TIM O’BRIEN, correspondent: There are some things the government must do, and the first reason for taxes is to pay for them. Beyond that there is wide debate over how taxes can be efficient and fair and what kind of society they should promote.

PROFESSOR GREG MANKIW (Professor of Economics, Harvard University): People on the left think that the tax code is not nearly redistributive enough, think that the rich are really getting away with murder. People on the right think that it’s not the job of government to be redistributing income and that the tax code we have is too progressive.

O’BRIEN: Greg Mankiw was the chairman of the Council of Economic Advisers in the second Bush administration.

MANKIW: It’s a difference of values, of what you think government should be. In coming to any sort of tax reform those different values are going to collide, and there’s no easy way to sort of reconcile these very different philosophical positions about what the scope of government should be.

Professor Michael Sandel teaching at Harvard: How should income and wealth and opportunities and the good things in life be distributed?

O’BRIEN: The collision of the competing views of the role of government is the grist for a very popular course at Harvard taught by Michael Sandel, a professor and political philosopher.

PROFESSOR MICHAEL SANDEL (Professor of Government, Harvard University): The main purpose of a tax system is to raise revenue for the common good, for the public good. That’s its purpose. But it has to do so in a way that is fair, that involves shared sacrifice, because really it’s a matter of sharing the burdens of a free society and of a good society. That’s, morally speaking, what taxes are about. So unless a tax system meets the test of fairness, none of its other advantages really matter.

O’BRIEN: For Peter Wehner, a former deputy assistant to President George W. Bush, the issue is freedom.

PETER WEHNER (Senior Fellow, Ethics and Public Policy Center): This country was founded on liberty. It wasn’t founded on income equality. And there is a certain view, which I subscribe to, which says that people ought to be able to keep much or most of what they earn and to have the government in the business of taking it and deciding how it, government, will spend it rather than you as an individual I think is flawed, and I think it’s contrary to much of the American tradition, and I happen not to think that it’s consistent with ethical or moral or religious traditions as well.

O’BRIEN: But according to Michael Sandel, fairness—“sharing the burdens of a free and good society”—may compel a significant redistribution of wealth.

SANDEL: Some people do work harder than others, but what’s reflected in the vast income inequalities that we’ve seen in recent years is not hard work primarily. School teachers work hard, bus drivers work hard, kindergarten teachers, daycare workers—they work hard. Do they work less hard than hedge fund managers and Wall Street bankers who reap hundreds and thousands of times what they do in the market economy? Most of the wage differences, most of the income differences have very little to do with differences in effort. Most of them have to do with supply and demand and with the qualities that our society happens to value, and a lot of this is no doing of the people who are lucky enough to have those talents and those abilities to wind up on top. And if that’s true, then it seems to me there is an obligation for those who are affluent, those who succeed under this system, to share their bounty with those who through no fault of their own are less well off.

O’BRIEN: In Alabama, which has its share of “less well-off,” families falling below the poverty level still pay income taxes and a hefty nine percent tax on groceries, while many wealthy property owners pay next to nothing in property taxes. Schools suffer, and some families find it even harder, because of taxes, to put food on the table. The Alabama legislature is composed almost entirely of Christians, but to one critic the state’s tax policy stands Christian values on their head.

PROFESSOR SUSAN PACE HAMILL (Professor of Law, University of Alabama): The moral principles of Judeo-Christian ethics demand that our taxes raise a level of revenue embracing the reasonable opportunity of all and that the burden be allocated in a moderately progressive way.

O’BRIEN: Susan Hamill is seminary trained, a United Methodist, a tax attorney, and a law professor at the University of Alabama, and she’s made a name for herself crusading for tax reform in Alabama based on Judeo-Christian ethics—the Bible.

HAMILL: The Bible, first and foremost, absolutely forbids oppression—this is where I got started with this in Alabama—forbids oppression. What is oppression? Oppression is taking a person who’s already down, who is struggling, who is vulnerable and making their situation worse, actively doing so.

