 Ladies and gentlemen, I have an introduction to make at this time. On page nine of the program you will see the information about the Carol Horne Fraser paintings. The reception this evening at eight o'clock is not the only time that the paintings can be seen. They are available for you at any time during the conference. Carol Horne Fraser is here. I'd like Carol, if you would please stand for a moment so people will see who you are and know where you are. Thank you. I have a double pleasure at this session to introduce Patricia Dean, a colleague of ours in the faculty who will introduce Karen Labax. I say a double pleasure because working with Patricia is a pleasure for me in the number of programs that we have cooperated with. And I have known Karen Labax since 1973 when we were participants in a seminar sponsored by the Hastings Center in Berkeley, California. But I will let Patricia do the introducing, Patricia Dean. There are several things that you should know about our second speaker besides what you find in your program. The first and most useful, Bob S. Bjornsson has already revealed and that is how to pronounce her name, Karen Labax. The second thing that you should know is that on her mother's side she is Norwegian, which is absolutely the best proof you can have that Gustavus Adolphus College is truly an open-minded institution and that this will truly be an unbiased conference. The third point is that she began life as a Lutheran but went astray as an adult and joined the United Church of Christ. All of these are minor offenses and we do welcome her to the Nobel Conference. There is good reason for our welcome. To begin with, her academic credentials are impeccable. She is a Phi Beta Kappa graduate from Wellesley College with a master's and a doctor's degree from Harvard. Among the numerous fellowships and consultancies which she has held are as a Kennedy fellow in medical ethics at Harvard, as a fellow of the Hastings Center, as a consultant for the California State Department of Health, and as a consultant for the National Cancer Institute. She has published widely. Her most recent publication, which is due to come out shortly, is Professional Paradox, Morality in Ministry. I haven't asked her about that title. I will let the ministers in the audience speculate about that. Karen LeBax brings to this platform a thorough and thoughtful grounding in the issues of medical ethics, having begun her research, writing, and speaking in that area over a decade ago. We look forward to benefiting from her exploration in the ethics of medicine as she delivers her address, the ghosts are on the wall. Karen? Thank you, Pat and Bob. It's traditional to begin such a lecture by telling you what an honor and a privilege it is to be with you. I would therefore like to begin by telling you what an embarrassment it is to be with you today. I come before you as the only self-acknowledged theologian on this panel. I'm probably not the only real theologian, but the only self-acknowledged one. In a day when theologians have recently made a name for themselves by saying a resounding, thou shalt not, on the very subject that we are discussing. In June of this year, a group of eminent clergy and theologians joined by several scientists signed a petition urging Congress to seek a ban on certain types of genetic engineering or perhaps better put, gene splicing. It is not the first time in the last ten years that public concern over new technologies has run high, nor is it the first time a ban has been sought. Nonetheless, the clergy involved have been derided for naivete and accused of apocalypticism and panic. Therefore, the speech that I had originally planned to give you, which was written about a year ago, is not the speech that I give you today. Hence, my embarrassment is not only being a theologian at a time when theologians seem to say, thou shalt not, but is also to my friend Bob S. Bjornsson, to whom I made great promises about what I would do, which are not, in fact, what I will now do. In the face of this current situation, and I really did not see how I could ignore it, I cannot help but think of a delightful children's song written by United Church of Christ minister Tom Hunter. The song is a child's lament, and the chorus goes as follows. There is a monster in the closet, and the ghosts are on the wall. So why do you keep on telling me there's nothing there at all? I know they're there. It's clear to me. I see them every night. And all I want is when I'm scared, you come and hold me tight. As Tom Hunter puts it, kids aren't the only people who know about them, nor are they the only people who want to be held tight. We all have monsters in the closet and ghosts on the wall, shadowy figures that threaten the security of our dreams. And any of you who remember your own childhood will know that to say to a child there's nothing there at all is not an adequate response. Now for some people today, new technologies in genetics are offering dreams of promises come true, perhaps the eradication of disease, the betterment of human life, or the solution to nagging theoretical and practical problems. But for others, these new technologies are more like the ghosts on the wall, threatening values and dreams held dear. Is there a monster in the closet? Are the ghosts on the wall? And if so, what