Communicating the Second Premise: Whether Obama or Bush, Values Drive Science Policy Decisions
This past weekend, a diversity of scholars and experts were called to Oregon for what might be described as a "three cultures summit" on climate change. The two-day deliberation included scientists, philosophers, poets, writers, social scientists, and filmmakers. Our focus, as Oregon State philosopher Kathleen Dean Moore defined it, was to figure out how to effectively communicate the "second premise on climate change," a set of moral and normative frameworks that can stir policymakers and the public to action.
An overwhelming majority of scientists have concluded that climate change is an urgent problem and requires societal action. Yet this scientific research--this first premise about climate change--does not offer an explicit normative framework that might guide decision-making, helping individuals decide whether action is worth the costs and trade-offs or which policy might be most in line with their values, whether religiously or secularly based.
In short, the science does not speak for itself, and as survey research shows, the first premise of scientific certainty remains selectively interpreted by the public based on their values and partisan identity.
Many environmentalists and advocates, of course, do offer an explicit second premise, though these values are probably not strongly shared by a majority of Americans. They argue that we should take action on climate change because human activities have shifted the planet into dangerous disequilibrium, altering the natural order of things. Not only is it morally wrong to violate and imperil nature but our actions threaten future generations of humans.
The challenge on climate change is to identity the moral framework--or second premise-- that works for specific segments of the public and to effectively "frame" the significance of climate change as in line with that framework. For example, a 2006 "Evangelical Call to Action" succinctly lays out the first and second premise for a Christian public. The document asserts that "human induced climate change is real" and that "the consequences of climate change will be significant." The document then articulates the second premise, or the reason why Christians should care:
Christians must care about climate change because we love God the Creator and Jesus our Lord, through whom and for whom the creation was made. This is God's world, and any damage that we do to God's world is an offense against God Himself (Gen. 1; Ps. 24; Col. 1:16).
Christians must care about climate change because we are called to love our neighbors, to do unto others as we would have them do unto us, and to protect and care for the least of these as though each was Jesus Christ himself (Mt. 22:34-40; Mt. 7:12; Mt. 25:31-46).
Every science policy debate, no matter how certain expert agreement, falls into the "second premise" category. In fact, as Obama's stem cell decision and speech yesterday makes clear, while there is often conflict and distortion over what "consensus" might be in the scientific community, most political battles over science revolve over the normative frameworks that are the grounds for action.
There was a lot to like about Obama's speech. He opened with the established framing playbook on stem cell research, defining the issue in terms of social progress and economic competitiveness, arguing that stem cell research offered great promise for medical advances and that the U.S. risked losing scientists to other countries if research did not move forward. However, unlike some other stem cell advocates and politicians, Obama was careful to be clear about the uncertainty in both the efficacy of therapies and the timeline for their availability.
Yet perhaps most importantly, Obama was explicit in acknowledging that science alone did not drive policy choices and decisions. He, in fact, was careful to articulate the second premise that lay behind his decision. First, he defined his decision in terms of a religious duty to help those in need. Second, he cited his governing duty to be in line with the wishes of a majority of Americans. (Though here the poll numbers fall short of his characterization. In fact as a consequence of Dems using stem cell research as a electoral wedge issue, the divide in support between Republicans and Democrats has actually widened since 2004.):
As a person of faith, I believe we are called to care for each other and work to ease human suffering. I believe we have been given the capacity and will to pursue this research - and the humanity and conscience to do so responsibly... The majority of Americans - from across the political spectrum, and of all backgrounds and beliefs - have come to a consensus that we should pursue this research. That the potential it offers is great, and with proper guidelines and strict oversight, the perils can be avoided. That is a conclusion with which I agree. That is why I am signing this Executive Order, and why I hope Congress will act on a bi-partisan basis to provide further support for this research.
In stating the moral and religious reasoning behind his decision, Obama is no different than Bush, who was equally open about his normative framework; it's just that Bush's framework led to a very different policy outcome. As a direct parallel to Obama's religious reasoning, consider this statement from Bush's 2001 speech announcing his compromise funding for stem cell research:
My position on these issues is shaped by deeply held beliefs. I'm a strong supporter of science and technology, and believe they have the potential for incredible good -- to improve lives, to save life, to conquer disease.... I also believe human life is a sacred gift from our creator. I worry about a culture that devalues life, and believe as your president I have an important obligation to foster and encourage respect for life in America and throughout the world.