O’BRIEN: The idea that those who write our tax laws should be in any way guided by religious beliefs has been greeted with a degree of skepticism by some leading economists, like Greg Mankiw.

MANKIW: I don’t think one can go straight from any sort of religious view to what an optimal tax system looks like, but in terms of thinking about fairness and what’s the role for government—sure, I think all of our values come into play.

O’BRIEN: There’s no debate that tax laws should be fair, but how in a pluralistic society such as ours do we even define the word “fair”? And assuming we can define it, how far should the government go using tax dollars to promote fairness?

WEHNER: The aim of tax policy is to generate economic growth. A rising tide lifts all boats. I don’t think that, as a general proposition, using tax policy to create fairness or equality works. To take money from the rich, money that they have earned because they have worked hard, is not by itself just, and again, if you take money from the rich beyond a certain point you’re going to create disincentives for wealth creators, and that’s going to have a huge effect on the poor as well.

O’BRIEN: One remedy championed by Steve Forbes in his run for the presidency in 1996 is a flat tax—17 per cent across the board, scrapping the current complicated and loophole-laden IRS code. The flat tax may have antecedents in the religious tradition of tithing, where each person gives the same percentage regardless of income.

MANKIW: Well, I think a flat tax would for sure be more efficient, and I think the strongest argument in favor of a flat tax has to do with efficiency.

O’BRIEN: Many economists, like Harvard’s Greg Mankiw, say the government should rely less on taxing income and more on a value-added tax on consumer goods, a form of flat tax found in much of Europe.

MANKIW: It’s a consumption tax rather than an income tax, so it does not tax savings. So if I earn some money and I put it in the bank and I don’t spend it, it doesn’t get taxed until I take it out and spend it later on whatever I buy. And I think there’s a lot of economists have argued over the years that consumption is a better basis for taxation than income, because consumption is actually what we’re enjoying. And also saving is a part of economic growth, so if we exempt saving until it’s later consumed, it’s going to tend to promote economic growth. So I think there’s a strong case to be made for using consumption as the basis for taxation.

O’BRIEN: If, however, sacrifices are to be shared equally, some adjustment would have to be made for those who have little money at all and are hard pressed to cover even the most basic necessities. Our tax code may be the best measure of what kind of a people we are and what kind of a country we have created. The late American philosopher John Rawls defined a just society as one you would want to live in, even if you did not know in advance what your place in it would be—whether you would be rich or poor, male or female, or what your race or I.Q. would be. In his course at Harvard, Professor Sandel also questions whether a country committed to equal opportunity should allow the wealthy to pass on their vast fortunes to their children and grandchildren.

SANDEL: If we believe that everyone should have an equal chance to work hard and aspire and succeed, then it’s very difficult to justify that children of wealthy parents should have a huge advantage even before they start. The estate tax, quite apart from raising revenue, is a way a society says we want to give everyone equal opportunity as far as we can, and we don’t want to give a huge advantage to people, to let them start way before everyone else simply because they had the good luck, or the good judgment, to be born to affluent parents.

WEHNER: If your parents, upon dying, want to give their children the money rather than going to the government, that’s a perfectly reasonable thing to do. Is it fair to the children who by birth might get that money that it’s taken from them and it’s given to the government? I don’t think that there is an ethical or moral imperative to do that.

O’BRIEN: Even if political philosophers and economists could agree on the fairest and most efficient method of taxation, that surely doesn’t mean it will ever happen, because of the power of special interests, such as homeowners.

MANKIW: So why should the tax code subsidize home ownership, which is eventually at the expense of renters? On the other hand, trying to get rid of that is very hard, because homeowners think they’ve become entitled to it, so there’s no question that that’s going to be a hard one to get rid of, but it’s also the right thing to do. It’s easy for me to talk about tax reform. I have tenure. The typical congressman has to get reelected every two years, and so that makes their set of constraints much more troublesome and difficult to navigate than mine.

O’BRIEN: What the tax debate makes clear is just how divided the country is over how to define the role of government and the values it should promote.

