist commensuration—like love or friendship or life itself…the bulk of their meaning and their human worth do not lend themselves to quantitative measures; for this reason, we hold them to be incommensurable, not only morally but factually” (193-194). Thus the bodily organs of a human person, which are goods of the person and not merely goods for the person ought not to have price tags placed on them and sold as marketable items.

Kass vigorously attacks the notion that there is a “right to die.” There can be no right to die in any real sense. Why? Kass’s answer: “Because death, my extinction, is the evil whose avoidance is the condition of the possibility of any and all of my goods, my right to secure my life against death—that is, my rightful liberty to self-preservative conduct—is the bedrock of all other rights and of all politically relevant morality” (213).

Moreover, death with dignity and the sanctity of life go hand in hand, and deliberate killing, such as that entailed in euthanasia, is incompatible with both. Man, the human being, has a more-than-human status because he is the being capable, by virtue of what he is, of doing godlike things: speaking intelligibly, marshalling arguments, reasoning, and discriminating truth from falsehood, and making choices. He is the only animal with the wherewithal, rooted in his being the kind of animal he is, capable of engaging in these godlike activities (241-242). Death with dignity means facing death with virtue, with courage, knowing that one will suffer death (247); and death with dignity means caring for the dying by being with them and refusing to treat them like mere animals.

Kass argues, moreover, that there is such a thing as a “proper lifespan.” Human beings do not long for endless existence as they are now. Human beings are indeed mortal, subject to death even if death is itself an evil and in a sense the ultimate indignity facing us. Our longing for immortality is not a yearning for more and more of our earthbound existence, whose meaning in many ways is bound up with our realization that we will eventually die. The fact that our temporal existence is framed between birth and death has many values for our lives here and now. It contributes to our interest and engagement in life, the seriousness with which we view it and the aspirations we seek to realize, our appreciation of beauty and of love, our struggle to acquire virtue and moral excellence. Our longing for immortality bears witness to our transcendence as animals who are more than mere animals. It testifies to our desire for wholeness, for wisdom, for goodness, and for godliness (269-270). We know that something higher and greater than this life is best (273).

Finally, Kass argues that biology is essentially limited because of its very nature. It seeks to discover solutions to problems, many of them real. But it can never plumb the depths of human life, for life is not a problem to be solved but a mystery to be contemplated.

As I said at the beginning, this is unquestionably one of the most important books on bioethics ever published. It is filled with wisdom, raising questions of utmost significance and providing direction to answering them honestly and truly.

I have already noted my disappointment over Kass’s treatment of in vitro fertilization and his ambiguity over the status of embryonic human beings. But my biggest disappointment is that not once in this marvelous volume does Kass refer to the magnificent contribution Pope John Paul II has made in defending human dignity from the threats posed by some uses of the new biology. This is in many ways puzzling, for like John Paul II Kass calls for a “proper” or “authentic” anthropology, one that respects our dignity as embodied beings, whose bodies, as it were, “reveal” the person. Again, like the Holy Father, Kass vigorously opposes as dehumanizing the transfer of procreation from the family hearth to the laboratory, the intentional killing of the sick and dying, etc. Indeed, Kass laments the failure of religious ethicists to continue the great tradition exemplified in the work of Paul Ramsey, yet he fails even to acknowledge the magnificent work of John Paul II. This failure was the source of my deepest disappointment. It is possible, however, that Kass deliberately refrained from noting John Paul II’s efforts to defend human dignity for political/practical reasons, fearing that drawing attention to the close affinities between his own views and those of the Bishop of Rome would hardly render them more persuasive to many of the elites of our culture. Notwithstanding this, I must conclude by urging everyone concerned with contemporary bioethics to study this book carefully and to take to heart its principal argument.

1. It is worth noting that the late, great Paul Ramsey (one of the three persons to whom Kass dedicates this work) had developed a similar argument thirty years ago to oppose in vitro fertilization. See Paul Ramsey, Fabricated Man (New Haven: Yale University Press, 1972).

2. Here it is worth pointing out that Gilbert Meilaender presented a similar argument in his “Personal Statement” appended to Human Cloning and Human Dignity: The Report of the President’s Council on Bioethics, with a Foreword by Leon R. Kass, M.D., Chairman (New York: Public Affairs, 2002), p. 339.