would it mean to come and hold each other tight in the face of the threat? I hope to argue to you today that the ghosts are on the wall and that there may indeed be a monster in the closet and that the mechanisms that have been proposed thus far for holding each other tight are not the appropriate mechanisms. Let me begin with a very rapid overview of only a few of the ghosts. Now the new technologies in genetics cover everything from in vitro fertilization to artificial insemination, genetic screening and counseling techniques, prenatal diagnosis, and selective abortion. And of course, the question that I think is before us primarily today is that of so-called genetic engineering or gene splicing. For our purposes here today, I will limit my comments to the ghosts and the monster that may be related to gene splicing. I have discussed some of the other issues in a small volume which I edited done for the United Church of Christ. The ghosts that surround the development of techniques for genetic engineering include at least the following. Biohazards, will we produce organisms that are potentially harmful to human beings and that cannot be controlled. Most people, and I think Lewis Thomas this morning, indicates that he would fit with them, no longer consider biohazards to be a great concern. We like to think that the mechanisms of physical containment that are now in place will be adequate to the task of controlling the possible hazards of new organisms. Nonetheless, we have no guarantee that we might not create an organism that would be hazardous to human life. Sparked by science fiction scenarios, other people worry not just about biohazards, but about whether we will create human animal hybrids, people with enormously long arms so that they are really half person and half ape, and they can reach to the top shelf where I can't reach. If we were to create such beings, what would they be? Would they be human? Would they be animal? Would they have any rights? Where would they fit in our society? Most people today consider this to be pure speculation. And yet, the ethical issues about animal rights and human rights are important issues that we have not totally resolved. And so we have another ghost on the wall. Perhaps more important, certainly in my opinion, is the question whether we will focus our energies on the correction of defect or on the improvement of human qualities, be they intelligence or beauty or whatever we might happen to value. Now again, most people, and I think Lewis Thomas among them, would suggest that we will use these techniques when they are developed only for the correction of obvious defect. But I like to think of myself as a person who is not defective. And yet, for decades and even centuries, women have been considered, by definition, defective. And so have those whose skin is black or brown, red, or what we call yellow, and does not fit that sort of unearthly pink that we, in our anthropomorphic way, like to call flesh color. Who defines what is a defect? That, of course, then takes me to another ghost on the wall, the question of who will control the vast powers that we might create. Surely these techniques are not accessible to the public at large, but require such refinement of skill that they will be largely in the hands of the few. Many people, including the president's commission, which recently expired after writing a lovely document on genetic engineering, even the president's commission, which is otherwise very circumspect and largely very supportive of the scientific endeavor, even that commission urged vigilance about who will control new technologies. And finally, I come to the ghost that has sparked the recent controversy with the clergy. Will we focus our efforts on the correction of somatic cells, or will we attempt to do research into what is called the germ cells? As one of the signatories of that petition put it, are we justified in taking risks with human life, especially when an entire lineage of descendants will be affected by our intervention? It's one thing to put a single human being or even a single family at risk. It may be another thing to threaten an entire lineage. So the ghosts are on the wall. The questions are not resolved. Nonetheless, and here I do agree, I think, with Lewis Thomas to a large extent. Nonetheless, the basic issues raised by these ghosts are not new. Which kinds of risks are acceptable in research? That's not a new issue. What does justice require between the current generation and generations to come? That's not a new issue. Is the germ line or something about the way we generate new human life inviolable in some way? That's not a new issue. Where should power be located in human society? That's not a new issue. And so important, though these issues are, and they are unresolved issues, I call them ghosts, and I do not think that they are a monster. I think they are ghosts on the wall. They are shadows of familiar things cast in an unfamiliar light. The fact that the light is unfamiliar should not blind us to the familiarity of some of the issues. It is possible that if we look harder, some of these ghosts will turn out to be nothing but the wind blowing the curtains or the street light reflecting through the lamp and casting peculiar shadows. Nonetheless, the issues are real, and they do call for