For Religion & Ethics NewsWeekly, I’m Tim O’Brien in Washington, DC.

BOB ABERNETHY, anchor: Parents want to give their children every advantage in life—music lessons, tutoring, sports camps. They also want to do whatever is possible to make their children healthy. But what about going beyond opportunities and health to enhancement, making kids bigger or smarter or more talented? Science is opening that door in a big way, and many ethicists debate where the line between health and enhancement should be. Kim Lawton has our story.

KIM LAWTON: Twelve-year-old Mitchell Greenwood has a nightly ritual. Before he goes to bed, he gives himself a shot of human growth hormone. Mitchell is healthy, but at 4′1″ he’s below the normal height for his age.

MITCHELL GREENWOOD: I’m just hoping that I get those couple of inches that I really wanted, that I’m taking it for.

LAWTON: Do some of the kids make fun of you? Are kids mean?

MITCHELL: Yeah. Well, like, some of my friends, they’re just like, “Ha, ha, shorty.” And I know they they’re just joking. But then there are also some people that do it to be mean.

LAWTON: Mitchell is genetically predisposed to be short. His mom, Lisa, is 5′3″ and Doug, his dad, is 5′4″. Their doctor projected that Mitchell may not get any taller than 5′1″ and he suggested human growth hormone might help add two or three more inches to that. They decided to try it.

LISA GREENWOOD: For Mitch, there have already been things in his life that he’s wanted to do that he’s been unable to do because he’s too small. I think that parents will always choose the things that will help their kids grow to be happier, more productive adults.

DOUG GREENWOOD: Some with reason and some without reason, you know. I think this has been a reasonable choice that we’ve made.

LAWTON: But as biotechnology advances, some ethicists are raising moral concerns about the extent to which parents may try to make even more radical alterations.

Harvard Professor Michael Sandel is a member of the President’s Council on Bioethics and author of the new book THE CASE AGAINST PERFECTION. He warns of a slippery slope in the drive toward enhancement.

Michael Sandel

Professor MICHAEL SANDEL (Department of Government, Harvard University): Aiming at giving our kids a competitive edge in a consumer society—that, in principle, is a goal that is limitless. It has—there is no end. In fact, one can imagine a kind of hormonal arms race, or genetic arms race, whether it’s to do with height or IQ, conceivably, in the future.

LAWTON: Scientists have mapped human DNA, making it possible to know what genes are responsible for particular illnesses. Clinical trials are now underway to find new treatments for genetically-based diseases. But what if this newfound genetic knowledge is used not only to cure, but also to enhance physical and mental capabilities and to enable parents to select the traits of their children? In 2003, the FDA approved the use of human growth hormone for healthy children who have no defined cause for their short stature.

Dr. PAUL KAPLOWITZ (Pediatric Endocrinologist, Children’s National Medical Center): The decision was controversial because there were a lot of people who felt that this was cosmetic treatment—like why take a normal child and put them on a medication that their body is probably making some of anyway just in order to make them grow taller?

LAWTON: Paul Kaplowitz is the pediatric endocrinologist treating Mitchell Greenwood. Although some of his colleagues treat normal height children who want to be taller, Kaplowitz says he would not.

Dr. KAPLOWITZ: If I see those children I simply say, “You know, this is not an appropriate use of growth hormone. Your child may be shorter than you would like, but they’re fine. They will reach a normal height.” And furthermore, I tell them that, you know, if we insist on treating them, we are sending them the message that there is something wrong with them. They are not okay the way they are.

LAWTON: Sandel says he does support the use of new biotechnologies to cure illness.

Prof. SANDEL: My argument is not that we must never intervene in nature. My argument is that there is a moral difference between intervention for the sake of health to cure or prevent disease, and intervention for the sake of achieving a competitive edge for our kids.

Gregory Stock

LAWTON: But according to UCLA professor Gregory Stock, author of the book REDESIGNING HUMANS, the line between therapy and enhancement is never clear-cut.

