Returning to take a more in-depth look at the work of The Hastings Center and its interest in bio-ethics, I would like to review their recent online and hardback publication entitled From Birth to Death and Bench to Clinic: The Hastings Center Bioethics Briefing Book for Journalists, Policymakers, and Campaigns.

Reading this book I became convinced that as Aristotle argued, ethics is a branch of politics.

The volume contains 36 overviews of issues in bioethics of high public interest, such as abortion, health care reform, human and sports enhancement, organ transplantation, personalized medicine, medical error, and stem cells, and as each article is limited to a maximum of 1800 words they are all very concise and clear. The chapters, written by leading ethicists, are non-partisan, presenting reasonable considerations from various perspectives that are grounded in scientific and ethical facts. They each include recent news stories, clickable experts to contact, linked resources, and (where available) recent legislation and campaign positions.

The essays are preceded by 4 interventions, the first three written by The Hasting Center Directorship, and I would firstly like to outline their contributions in order to gain a better understanding of the working policies that the center advocates.

In her introduction, Mary Crowley the editor of this volume and the center’s Director of Public Affairs and Communications, states that the book is an effort to enhance knowledge and inform debate around the topics outlined above. She continues explaining that “the various entries are designed to give journalists, policymakers, and political campaigns the tools they need to best write about and respond to the challenges posed by advances in medicine and science that directly affect individuals, families, and communities. This volume is grounded in the Hastings Center mantra that good ethics begins with good facts. Hence each of the entries includes a careful description of the relevant science, social science, statistics, legal history, and other research”.

In the second intervention the President of The Hastings Center Thomas H Murray provides a brief history of both his involvement in the centre itself and the social changes that have placed medical ethics around the breakfast table of American civil society, highlighting the problems of sound-bite science reporting and the changes that the art of debate have suffered (the lack of mutual respect for opposing arguments and the movement towards ridicule and slander). He states that the contributions offer various sides to each argument in the hope that those who seek a deeper understanding and appreciation of thoughtful ethical analyses of these issues can make use of the book and references given.

Daniel Callahan, co-founder of the center presents a short history of bio-ethics and policy, addressing the ethical issues raised by the great post 1960’s advances in medicine and resulting emergence of bio-ethics. He makes several interesting arguments, demonstrating how the US courts are reluctant to handle the big ethical problems at their base level as they are very difficult to resolve through legislation, the lack of a public health policy that addresses the wider problems surrounding sickness prevention and the influence and importance of bio-ethics in health care reform. He concludes that “because of the unique way bio-ethics brings ethical and policy issues together, it has some special contributions to make. It asks questions and pursues solutions in ways different from much policy analysis. It can touch our lives at their deepest points, when life and death issues must be confronted. It can no less touch us in our daily lives, working to keep us healthy in ethical ways, yet also knowing when the quest for health becomes disproportionate in comparison with other pressing national needs”.

The fourth and final introductory intervention is entitled Why Bio-ethics Matters Today – A Journalist’s Perspective and written by Nancy Gibbs, the Editor at large of TIME. She argues that ethical issues will become the new political talking points, and that the population must “go back to school” in order to deepen their understanding of ethical problems faced today and look beyond the thirty second publicity explanations offered by politicians. She offers a brief description of the ways in which new medical advances have been received and portrayed in the press, showing how advances such as the advent of the test tube baby and heart transplantation have been described in Frankensteinian and mad scientist terms by non expert writers and reporters.

The essays follow, can be accessed through the table of contents, and as noted above they are surprisingly short, requiring no more than 10 minutes a piece. Each article begins with a highlights section that outlines the argument that is to follow, and finishes with a further reading and associated websites section, alongside a bibliography of recently published news articles. The topics covered are vast and varied, but tend to focus on the US situation and offer examples and critique taken from the US point of view, offering US data and addressing US problems such as the necessity for health care reform, although the ethical arguments are obviously not constrained by boundaries and the topics have global validity.

Reading the book makes one aware of the all-encompassing nature of ethical thought within legislation. From defining the official start and end of life to problems of informed consent and privacy, from public health disaster planning to one’s right to refuse medication on the grounds of religion or other convictions.

Many of the essays refer to arguments that have been treated on this website by various contributors. For example the Nanotechnology piece written by Evan S. Michelson, Ronald Sandler, and David Rejeski addresses issues that appear in some of my previous posts such as possible unforeseen health risks brought about by carbon nano-tube use, and governance, responsibility and sustainability in nanotechnology research. There is an article on health care costs by Daniel Callahan, another addressing Health Care Reform by Norman Daniels and Marc Roberts a third about introducing non pharmaceutical interventions during an Influenza Pandemic by Alexandra Minna Stern and Howard Markel and another addressing Disaster Planning and Public Health by Bruce Jennings that address issues raised in another posting on this site on Flu pandemic from different points of view, expanding upon these arguments and presenting new philosophical issues to be resolved.

The essay entitled Enhancing Humans written by Mark S. Frankel and Cristina J. Kapustij could be read alongside Jeff Ubois’ article entitled Nature, New Yorker on Cognitive Enhancement, published here on the foundation website as it offers data regarding US students’ use of prescribed drugs to aid memory enhancement and give themselves the edge at school, but also touches upon the idea that new technologies may give people the possibility of selecting particular trends that they could then enhance either in themselves or in their children, through nanotechnology, biotechnology, information technology, and cognitive science–known as NBIC. They claim that the combination of science at the cellular level (nanotechnology), biomedicine and genetic engineering (biotechnology), advanced computing and communications (information technology), and the science of the brain (cognitive science) creates a synergistic effect that will produce powerful new enhancement technologies. These have the potential to affect the types of children we have, the way we think, the way we play, how we age, and how long we live, with all of the ethical and practical implications that these things bring.

Read alongside Cristina Grasseni’s article entitled Is biotechnological research in Italy a chimera? An interview with Giovanna Lazzari and Cesare Galli published in Italian on this website, the Cloning article written by Christopher Thomas Scott and Irving L. Weissman offers an interesting ethical and practical outline of the problems involved in cloning encountered throughout its history, including a cloning and stem cell timeline and offering a discussion of the many legal, policy and bio-ethical considerations involved, all of which offers an informed background to the interview conducted with one of the world’s leading cloning experts based here in Italy.

Having read this book my I am left with an overriding impression of the importance of ethics in political decision-making, public policy and planning. There are several essays that raise issues that have been fiercely fought over in Italy regarding the genetic testing of embryos and definitions of life. Ethics and politics are intertwined, or probably better knotted or fused together in a way that makes the two seem inseparable, and the implications for policy and lawmakers seem endless. This is an interesting and thought-provoking book, easy to access, well written and designed and well worth a read, but not just before you go to bed.