Home' Technology Review : September October 2006 Contents Q&A
TECHNOLOGY REVIEW /
Round and brash, with the grav-
elly voice of a street ghter,
Arthur Caplan looks and
sounds more like a boxer than an ethi-
cal philosopher. The director of the
Center for Bioethics at the Univer-
sity of Pennsylvania, Caplan has been
enormously in uential in a variety
of debates in moder n biomedicine,
from the fate of Terri Schiavo to the
market for organs for transplant. He
has written or coauthored more than
400 peer-reviewed articles and sev-
eral book on the ethics of new medi-
TR: Why should we care about bioeth-
icists? Are they really so influential?
Caplan: Bioethics is most in u-
ential at the bedside. But the in u-
ence of bioethicists on research
and human experimentation is
also strong. Finally, conser va-
tive bioethicists have a lot of in u-
ence in Washington these days.
How much of this activity is just win-
dow dressing? Arguably, it allows
interested parties to say, "Look,
we ve got bioethicists here! We
must be taking care of the ethics!"
Well, that happens, but it doesn t
mean bioethicists don t make a dif-
ference. Bioethics has real in uence
on legislation and regulation.
What debates have you
I was involved in the National
Organ Transplant Act. I single-
handedly held up the movement
toward creating markets in organs.
In genetics, I was the rst guy on
embryonic-stem-cell research. I was
able to undermine the administra-
tion s argument that the president s
position [which allowed federal fund-
ing of stem-cell research with cell
lines that were already established]
was a compromise. Since then, I ve
worked with patients groups and
scientists to nd a moral framework
for embryonic-stem-cell research.
You have not mentioned the death of
Terri Schiavo. But last year it seemed
you talked of little else: you were
ceaselessly quoted in the media.
I was the most outspoken critic
of government inter vention, that s
true. And I felt bullied by the presi-
dent and by some members of
Congress. But although we were
outnumbered and outspent, it s fair
to say that we won that ght. Most
Americans don t want government
intervention in end-of-life cases.
Why should anyone listen
Critics sometimes say, "Well,
who elected you king?" I smile and
say, "If you don t like what I say, just
ignore it." Look, bioethicists became
in uential for a reason: they were
able to bridge the gaps between
politicians, the media, and the sci-
ences. But they re not a priesthood,
and they don t have any authority
to dictate anything to anybody.
Do bioethicists say no a lot?
We jokingly say that anyone can be
a bioethicist: just say no to everything.
You are held up as an expert on
everything from assisted suicide to
designer babies. You give great one-
liners. But your ability can at times
seem facile. Does this bother you?
No---because it s a skill I have, and
I m a quick study, and I can track a
lot of stu .
Do some bioethics for us.
There are people who have
argued that tamoxifen [which may
be an e ective treatment for breast
cancer] has too many side e ects,
such as ovarian cancer and eye
problems. They think it might be
unethical to use it as a prophylac-
tic. I don t agree. I think prevention
is in some ways better than treat-
ment. I m not saying we should
take every crazy risk, but I argued in
favor of tamoxifen s clinical trials.
What are the principles that inform
I m a consequentialist: I m look-
ing at outcomes. I m trying to decide
if a particular policy---such as allow-
ing surgeons to do face transplants---
would do more harm than good.
That s not much of an answer. What
else would you do? Do consequen-
tialists work from first principles?
They can and do. Peter Singer
[a Princeton University philoso-
pher known for his view that acts
should be judged according to
whether they promote the prefer-
ences of feeling creatures, regardless
of species] has his consequential-
ist utilitarianism, and he rigorously
applies it. He says that if animals
are smarter than retarded chil-
dren, then experiment on retarded
children. I m not willing to tr ust
any theory that far. In general, I m
not looking for fundamental truths
when I discuss ethics. What matters
is what is most practical at a given
time. I ask, "What are the bene ts
and costs?" And I understand that
the answer will change over time.
Scientists often look down on bioethi-
In the culture of science, the only
thing that counts is the science.
If you re not doing that, it means
you re not smart or good enough.
Do you ever wish you had
become a scientist?
I did go to medical school for a
while, at Columbia. I liked it, but I
don t have the patience for the level of
detail that makes good science.
DAVID EWING DUNCAN
Disclaimer: Arthur Caplan is on the board of
advisors of BioAgenda, the nonprofit insti-
tute of which David Duncan is the editorial
Who elected you king?
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