Professor GREGORY STOCK (Department of Psychiatry and Biobehavior, UCLA): Any time there is a reduction in some disease process, in some affliction which we can all support, the possibility exists of other enhancements, and I see this as a very robust development. I don’t see that we’re moving toward some sort of a cliff.

LAWTON: Few people think twice about getting their kids braces, but what about genetic help to boost their memory? Stock’s company, Signum Biosciences, is researching therapies for Alzheimer’s patients. He’s not concerned that parents might also use that therapy to help their children do better in school.

Prof. STOCK: If we could enhance our memories, to me that superficially seems desirable. It’s not clear that it would be of as much value as we want, or that it’s as necessary since we have all sorts of electronic devices that are essentially memory enhancers.

LAWTON: Technologies are also moving forward that may one day allow parents to pre-select various traits, including personality or temperament. In Scarsdale, New York, Dr. Andrew Silverman is already helping parents choose the gender of their children. Most couples come to him for family balancing. Silverman is Jewish and says he initially did have ethical concerns, until he consulted with a rabbi.

Dr. ANDREW SILVERMAN (The Silverman Center for Gender Selection): He says he doesn’t see a problem. He said, “You are helping couples procreate. You’re not destroying life, you are creating life. You are a partner with God. Go ahead.”

LAWTON: Still, Silverman says he would draw a moral line at helping parents pick other qualities, such as personality.

Andrew Silverman

Dr. SILVERMAN: I’m sure there’ll be other professionals who will. If it’s available and it’s not illegal, people will offer it. You know, the greatest joy and mystery of life is seeing how your kids turn out, because they are in the same home environment. They have relatively the same genetic spread, assuming it’s the same marriage. Then how they turn out is the wonderment of life.

LAWTON: Professor Sandel opposes sex selection because he believes it changes the parent-child relationship.

Prof. SANDEL: The norm of unconditional parental love, I think, depends on the fact that we don’t pick and choose the traits of our children in the way that we pick and choose the features of a car we might order.

Prof. STOCK: Is it the child that is being damaged by being the gender of choice of that parent? I don’t think so. Who is being injured if parents have a predilection for certain types of personality and temperament, if they would be more comfortable or think they really would prefer to have a child who’s a little more outgoing, or who’s more introverted, or who is a little brighter?

LAWTON: Stock believes there is a moral responsibility to push forward with research, trusting that human beings have a great capacity for adapting to technology.

Prof. STOCK: So, you know, where is this going to lead us? We don’t really know. And to sort of be engaged in this process, which is changing the world around us, which is, you know, changing ourselves, which is life beginning to get control of its own processes and to act upon that information, and to me it’s awe-inspiring.

LAWTON: Such power is precisely what worries Sandel.

Prof. SANDEL: In most of our lives, we are accustomed to aiming at mastery and control and dominion—over Nature, over our lives, over our jobs, over our careers, over the goods that we buy. But parenthood is a school for humility.

LAWTON: And there are larger social questions, such as cost.

Dr. KAPLOWITZ: A course of growth hormone to add an extra couple of inches could easily get close to $100,000, and the question is who is paying for this? Well, in most situations the insurance companies are paying for this.

LAWTON: Some worry about the creation of two very separate classes of people: those who can afford genetic enhancements and those who cannot.

Prof. SANDEL: It will only deepen the gap between rich and poor and possibly inscribe that gap in our biology.

LAWTON: Already, many parents compete to give their children every possible advantage. There are tutoring and private coaching lessons. Would they consider genetic enhancements as well?

WENDY: If there was a drug or something that people had, and it was like they could prove that it wasn’t harmful, I don’t know how people would react. I mean, we can all say we wouldn’t do those things, but it’s hard to say.

GREG: If you found out there was possibilities you haven’t thought of, and the research was done to make it safe, but then you might end up with the Bionic Man or Wonder Woman or something like that. I don’t think that would be right.

MARA: I just think that you don’t play God.

LAWTON: For Doug and Lisa Greenwood, it came down to doing what they thought was physically and emotionally best for Mitchell.

