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No Virtue In Fatalism

Conservative Bioethics and Eric Cohen’s In the Shadow of Progress

red stoplight SOURCE: iStockphoto Refusing to pursue recent and possible future developments in medical research is itself a morally momentous decision—and that inaction has consequences Cohen and other right-wing thinkers refuse to acknowledge.

In the opening pages of In the Shadow of Progress, Eric Cohen describes himself as a “contrarian,” because he does not take “the virtues of progress” for granted. This implies that most people do take the virtues of progress for granted. Indeed, Cohen addresses himself indiscriminately against “scientists,” “liberals,” “modern liberalism,” “rationalists,” atheists, and most bioethicists. However, all of these groups are far more heterogeneous than Cohen acknowledges and few if any members believe in the unfettered pursuit of all scientific possibility. In the end, Cohen is only preaching to the choir. Unfortunately, his skills in the art of sophistry make this book a valuable resource for the religious right’s efforts to control science policy in the United States.

Throughout, Cohen makes heavy weather of the point that science cannot tell us whether its ends are worthwhile, or its methods within the bounds of moral decency or virtue. In the first chapter, “The Spirit of Modern Science,” he tries to establish that “scientists” deny this rather obvious truth. He first sets up science as opposed to theism, and then suggests theism is the only genuine source of meaning and moral guidance. We are meant to conclude that those who embrace the scientific endeavor are left with scientific enquiry as the only possible source of meaning and moral guidance—thus science has to justify both its aims and means. The purported incompatibility of the modern scientific world-view and theism is dubious. But it is Cohen’s second premise, which entails dismissing scores of secular and deist moral philosophers, some of whom antedate his preferred versions of theism by hundreds of years, that is truly jaw-dropping.

It is also a dangerous book, because it contains reactionary policy recommendations, nestled within pages of highbrow prose carefully structured to mimic fair- and open-mindedness.

There are three values Cohen appeals to at various points, and that he claims we have to be Jewish or Catholic theists to appreciate: love, excellence, and the equal dignity and worth of all human beings. He ignores the fact that the philosophy of Ancient Greece and its descendants place excellence and loving well at the center of the good life. And he fundamentally misrepresents a tradition that places people’s basic moral equality at its center: modern liberalism. Cohen repeatedly describes the liberal project as trying to make people equal. This description skews the liberal belief that justice requires structuring society so that people are free to pursue their own conception of the good—a requirement based on the assumption that all people are equal. Different liberal theorists believe in this basic moral equality for different reasons. Kant and the early Rawls find it in the fact that we are capable of principled self-government. Locke finds it in his deism.

Thus, the entire book is based on a false dilemma. It is also a dangerous book, because it contains reactionary policy recommendations, nestled within pages of highbrow prose carefully structured to mimic fair- and open-mindedness. Cohen is forever attributing humanitarian and just motives to his opponents, and rather than state his opposition outright, he usually leaves off his enquiries with a set of rhetorical or near-rhetorical questions. For example, his opposition to genetics is encapsulated in the following remarks on testing for genetic disease: “In those situations where some therapeutic preemption is possible, like for those who test positive for the breast cancer mutation, the young often face drastic and wrenching decisions: Is the greater chance of longer life worth living with the scars of mastectomy, or living without the possibility of bearing children of one’s own? Is it really better to have the knowledge that makes such a tragic choice necessary, rather than the ignorance that would allow us to live without being so haunted until the disease really comes?” (91).

Cohen is more straightforward when it comes to research using human embryos. He writes, “If I could stop all embryo research before it really gets going I would do so, and if I could put the embryo back inside the [woman’s] body, I would probably do so” (78). But why? He clearly wants to side with the religious right, and so writes admiringly of conservatives who “are for treating seemingly unequal beings (like early stage embryos) more equally” (68). He also says he believes “the only rational view of the embryo that is fully consistent with democratic decency and democratic equality is the welcoming one—to treat the embryo as ‘one of us’” (75).

Yet he also rightly recognizes that human embryos pose a unique challenge to our moral categories. Particularly when created in a lab, they lack all resemblance to the creatures we know as rights bearers; nor do they resemble the creatures we know we owe protection and love. However, many of them would become such creatures, if nourished in a certain way. Also, these embryos are genetically related to us, and we have only just begun to think about the moral significance or insignificance of genetic relatedness. (Cohen appears to think he knows the significance, and it is high—in chapter six, he accuses an egg donor of “abandoning her child.”) In short, it is not easy to know what to say about the right and decent ways to relate to embryos, and kudos to Cohen for not jumping on the human-genetic-code-equals-right-to-life bandwagon. Unfortunately, he instead leaps from the difficulty of the issue to the impossibility of reasoning about it, and then abruptly concludes that we should stop all research that requires destroying embryos, plumping for his preferred answer because the question is too hard.

This is not the only place in the book where Cohen opposes medical research and discovery on the grounds that they pose difficult moral questions. In chapter five, it would be better not to pursue knowledge about genetic disease because it is hard to know what to do with such knowledge. In chapter six, the fact that anti-depressants are morally problematic means it would be better not to have these drugs at all. Although he pretends to acknowledge the value and promise of recent and possible future developments in medical research, he does not seem to realize that refusing to pursue these developments is itself a morally momentous decision—that inaction has consequences too.

Cohen exhorts us to see the “wretchedness” of disability and disease as “a pilgrimage” culminating in salvation in the afterlife. On the individual level, such a view is no doubt of great comfort to many. But as policy, it abandons future persons. As a society, we should do our best to help the diseased and disabled by removing or alleviating their suffering. There is virtue in thoughtfulness and moral caution in our efforts to relieve suffering through science and medicine. There is no virtue in evading hard questions through fatalism.

Adrienne M. Martin is an assistant professor of philosophy at the University of Pennsylvania and a Senior Fellow at the Penn Center for Bioethics.

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