considerably more sustained discussion than some would urge. But these are only ghosts on the wall, and I really want to focus today on whether there is a monster in the closet and if so, what it might be. In its report, the president's commission proposed that the monster might be one of two things. It didn't use the language of monster. This is my interpretation. It focused quite a bit on what it called the Frankenstein factor, arguing that one of our basic fears is that we will create something that is both other than human and is on some level a threat to human life. In short, a concern about the consequences of the powers that we would wield. Now, I really think that this Frankenstein factor is nothing but a summary of all the ghosts that I've already talked about, the fears of the dangers that we might create, the fears of our inability to resolve some of the deep ethical issues, the fears about who will control new powers and the like. So I will dismiss the Frankenstein factor. However, at the same time, I want to argue that the very term chosen by the president's commission is an unfortunate term. As soon as we hear the word Frankenstein factor, we think, oh, Frankenstein, that was just a science fiction novel, and now it's a late night movie that you can watch about every four weeks as it comes around again on some channel or other. And so we tend to put it aside and not take it seriously. The ghosts are to be taken seriously. But the ghosts are not the monster, and I do not think the Frankenstein factor is the monster. What then might it be? The other suggestion that's very common today is that the monster might be our propensity to play God, to try to extend human power and gain control over things that we have never controlled before, to know something that is unknowable or ought not to be known, perhaps to become creator instead of creature. Most religious faiths encourage the growth of knowledge and the exploration of nature. And yet most also see limits to human knowledge and limits to human control. Mythologies express these limits by describing us as creatures instead of creator. Now these new technologies appear precisely to thrust us into the role of creator, and so we talk about playing God. And we wonder whether playing God is the hidden monster in the closet that might devour our dreams. I think the issue is misplaced. There is nothing wrong with playing God. Nowhere in Judeo-Christian tradition is there anything wrong with playing God so long as we know that we are only playing and that God remains God in spite of all our play. There's no problem. Human beings were meant to play. But when we confuse play and reality, then we have a problem. Let me illustrate from the book of Job. The book of Job, you say? Job is usually taken to be a book about human suffering. It's a book about the problem of theodicy. Why is there evil in the world and why do the righteous suffer? And that is true. Job is all of those things. But on another level, the book of Job speaks not simply to the substantive issue of suffering but to a fundamental methodological issue which is precisely what kinds of questions should we ask? The book of Job invites us to challenge the very ways in which we think. It invites us to question human logic and paradigms. It invites us to learn to ask different questions. Now in this story, if you remember, Job is an innocent man. In fact, the book begins with God proclaiming Job's righteousness. Have you considered my servant Job? He is blameless and upright. To this, of course, Satan retorts, well, he is only innocent and upright because he's never suffered. If you took away your protective shield and let him suffer a little bit, then he wouldn't be so good anymore. So a bargain is struck. And there follows a litany of the sufferings inflicted upon Job by Satan in an effort to make Job abandon God. All of his children are destroyed. All of his flocks are destroyed. All of his herds are destroyed. All of his possessions are destroyed. And finally, his own body is afflicted with sores and lesions, almost unto death. Now think for a moment about what this looks like from Job's perspective. I have always been a blameless and upright man. Why am I suffering so? And the bulk of the book is the series of arguments between Job and his friends about whether it is right that Job should suffer. Is his suffering merited in some way? Appearance is notwithstanding, in spite of the fact that Job appears to be an innocent man. His friends argue that he must be guilty or he wouldn't suffer. Job argues that he is not guilty and that his suffering is unmerited and God is being unjust. It appears as though Job and his friends are on opposite sides of the issue. The friends think he is guilty. Job thinks he is innocent. Yet underneath this disagreement, they share a common assumption. All think that only the guilty should suffer. Since Job, in fact, suffers, his friends jump to the conclusion that he must be guilty. Since Job knows that he is not guilty, he declares his suffering unjustified. But all of them are operating on the same basic paradigm. Only the guilty may justifiably be made to suffer. Now, at the end of the story, as you recall, God vindicates Job in Job's understanding of divine justice. But God also rebukes Job, and it is in the rebuke that we find