Ms. GREENWOOD: I think it’s easy to have this debate when it is just a debate that you’re having. But when you are faced with, well, your child could be 5′1″ or maybe he will be 5′5″ or 5′6″ you are going to choose 5′5″ or 5′6″.

Mr. GREENWOOD: You want to give your kids the very, very best so they can have opportunities that you haven’t had in education. And growth is certainly one of them—and health.

LAWTON: With new technological breakthroughs, those decisions will only get more complicated in the years to come, and society will have to grapple with what should be allowed. I’m Kim Lawton reporting.

Q: Why did you write THE CASE AGAINST PERFECTION?

A: I initially became interested in the subject through my service on the President’s Council on Bioethics. One of the topics we dealt with was the question of enhancement and genetic engineering for enhancement, and I became fascinated by the topic there and began teaching a course that dealt with these issues and wrote what initially was an article in The Atlantic. Both got into this book. What intrigued me most about it was not the technology as such but the questions about the human goods, the fundamental human values and virtues that are raised by debates over biotechnology. What struck me as especially interesting was that our usual way of talking about ethics, bioethics, moral philosophy didn’t seem to capture fully what’s at stake in the debate over genetic engineering. We usually debate costs and benefits, autonomy and rights. But that moral vocabulary doesn’t really seem to capture what’s at stake in this whole question of genetic engineering and eugenics. That, I think, is really what intrigued me most: If not autonomy and rights and utility, then what? That was why it was a philosophical challenge.

Q: What is at stake? You say these questions are almost theological.

A: Yes. Really to grapple with the ethics of enhancement requires us, I think, to confront questions that have been crowded from view in the modern world, certainly within modern philosophy. It raises fundamental questions that really do verge on theological questions: What is the proper stance of human beings toward the given world? What is the proper stance toward nature? Are there certain limits to the project of human mastery and dominion? Those are questions in moral philosophy, but they are also questions of theology and of religion.

Q: Have the teachings of faith traditions addressed these issues—whether man should aim for perfection?

A: Yes, different religious traditions give different broad perspectives on this question. Some sanctify nature as inscribed with inherent meaning. Others see the moral importance of nature as flowing from the fact of God’s creation. And there are some religious traditions that view human beings as participants in creation. This is true of the Jewish tradition, from which I come. On the one hand, human beings are empowered to exercise dominion over nature and even to be participants in creation; and yet, at the same time, there are strictures against idolatry, which is a kind of overreaching and confusing human beings’ role with God’s. So the tension between these two impulses-—to participate in creation and yet not to overreach-—that, I think, is at the crux of some of the most interesting theological aspects of this debate.

Q: Where do you draw the line between trying to heal and trying to enhance?

A: I draw the line with health, with medical purposes. So I think it is one thing to try to restore normal human functioning—that would be health, that would be medicine, that would be curing or repairing. I think it’s something else to try to use biotechnology to enhance, to try to lift people above the norm, let’s say, of intelligence, or of height, or of musical ability, or to try to pick and choose the genetic traits of our children, to aim at designer children, to choose the sex of our children for purely non-medical reasons. These are really exercises in a kind of consumerist ethic that I think don’t have the same moral weight as medicine or health.

Q: But as a parent don’t you want the best for your children?

A: What I really want for my children is that they be loved and that they be happy and that they lead a good life. I suppose you could say that those goals could be captured in the idea of wanting the best for my children. But very often when we aim at the best, or what we may think is the best for our children, we aim really at lesser things, such as getting into a certain college. Never mind college, some parents expend great efforts to get their kids into the right nursery school or the right preschool, with the thought that that will set them on the path to success, to competitive success especially. So I think very often when we think we are aiming at the best for our children, what we are really doing is trying to position them for competitive success in an intensely driven kind of society. I’m not sure that always leads to the good life or to happiness.

Q: You have said maybe we should change the driven climate of the culture, and perhaps this quest for perfection really undermines the sacredness of the child-parent relationship.

