The Science Journal
Nature Thinks NICE Is Nice–Naturally
Part One of
Two
By
Wesley J. Smith
Editor's note.
One of our readers' favorites--and mine--is bioethicist Wesley Smith. The following is
reprinted with permission. You can follow
Wesley at
http://www.firstthings.com/blogs/secondhandsmoke.
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When I was researching Consumer's Guide
to a Brave New World, it hit me that the
ethical values of many scientists cut
against the grain of most of the citizenry.
Actually, that didn't just hit me–I quote a
major scientist making that very point.
From my book (citations omitted):
…[T]he scientific establishment seems to
be increasingly insular from the rest of
society. It is thus unsurprising--if
disturbing--that Bruce Alberts, president of
the National Academy of Sciences
hubristically told a reporter for the
National Journal, "We [scientists] care
a lot about how other scientists think about
us, and we don't care a lot about others who
are not scientists."…
Making this even more worrisome, the
moral views of the scientists who are
supposed to decide these issues on our
behalf often do not comport with the general
moral sensibilities of society. "Most
scientists adopt utilitarian perspectives on
ethical and political questions, and they
use their values to estimate costs and
benefits." Thus, the NAS's Alberts admitted
that the moral views of the general public
sometimes prevent research that scientists'
general utilitarian outlook would cause few
qualms. For example, in the 1970s, a public
outcry halted the practice of using
condemned prisoners in experiments, whereas
according to Alberts, "If it was purely up
to the scientists, they might accept the
idea of doing experiments on death row
[because] the person will be dead in six
months anyway."
And now the science journal Nature
provides further proof to the point by
supporting the utilitarian rationing board
NICE, that is doing so much harm to the weak
and vulnerable in the UK.
From the
Nature editorial
[http://www.nature.com/nature/journal/v461/n7262/full/461315b.html]
In the highly polarized debate over US
health-care reform, opponents of increased
government involvement in the system
frequently caricature Britain's National
Health Service (NHS) as the disaster they
want to avoid -- an impenetrable snarl of red
tape that keeps ailing pensioners on
years-long waiting lists for even the most
essential procedures. And at the heart of
their nightmare is the UK National Institute
for Health and Clinical Excellence (NICE),
portrayed as a bunch of callous government
bureaucrats ruling life-saving medications
as off-limits to dying patients.
Globally, however, NICE is widely
regarded as a world leader in
comparative-effectiveness studies: research
that aims to show which of the available
medical options is most effective at
treating any given condition, and which is
worth the money -- what US reform opponents
might call 'health-care rationing'. Faced
with an overwhelming yet incomplete medical
literature, most medical professionals
welcome NICE's best-practice guidelines on
everything from early testing for breast
cancer to child nutrition.
I doubt that--at least in the USA. But
notice: NICE explicitly adopts a quality of
life ethic in making its rationing
decisions. That is a view that rejects
human equality by definition, not to mention
human exceptionalism, views that I don't
think the American people are willing to
swallow–as illustrated by the resistance to Obamacare and its supporters many pretenses
that the plan would not impose a rationing
regime. Excuse me for not being surprised
that the Science Establishment thinks that
this is a splendid approach.
Sure the big brained and the bioethics
community are hot to trot for rationing,
since many–I would say most–accept explicit
or implicit utilitarian approaches as the
best way to provide for the greater good.
But I can't help but think that NICE-type
boards, the foundations for which are being
laid in Obamacare legislation, would also
mean greater power for bioethicists,
which, as I reported
previously, is already being advocated in
high places like the Hastings Center blog.[
http://www.firstthings.com/blogs/secondhandsmoke/2009/08/24/4641/]
Add this as just one more reason why we
can't let "the experts" have the final say.
Please send your comments to
daveandrusko@gmail.com.
Part Two |