December 28

1970–71: Birth of American Bioethics

Although its true birth is rooted the revelations at the Doctors Trial at Nuremberg, the birth of American Bioethics is credited to The Hastings Center and Kennedy Institute for Bioethics, Georgetown. “Bioethics was born in scandal” — the unholy trinity of American research travesties: Jewish Chronic Disease Hospital cancer cell injections in elderly patients (1964–65); Willowbrook deliberately infected retarded children with hepatitis (1963–66); and Tuskegee failure to treat (1932–72). Tuskegee has had the longest life in bioethics and American public memory. It has become a metaphor and has had the greatest impact on public policy and the growth of bioethics. (Susan Reverby, Examining Tuskegee, 2009)

Two of its intellectual founders — the philosopher Hans Jonas and the psychoanalyst and legal scholar, Jay Katz — both of who were Jews who had fled Nazi Germany — had a humanitarian perspective. They recognized that by protecting the right of the individual, society protects itself against atrocities such as the Nazi experiments on Concentration Camp prisoners. Their views, however, have been largely eclipsed by the dominant faction in bioethics which is driven by utilitarian values that apply a moral calculus grounded in business ethics.

Utilitarian Bioethicists embraced “scientific progress” as the overarching value, rationalizing government policies that override individual rights. They calculate a risk / benefit ratio in medicine and healthcare from a societal viewpoint for the supposed “greater good.” Implicit in utilitarian ethics is the eugenic rejection of the guiding principle in Hippocratic medicine that values each individual. Public health policies are formulated to facilitate “scientific progress” as defined by the biomedical industrial complex, and enforced by government. That mind set of bioethics and government policymakers is rooted in the American Eugenics movement — though Bioethicists self-consciously avoid using the term “eugenics” because of its inexorable link to Nazi ideology and the “Final Solution.”

Bioethics, however, also promoted the myth of scarcity and population control. Bioethicists have promoted a view of medicine as a commodity whose delivery is predicated not on care but on economic efficiency.

Read Thieves of Virtue: When Bioethics Stole Medicine by Tom Koch, MIT, 2012

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