A: I think part of being a parent, to love one’s child, is to accept them as they come—not to see them as instruments of our ambition or as creatures to be molded, as if they were themselves commodities. I think too often in our society parents, who may have good impulses, overreach and try to mold and shape and direct their child. That’s the phenomenon of hyper-parenting. I think people who want to use genetic technologies to gain a competitive edge for their children are engaging in a kind of overreaching that could really undermine our appreciation of children as gifts for which we should be grateful and, instead, to view them as products or instruments that are there to be molded and directed.

Q: You talk about gifts. Is that a religious argument?

A: Yes and no. It’s true that to speak of an ethic of giftedness, which is very much the ethic that I deploy in raising questions about designer children and genetic engineering—an appreciation of the giftedness of the child or the giftedness of life does have religious resonance, because a great many religious traditions emphasize the sense in which the good things in life are not all our own doing; they are gifts from God. So that is one source of an ethic of giftedness, a religious source—the idea of God as giver of gifts. But what I argue in the book is that that is one important source for the ethic of giftedness but not the only source. It’s possible to make sense of what’s morally at stake in an appreciation of the gift of life, or the gift of a child, without necessarily presupposing that there is a giver. What matters is that the gift—in this case, the child—not be wholly our own doing, our own product. So I think there is a religious source, but I want to make room for religious discourse in arguments about bioethics and also for an ethical appreciation of these ideals and values by those who may not come from a religious tradition.

One of the ways in which parenting is a learning experience and an opportunity for moral growth is that we learn as parents that we don’t choose the kind of child that we have. In most of our lives, we are accustomed to aiming at mastery and control and dominion-—over nature, over our lives, over our jobs, over our careers, over the goods that we buy. But parenthood is a school for humility. We can’t choose the precise traits of our children, and that is morally important. It teaches us what William May, a theologian whom I greatly admire, calls “an openness to the unbidden.” I think this quality, as a trait of character, as a moral disposition—an openness to the unbidden—teaches us to rein in the impulse to mastery and control that we experience in so many other parts of our lives.

Q: What technologies really concern you, like non-medical sex selection? Say a family has five girls and wants a son. What would you ban or not ban and why?

A: My emphasis in the book is not on banning or regulating. I am trying to get at the moral arguments and the ethical status of various attempts at enhancement, or genetic engineering, or the bid for designer children. But there are implications for society at large. I would include non-medical sex selection as one of those practices that I think is morally questionable and that can carry adverse social consequences. We see, in some parts of the world, that sex selection for boys—and it’s usually for boys—reflects sex discrimination against girls, and it leads to very large imbalances—in China, in Korea, in India—in the population between boys and girls, a vast disproportion of boys to girls, and it reflects really this discriminatory attitude toward girls. So that’s one social consequence. But another consequence is really to our culture, to our moral landscape. The norm of unconditional parental love, I think, depends on the fact that we don’t pick and choose the traits of our children in the way that we pick and choose the features of a car we might order, or a consumer good. If we go too far down the road of choosing the genetic traits of children, my worry is that parenting will be less a kind of school for humility than it should be, and we will become too accustomed to regarding children as instruments of our ambition and of our desires.

Q: What would a “perfect” society look like if parents did pick the traits of their children?

A: By a perfect society you mean a dystopian society?

Q: Yes.

A: I think [there are] two kinds of risks. One has to do with the life of the children who would not only feel molded and made and packaged almost as commodities by their parents, but might feel the intense pressures that go with that, because if parents are aiming at choosing children who will be good athletes, or great musicians, or who will get into Ivy League schools, or who will be tall enough to make the basketball team, then there is a danger that the life of the child will bear the burden of that expectation; and the risk of disappointment and the cost of disappointment will be even higher than they are now, and even now they can be considerable. So that’s one, the effect on the child. The other effect that I worry about is the effect on the parent, that the moral teaching of humility and of the limits to our control that parenthood teaches-—that that will be lost and that we will begin to think of children more as consumer goods than as gifts that we can’t fully control and for which we aren’t fully responsible.