Or this 2006 speech announcing his decision to veto stem cell funding legislation, delivered a press conference where he was surrounded by "snowflake babies," children born from so-called spare embryos:
This bill would support the taking of innocent human life... Each of these human embryos is a unique human life with inherent dignity and matchless value...These boys and girls are not spare parts.
This recognition of the first and second premise also comes through in Obama's statement on scientific integrity, though not as clearly as it should be articulated. In short, Obama's directive to his science advisors to "develop a strategy for restoring scientific integrity to government decision-making" is about protecting the ability of scientists to establish the first premise, to be free to accurately identify through research potential opportunities and risks to society.
This is the big difference between the Obama and Bush administration. When it comes to the second premise, both apply their own set of values in deciding how to take policy action on the conclusions of science. As a matter of governing there is no way to avoid applying values to craft science policy.
Where they appear to differ is that the Bush administration was also willing to move into the territory of the first premise, actually shaping, re-interpreting, or obstructing what scientists might conclude about opportunities and risks to society.
Finally, even Obama's decision to leave the specifics of policy to the NIH flows from his values and his political strategy for implementing those values. As I have shown in several studies, when a President or political actor shifts scientific debate away from an overtly political arena such as Congress or the White House to an administrative arena such as the NIH, it serves to limit the scope of participation in decision-making, favoring the views and preferred frames of scientists, industry, and academic ethicists rather than other interest groups who have a stake in the outcome. Delegating to the NIH is therefore a favorable move for Obama, but not for his opponents on stem cell research.
Subsequent to his 2001 decision, Bush applied a similar strategy though just in the opposite direction, delegating decision-making about ethics to his President's Council on Bioethics, a context where the terms of debate could continue to be controlled by the White House and that gave greater participation to stakeholders who normally might have little access or influence over NIH decision-making. The Bioethics Council was a favorable move for Bush constituents, but not for his opponents, including scientists.
News reports, for the most part, have missed this important aspect of Obama's decision, failing to recognize that just like Bush, Obama has imposed his own values in setting stem cell policy. Sheryl Gay Stohlberg gets it right at the NY Times. Ironically enough, in an op-ed at the Washington Post, Yuval Levin gets it wrong. He carefully notes the importance between the first and second premise in science policy, but doesn't give Obama credit for explicitly laying out the normative framework that shaped his decision.
Upstreamism advocate Rishi Manchanda calls us to understand health not as a "personal responsibility" but a "common good."
- Upstreamism tasks health care professionals to combat unhealthy social and cultural influences that exist outside — or upstream — of medical facilities.
- Patients from low-income neighborhoods are most at risk of negative health impacts.
- Thankfully, health care professionals are not alone. Upstreamism is increasingly part of our cultural consciousness.
Researchers hope the technology will further our understanding of the brain, but lawmakers may not be ready for the ethical challenges.
- Researchers at the Yale School of Medicine successfully restored some functions to pig brains that had been dead for hours.
- They hope the technology will advance our understanding of the brain, potentially developing new treatments for debilitating diseases and disorders.
- The research raises many ethical questions and puts to the test our current understanding of death.
The image of an undead brain coming back to live again is the stuff of science fiction. Not just any science fiction, specifically B-grade sci fi. What instantly springs to mind is the black-and-white horrors of films like Fiend Without a Face. Bad acting. Plastic monstrosities. Visible strings. And a spinal cord that, for some reason, is also a tentacle?
But like any good science fiction, it's only a matter of time before some manner of it seeps into our reality. This week's Nature published the findings of researchers who managed to restore function to pigs' brains that were clinically dead. At least, what we once thought of as dead.
What's dead may never die, it seems
The researchers did not hail from House Greyjoy — "What is dead may never die" — but came largely from the Yale School of Medicine. They connected 32 pig brains to a system called BrainEx. BrainEx is an artificial perfusion system — that is, a system that takes over the functions normally regulated by the organ. Think a dialysis machine for the mind. The pigs had been killed four hours earlier at a U.S. Department of Agriculture slaughterhouse; their brains completely removed from the skulls.