something important for our purposes. To Job's demand for justice, to his demand that he be vindicated, God responds, where were you when I laid the earth's foundation? Have you ever given orders to the morning? Have you journeyed to the spring of the sea? Who cuts a channel for the torrents of rain? From whose womb comes the ice? And the litany goes on and on at some of the most beautiful passages in the Bible. Where were you when this happened? Can you do this? Did you do that? And in the midst of this litany, this rebuke, appear these words. Who has a claim against me that I must pay? Everything under heaven belongs to me. What happens in the rebuke is this. Job has approached God with the language of justice. God responds with the language of creation. God's response changes the rubrics of the conversation from those of justice to those of creation. The rebuke constitutes a challenge to the paradigm accepted in common by Job and his friends. The rebuke suggests that Job, though righteous, has asked the wrong question. Within the limits of human vision, within the limits of the paradigm presented by Job and his friends, Job was right. But the paradigm itself was wrong. And so it might also be with us. While right within the limits of human vision, we might nonetheless be asking the wrong questions. Like Job, our very paradigms might be wrong. Consider, for example, that in the passage that I just read to you out of the book of Job, God says very clearly, from whose womb comes the ice and yet for centuries we have persisted in calling God male and father and he in spite of the obvious reference to a female God. If there is a monster in our closet then, I do not think it is the new technologies themselves, nor even the powers they would give us. I do not think it is the Frankenstein factor that collection of fears about the consequences of what we do, nor do I think it is our propensity to play God or try to extend human powers. I think it is our failure to be suspicious about our own paradigms. Job was a righteous man, blameless and upright, and yet his vision was limited, his question wrong. I doubt that many of us can claim the same righteousness Job did. Could it always be said of us that we gave to the poor, honored the socially outcast, took in the widow and the orphan? I know that I cannot say it of myself. If even the righteous can ask the wrong question, how much more so might we? In fact, I am now inclined to think that even I, in some of my earlier work, have misunderstood the nature of the monster. Like Jeremy Rifkin and others, I once thought that the monster lay in our desire to control, and I would still urge a stance of humility and urge us to be cautious about the limits of human control. But I no longer think that the issue is just a question of our desire to control. So even the monster may have been posed wrongly because we have brought the wrong paradigms into the situation. Job and his friends appeared to be on opposite sides of an argument, and yet they shared a basic paradigm, and that paradigm itself was the problem. So also I would argue that many who appear to be on opposite sides of the issue today actually share a common paradigm, and that paradigm may be the problem. For instance, those on both sides of the current debate about whether we should move forward with genetic technologies or whether we should urge bands or moratoriums or whatever, those on both sides of the debate tend to think that what we should do depends on how much we know. If we know enough, then we can act. If we don't know enough, we should be cautious and not act, and some, of course, would say, well, how can we ever come to know enough without risking a little action here and there? All of them, though they appear to be on opposite sides of the policy issue, seem to assume that whether we act or not is a function of what we know. And I would further suggest that they tend to take knowledge in a rather narrow way. By knowledge in this debate is largely meant reason, scientific evidence, and logic. Let me take as my example the recent work of the President's Commission. Cautious and careful, attuned to subtle distinctions and innuendos, modest and amazingly thorough for its short space, the report of the President's Commission on Genetic Engineering or Gene Splicing is, in some ways, a model for ethical analysis. It is the very sort of thing that I am always urging my own students to do. Yet as I read the report, I got more and more uncomfortable. I began to have the feeling that too much depended on logic and rationality. The report calls for a dispassionate appraisal, sober recognition. It looks for the rational kernel underneath the fears and admonitions. No room is made in this report for passionate appraisal. No room is made for a form of knowledge that in biblical tradition is prophetic knowledge. The word of passion that nonetheless has substance. No room is made in this report for a form of knowledge that goes beyond logic and rationality. In its discussion of playing God, the Commission lines out the various alternatives for what that phrase might mean and proceeds to knock them down one by one in the assumption that if we can show that all of these possible alternative meanings don't hold water, then obviously we don't need to worry about playing God. Now, I've already