Q: You see troubling comparisons with the eugenics movement.

A: I do think there is a similarity between the dark history of eugenics and present attempts to pick and choose the genetic traits of children. There is one very important difference. Traditionally, eugenics was state-sponsored and coercive. They were collectivist, and so there was the dark history of forced sterilization. The majority of American states had laws by the 1930s that allowed for forced sterilization of socially undesirable categories of people, so-called feeble-minded, for example, and with Hitler culminating in genocide. So the real question is: If you remove the coercion and you make it an individual choice, is eugenics still objectionable? I would say that it is. What we have today is a kind of privatized or free-market eugenics. It’s not an attempt to try to improve entire societies or to increase humanity’s germ plasm, as the old eugenicists said. It’s an attempt, usually by affluent parents, to give their kids an edge in a highly competitive society. But it does carry the idea, which comes from the eugenic past, that it is for this generation to pick and choose the genetic traits of the next generation.

Q: And it’s only for those who can afford it.

A: In the privatized version, it’s only for those who can afford it. So a further objection now to eugenics is that it will only deepen the gap between rich and poor, and possibly inscribe that gap in our biology. That is also a troubling prospect.

Q: Should faith communities speak out? If it is just left up to the marketplace, will that determine who can afford the technology? Should there be more discussion, and should religious groups get involved?

A: Yes, I do think this is an issue that faith groups should become involved in, because it does raise questions about the proper stance of human beings toward the given world. It involves the tension between the aspiration to human mastery, control, and dominion over nature, over children, over future generations-—the tension between mastery and dominion, on the one hand, and reverence, or respect, or restraint, or humility, on the other. And most religious traditions speak to this deep human tension between mastery and restraint, between dominion and humility. I think that’s the kind of moral vocabulary we need to make sense of the challenge posed by new genetic technologies. Unless faith communities participate in public debate about these questions, that part of the moral vocabulary will not find full expression.

Q: What is morally owed to those who suffer from disease or disability if not healing or trying to make them more perfect, healthier? Is there a higher good than relief of suffering?

A: The relief of suffering is a great good. The curing of illness and disease—these are great human goods. This is the mission of medicine. I do not argue that nature is sacrosanct in the sense that we must never tamper with nature. That would disempower, really, all of medicine. That would mean that we can’t combat dread diseases—malaria, polio, all of which are given by nature, if one thinks about it. So my argument is not that we must never intervene in nature. My argument is that there is a moral difference between intervention for the sake of health, to cure or prevent disease, and intervention for the sake of achieving a competitive edge for our kids in a consumer society. I think morally those two ambitions have a very different status. One of the differences is that aiming at health, restoring health—that is a goal that is both morally important and limited, because it aims at the restoration of normal human functioning, which is an important part of human flourishing. But aiming at giving our kids a competitive edge in a consumer society—that, in principle, is a goal that is limitless. There is no end. In fact, one can imagine a kind of hormonal arms race or genetic arms race, whether it’s to do with height or IQ, conceivably, in the future. So it’s limitless, and that’s another of the features that sets it apart from medical intervention. It really puts biotechnology in the service not only of health but of consumerism, really, and the drive for better consumer goods than one’s neighbor has, or than one had last year. This is a kind of limitless spiral, and even from the standpoint of resources I think it would be a great tragedy to devote medical resources and genetic technological breakthroughs to purposes that are not to do with health or medicine, but instead are to do with satisfying the desires that are created by the consumer society.

Q: You mentioned the Presidents Bioethics Council, and stem cell research has been a huge subject there. What needs to be done about stem cell research? What are the moral arguments?

