Reshaping the bioethical landscape

The electoral tidal wave
which swept Democrat Barack Obama into the White House and Democrat
majorities into the Senate and the House of Representatives could
reshape the bioethical landscape in the United States.

The most obvious issue is
abortion. Mr Obama is a strong supporter of a woman’s right to
abortion. The leading abortion action group, Planned Parenthood, gave
him “100%” on its electoral
. After reviewing Obama's legislative record, Professor
Robert P. George, of Princeton University, wrote a scathing
of his views on pro-life issues. His conclusion: “Barack
Obama is the most extreme pro-abortion candidate ever to seek the
office of President of the United States. He is the most extreme
pro-abortion member of the United States Senate. Indeed, he is the
most extreme pro-abortion legislator ever to serve in either house of
the United States Congress.”

Under George W. Bush, a
relatively pro-life president, abortion activists felt threatened. On
his first day in office he had blocked federal aid to foreign groups
that promoted abortion. He appointed two justices to the Supreme
Court who apparently took a dim view of Roe v. Wade, John Roberts and
Samuel Alito. He signed a ban on partial-birth abortion. His
appointees in the Federal bureaucracy tried to thwart sales of
emergency contraception to minors and promoted abstinence-only sex
education. In Planned Parenthood’s eyes, Bush had declared war on

Nor, before the election,
was the situation in all of the 50 states altogether favourable for
abortion supporters. The 1973 Roe v. Wade decision by the Supreme
Court effectively guaranteed abortion on demand. However, opponents
have managed to restrict this in a number of small ways on a
state-by-state basis – banning late-term abortions, requiring
parental notification, mandatory counselling, restricting health
insurance payouts and so on. These form a patchwork of regulation
throughout the 50 states.

But with the election of
Obama and a Congressional majority which is broadly favourable to
abortion rights, all restrictions could vanish. In 2007, as both
sides of the abortion divide remember well, Obama
promised Planned Parenthood
that "the first thing I'd do as
President is sign the Freedom of Choice Act" (FOCA). This act
has been kicking around Congress since 2004, but Obama became a
co-sponsor of the Senate version in 2007. The purpose of FOCA is to
codify Roe v. Wade, invalidating every restriction on abortion at
least up to the stage of viability.

The website of the new administration’s transition team does not mention FOCA.
But it does reassure abortion activists that Obama “has been a
consistent champion of reproductive choice and will make preserving
women's rights under Roe v. Wade a priority as President. He opposes
any constitutional amendment to overturn the Supreme Court's decision
in that case.” It also declares that he will support the Prevention
First Act, which will increase funding for family planning and
comprehensive sex education and promote emergency contraception.

Obama still has not taken
office, so many details remain to be worked out. Will hospitals which
currently refuse to do abortions be threatened with loss of funding?
Will health care workers effectively lose the right to conscientious
objection in abortion and emergency contraception?

Stem cell research is
another area which will be affected by the Democrats' victory. Obama
supports “research of human embryonic stem cells derived from
embryos donated (with consent) from in vitro fertilization clinics”.
Restrictions on Federal funding for existing stem cell lines are
likely to be lifted.

The result is unlikely to
be a rapid proliferation of embryonic stem cell research. Few
scientists are placing their hopes for cures in ESCs. First of all,
after ten years, no one has yet derived a flourishing stem cell line
from cloned human embryos. And second, reprogrammed cells, which are
uncontroversial ethically, are currently the best hope for useful
therapies. Federal funding in the Obama Administration is likely to
be directed towards them.

But what will happen when
Obama is asked to fund innovative fertility technologies – as he
surely will be? The Parliament in the United Kingdom recently
approved a thorough-going revision of its fertility act. Apart from
authorising saviour siblings, making abortion easier, and doing away
with the need for a father in IVF treatment, it also gave a green
light to hybrid embryos and cloning embryos with tissue harvested
without consent from incapacitated adults or children. The rapid advance of stem cell technologies guarantees that scientists will be creating new dilemmas for law-makers. Artificial sperm and eggs are on the horizon, for example. These would make it possible for gays to create their own children without resorting to donors. Genetic engineering could be used to manufacture children who are free of genetic diseases or who have high IQs. Given his permissive views on abortion, would Obama resist pressure to allow these techniques to proliferate? 

Another important issue
which may emerge while Obama occupies the White House is
physician-assisted suicide. Voters in the state of Washington
followed the lead of neighbouring Oregon on Tuesday and approved
Initiative 1000, which allows doctors to prescribe legal drugs for
terminally ill patients. The measure sailed through by a margin of
58% to 42%. This will embolden euthanasia activists in other states,
especially California.

His attitudes on
bioethical issues like these will show whether Obama is a vote-hungry
pragmatist, a progressive ideologue, or basically a Christian social
democrat. Any of these interpretations can be supported – although
the last of these is increasingly unlikely. A few months ago,
fundamentalist pastor Rick Warren organised a forum in which he tried to draw out both McCain and Obama on when life
begins. McCain immediately blurted out, “At the moment of
conception.”. Obama wriggled: “whether you're
looking at it from a theological perspective or a scientific
perspective, answering that question with specificity, you know, is
above my pay grade.”

Bush also faced the
thorny bioethical issue of stem cell research early in his first
term. To give him advice he created a President’s
Council on Bioethics
. This body was split down the middle on the
issue between “progressives” and “conservatives”, but under
the leadership of Dr Leon Kass it produced some of the most
thoughtful, well-reasoned, and eloquent discussion papers ever to
emerge from a government department. Since bioethical questions are
above his pay grade, Obama will no doubt appoint his own panel of
bioethics experts. Which advisors he chooses will provide the best
clues about the future of bioethics in the United States -- and possibly the world. 

Michael Cook is
editor of MercatorNet. He also edits the bioethics newsletter BioEdge.


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