Bioethics, healthcare policy, and related issues.
Ms. Magazine’s “Feminist Wire” reports that a federal district judge today overturned a Mississippi law requiring all second-trimester abortions to be performed in a hospital, on grounds that it imposed an unconstitutional “undue burden” on women’s ability to exercise their right to abortion. The law was explicitly aimed at making such procedures impossibly expensive to get, and Governer Haley Barbour had campaigned for it as a measure intended to make it impossible for the state’s only second-trimester abortion provider clinic to remain in business.
The “undue burden” test cooked up by Justice O’Connor has been unworkably restrictive from the beginning. Seemingly a compromise between women’s rights and states’ authority to impose limits on them, in practice almost anything has been held by the Supreme Court to be not an “undue burden”, including restrictions that double or triple the cost of abortion or impose waiting periods that make it impossible for women from out of town to schedule abortion procedures (a terrible problem in the over-80% of US counties - many of them large and rural - that have no local abortion provider). The Court has repeatedly pretended that restrictions which, in practical effect, actually prevent women from exercising their right to abortion at all are not “undue burdens” - notwithstanding that actual prohibition would seem to be as great a burden as it is possible to imagine. So it is welcoming to find some burden, imposed deliberately to prevent women from exercising their right to abortion, finally recognized as constitutionally “undue”. It is much too soon to imagine that the “undue burden” test itself will be recognized for what it is - a wink-and-a-nod invitation to anti-choicers to impose whatever burdens they can think of and then contrive to slip under that invitingly high constitutional bar. But if “undue burden” has been a failure as a compromise, there are at least some judges who recognize it is not meaningless entirely.
AJOB’s blog has an outstanding article today on Tom Delay’s manipulative use of language in describing stem cell harvesting from embryos as “dismemberment” - citing similar abuses by President’s Council member William Hurlbut, and Chair Leon Kass. It goes on to link this to similarly heated language used against intact-dilation-and-extraction procedures.
The article is a sweeping indictment of misuse of scientific-sounding language on both sides of these debates, though acknowledging that the abuses by conservative figures have been more extreme and more calculated. In particular, the article notes, there is a tendency to employ outmoded or suspicious scientific language with a pretended authority that attempts to pre-empt opposition with terms like “without a doubt”. There is also a strange tendency for conservatives to insist that their neologisms and declarative nomenclature are “clear language”, while accusing opponents of euphemism.
The issue is rich, and the short article linked above covers a lot of ground. Go read the whole thing.
Ronald Bailey has an engaging essay in Reason Online, on the familiar subject of biological enhancement. Citing a paper by neurologist Anjan Chatterjee, he poses the usual examples of technological betterment - the business executive who takes anti-depressants to cope with stress and “soon gets another promotion”, the teenage girl who takes Adderal for anxiety and improves her grades - as well as more speculative ones - amphetamines to speed learning a foreign language, and Viagra to improve oxygen transpiration for a teenage distance runner. In Chatterjee’s tale, almost every aspect of life, and perhaps every hour of every day, is modified by neuro-stimulants carefully chosen for specific contributions to specific tasks. Bailey notes that some of these benefits may be so positive it is difficult to think of turning them down: beta blockers to control hand tremors for neurosurgeons, perhaps, or cholinesterase inhibitors, which have been shown to improve performance on flight maneuvers, for commercial pilots.
Apparently, most of the applications Chatterjee cites are already in use, or at least have been tested and shown to be possible. What is different is his picture of a life lived under minute-by-minute chemical adjustment, in which moods and even neurological capacities can be fine-tuned to the needs of the moment. Typically enough, in Chatterjee’s chemical utopia, there are no side effects from any of these drugs. “When the executive arrives in Riyadh, he swallows modafinil to keep himself awake and alert without jitteriness . . . .” The cool-hand neurosurgeons never faint or get dizzy at the operating table. And, apparently, the teenage boy’s track team doesn’t think it odd that he sports a prominent bowsprit in every big race. (Bailey links an article that notes the surprising prevelance of beta-blocker usage among professional concert muscians - mentioning one recital pianist who overdosed, lost his memory, and staggered off the stage five minutes into his performance - but, hey!, these things happen!) What Chatterjee envisions - and predicts - is a life in which our neurological activity is as much under our control as our clothing or hairstyle, and in which exercising that control is just one part of the choices and adjustments we make every day in response to the circumstances we face.
Chatterjee ended by joking that if his next NIH grant got turned down, he might “stop what I’m doing and open up a brain spa.” Whether or not he decides to hang out a shingle, he predicted, “There will be a brain spa opening close to you in the near future.”
It is easy to conjure up the traditional worries about “meddling with normal health” and the loom of a “post-human future”. What is more interesting to me about Chatterjee’s scenario is not the concept of deliberate intervention in biological processes so central to personal identity - mood, memory, and cognitive ability - but the idea that those processes can be regarded as continuously adjustable, amenable to tweaking at any time to meet any need. Previous hesitations at trespassing in the Lord’s domain (and the tedious citations of Brave New World that invariably accompany them) focused on permanent changes to human biology, or at heritable changes that could prove permanent for the human species itself. What Chatterjee foresees is not “enhanced” human nature - brain implants or genetic engineering - but “tunable” human capacities, now stronger, now weaker, now primary, now pushed to the background.
One can posit a bio-logical conundrum: if we use pharmacology to dictate our own moods and outlook on life, and then, from that altered perception, choose other pharmacological moves to other altered states, who is really in control? Which point within the multi-dimensional state space of possible combinations of moods, abilities, desires, and other mental characteristics is our “real” personality - and will we recognize it if we stumble across it while careering chemically through our own mental universe? (Molly Ivins once wrote a column about a friend of hers who had died her hair so many times she had to stop at one point and let it grow back out just to remember what color it really was - then decided she liked it that way. Will we do the same with our personalities?) I personally am not impressed by these questions, however. I see nothing different about a mental state one reaches through ingested chemicals and a mental state one reaches through inherited chemicals (though I will admit that the little man inside my head, with whom I had a very long conversation on a rooftop one night during my first year in college, isn’t really there). Our “real personality” may simply be the mental state we are most likely to settle in with minimal intervention - but what of that?
It is, again, this notion that we can and will take our minds into our hands, use ourselves to make ourselves to use those new selves to new ends, that seems different to me. As a strong autonomy advocate I find this exhilarating in a potlatch kind of way - self-determination glorying in an excess of itself - and I don’t mind it. I do wonder at it, though. Strange days ahead.
“Sufficient Scruples” is now “live”! Great things ahead - I hope you’ll come by frequently.
Thanks to all those who encouraged, supported, or assisted in this endeavor. Thanks in advance to readers and commenters to be - may your numbers be legion.
I’m excited to be doing this and hope you will find it as stimulating. Welcome aboard.