A: In my criticism of genetic engineering for enhancement I am more in line with what my colleagues on the council thought than in my views on embryonic stem cell research. I’m a supporter of embryonic stem cell research. I do think there are very important moral and also religious questions at stake in the debate over embryonic stem cell research. The most fundamental question is: What is the moral status of the early embryo or blastocyst, which is destroyed in the course of stem cell research? And so those who view the blastocyst, the very early unimplanted embryo-—we are not, of course, talking about a fetus, but an unimplanted embryo in a lab-—there are some who believe that blastocyst has a moral status equal to that of a baby or of a fully developed human being, and if they’re right about that then embryonic stem cell research should not be permitted. I don’t think they are right about it, but in the book I try to take seriously their arguments and to address them. I think it’s important, where moral arguments do inform political views, to welcome those religious arguments into the public sphere; not to exclude them and say no, no, no, that has no place; to welcome them but also to engage with those views, to test them, to argue with them, and in some cases to learn from them. So my argument about stem cell research in the book defends it, but only after taking seriously the religious objections that people raise based on the moral status of the embryo.

Q: Defend it based on what?

A: Mainly the way I try to go about engaging with the debate about the moral status of the embryo is to try to lay out what I take to be the strongest possible arguments in favor of regarding the blastocyst as morally equivalent to a baby and then seeing whether those arguments can be sustained, whether they are adequate arguments. So I think that it’s important not to—just as faith-based arguments should not be kept out of the public arena, neither should they be exempt from critical scrutiny and rigorous philosophical argument.

Q: What is your reasoning to support the view that embryonic stem cell research is moral?

A: The main way of arguing is to see whether those who object to embryonic stem cell research on the grounds that the blastocyst is morally equivalent to a person—whether they are prepared to pursue the full moral logic of that position. And if they were, then you would not only restrict, as President Bush has, federal funding of embryonic stem cell research; you would ban all embryonic stem cell research. Right now, the Bush position is that it shouldn’t enjoy federal funding, for the most part, but it should be permitted in the private sector. If it were truly infanticide, if destroying that embryo were really morally equivalent to infanticide, you wouldn’t say we should deny federal funding to this infanticide but we should allow it to continue in the private sector. Take the example of yanking organs from babies to save other people’s lives. You wouldn’t permit that. Not only that; you would not permit fertility clinics to create and discard excess embryos if you really regarded those excess embryos as siblings of the children who were implanted and created. You wouldn’t say, well, we’ll ban embryonic stem cell research or deny it federal funding, but we’ll let fertility clinics create and discard thousands upon thousands of frozen embryos. You wouldn’t permit it, and yet many of the people who want to restrict embryonic stem cell research are not raising their voices to shut down fertility clinics that create and discard excess embryos. So it’s a test of consistency, mainly. Now some are consistent and would shut down fertility clinics that create and discard excess embryos. There is a further test for them, which is: In natural pregnancy, more than half of fertilized eggs fail to implant or are otherwise lost. Should we regard that as an instance of infant mortality? And if so, why are we not mounting ambitious public health campaigns to try to save and rescue all of the fertilized eggs that are lost in natural pregnancy? We would need a public health campaign of massive proportions if there really were over a fifty percent rate of infant mortality. And what about the religious traditions that consider those lost embryos as infant deaths? Do they mandate the same burial rites for lost embryos as for babies who die just after birth, and if not, why not? So it’s a test. And this is not to parody the religious position; it’s to take it seriously and to explore its moral logic and to see whether that moral logic is carried out fully by those who profess to hold the position in the specific case of embryonic stem cell research, but not in all of these others.

Q: Does Jewish teaching about the importance of doing everything to save a life influence your thinking on this and other bioethical topics?

A: I have a broad but not an expert or scholarly background in the Jewish tradition. I’ve tried to learn what I can from childhood, but I am not an expert on Jewish teachings in this area. It is true that the Jewish tradition emphasizes the moral mandate to save life. It also has a different position from the Catholic Church on the moral status of the embryo. It has a more developmental view of when human life, in the sense of personhood, begins than does the Catholic Church. And so that may have influenced me, but I think I’ve also been influenced by arguing through these questions with colleagues on the President’s Council on Bioethics, with students, and with others, some from religious backgrounds, others not. I do think it is very important that the religious communities do try to bring their teachings and their insights to bear on the stem cell debate and on the debate about genetic engineering.