BrainEx pumped an experiment solution into the brain that essentially mimic blood flow. It brought oxygen and nutrients to the tissues, giving brain cells the resources to begin many normal functions. The cells began consuming and metabolizing sugars. The brains' immune systems kicked in. Neuron samples could carry an electrical signal. Some brain cells even responded to drugs.
The researchers have managed to keep some brains alive for up to 36 hours, and currently do not know if BrainEx can have sustained the brains longer. "It is conceivable we are just preventing the inevitable, and the brain won't be able to recover," said Nenad Sestan, Yale neuroscientist and the lead researcher.
As a control, other brains received either a fake solution or no solution at all. None revived brain activity and deteriorated as normal.
The researchers hope the technology can enhance our ability to study the brain and its cellular functions. One of the main avenues of such studies would be brain disorders and diseases. This could point the way to developing new of treatments for the likes of brain injuries, Alzheimer's, Huntington's, and neurodegenerative conditions.
"This is an extraordinary and very promising breakthrough for neuroscience. It immediately offers a much better model for studying the human brain, which is extraordinarily important, given the vast amount of human suffering from diseases of the mind [and] brain," Nita Farahany, the bioethicists at the Duke University School of Law who wrote the study's commentary, told National Geographic.
An ethical gray matter
Before anyone gets an Island of Dr. Moreau vibe, it's worth noting that the brains did not approach neural activity anywhere near consciousness.
The BrainEx solution contained chemicals that prevented neurons from firing. To be extra cautious, the researchers also monitored the brains for any such activity and were prepared to administer an anesthetic should they have seen signs of consciousness.
Even so, the research signals a massive debate to come regarding medical ethics and our definition of death.
Most countries define death, clinically speaking, as the irreversible loss of brain or circulatory function. This definition was already at odds with some folk- and value-centric understandings, but where do we go if it becomes possible to reverse clinical death with artificial perfusion?
"This is wild," Jonathan Moreno, a bioethicist at the University of Pennsylvania, told the New York Times. "If ever there was an issue that merited big public deliberation on the ethics of science and medicine, this is one."
One possible consequence involves organ donations. Some European countries require emergency responders to use a process that preserves organs when they cannot resuscitate a person. They continue to pump blood throughout the body, but use a "thoracic aortic occlusion balloon" to prevent that blood from reaching the brain.
The system is already controversial because it raises concerns about what caused the patient's death. But what happens when brain death becomes readily reversible? Stuart Younger, a bioethicist at Case Western Reserve University, told Nature that if BrainEx were to become widely available, it could shrink the pool of eligible donors.
"There's a potential conflict here between the interests of potential donors — who might not even be donors — and people who are waiting for organs," he said.
It will be a while before such experiments go anywhere near human subjects. A more immediate ethical question relates to how such experiments harm animal subjects.
Ethical review boards evaluate research protocols and can reject any that causes undue pain, suffering, or distress. Since dead animals feel no pain, suffer no trauma, they are typically approved as subjects. But how do such boards make a judgement regarding the suffering of a "cellularly active" brain? The distress of a partially alive brain?
The dilemma is unprecedented.
Setting new boundaries
Another science fiction story that comes to mind when discussing this story is, of course, Frankenstein. As Farahany told National Geographic: "It is definitely has [sic] a good science-fiction element to it, and it is restoring cellular function where we previously thought impossible. But to have Frankenstein, you need some degree of consciousness, some 'there' there. [The researchers] did not recover any form of consciousness in this study, and it is still unclear if we ever could. But we are one step closer to that possibility."
She's right. The researchers undertook their research for the betterment of humanity, and we may one day reap some unimaginable medical benefits from it. The ethical questions, however, remain as unsettling as the stories they remind us of.
Can you make solar power work when the sun goes down? You can, and Dubai is about to run a city that way.
- A new concentrated solar plant is under construction in Dubai.
- When it opens next year, it will be the largest plant of its kind on Earth.
- Concentrated solar power solves the problem of how to store electricity in ways that solar pannels cannot.
Believe it or not, for a few decades, giving people "milk transfusions" was all the rage.
- Prior to the discovery of blood types in 1901, giving people blood transfusions was a risky procedure.
- In order to get around the need to transfuse others with blood, some doctors resorted to using a blood substitute: Milk.
- It went pretty much how you would expect it to.
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