told you that I'm not worried about playing God, and I don't think it's the issue. But I think the Commission's approach to that issue is wrong. Is it possible that we could knock down logically all of the alternatives, and yet that there still might be reason for anxiety? I think so. Two problems are hidden by this trust in rationality and logic that is exhibited in the Commission's report and elsewhere. First, the report gives the impression that we can set aside our biases, that there is such a thing as an objective answer good for all people in all time and totally unaffected by the whims, the wills, and the interests and biases of human beings. This ignores the deep biases that are built into Western forms of thought. And this leads, of course, to the second problem. It also ignores many forms of thought or knowledge which are honored in other cultures and which might provide modes of insight. Prayer, meditation, dreams, the cry of pain from a child, the insight that comes as a gut-level response. All these and many more are recognized as sources of knowledge in other traditions, but largely ignored in our own. To depend on the forms of knowledge that are honored in this culture is not only to ignore our biases, but is to ignore other sources of insight. So I think that there is a monster in the closet, but it's not just the possible harms or the technologies themselves. Nor is it just that our deeply held values will be threatened. I think it is our tendency to trust in the limited forms of human knowing that we consider to be knowledge and to trust in the paradigm that says what we should do depends on what we know. The monster is our tendency to think that God or reality should be conformed to our paradigms just as Job fought that God should be conformed to his paradigm. To assume that we can even pose the questions correctly is not merely to play God, but is to try to be God, and this is a problem. Now, if this is true, and if this is the nature of the monster, how do we come and hold each other tight? I think there are some ways that are being proposed today that do not work. One of those is to say there's nothing there at all. These issues do not merit your attention. Those who deride the clergy for panic or assume that they were simply taken in by Jeremy Rifkin are mistaken. Many of these theologians have worked in this area for a long time, and their concerns were there long before Jeremy Rifkin got into the act. Many of these theologians were influential in getting the president's commission established in the first place and putting genetic engineering on its agenda. The clergy's concerns are not recent, nor are they the simple result of one man's campaign. Belittling the concerns by saying there's nothing there at all, you're being childish, is not the proper response. At the same time, I would have to say that calling for a ban on research does also not strike me as the proper way to come and hold each other tight in the face of the monster. If what I have said above is correct, then the question is not so much to stop what we do but to change how we think about it. The problem is not whether we proceed with research, but what are the paradigms that we use even to think about that research. Nonetheless, the clergy do have some force in calling for a ban or at least a moratorium since thinking new thoughts and being open to new insight does take time. Finally, I'm a little skeptical about the establishment of another national commission. I served on a national commission for four years. It was a good commission. It left, I think, an important legacy protecting human subjects of research. My fellow commissioners and I differed greatly, and yet, like Job and his friends who differed greatly but shared some basic paradigms, I am not convinced that a national commission for all of its diversity may not operate out of some shared paradigms that may be themselves the problem. We could be right and yet also wrong as Job was. How, then, do we hold each other tight? I have two proposals. First, we need to exercise what I call a hermeneutic of suspicion, a way of interpreting the world around us with great suspicion that goes to radical depths. We should be suspicious not only about the consequences of technologies, not only about what we might do, not only about who will control, but even about how we are thinking about and framing questions about these technologies. We should be suspicious about what constitutes knowledge in this arena. Now, how do we get such a hermeneutic of suspicion? Well, to be very honest with you, if one is a woman or a member of a minority community in this country, it is not hard to come by a certain amount of suspicion about the way we have been told the universe works and what our place in it is. We have long been suspicious of the logic and rationality that tells us that we are inferior by nature, the logic and rationality that is paraded before us by those in power in this white male-dominated society of ours with all of its white male-dominated institutions. Similarly, those from the so-called Third World, I don't like that designation, but I use it so that you will know the people of whom I speak, those from the so-called Third World hold deep suspicions about white Western paradigms. One way to find a hermeneutic of suspicion is to take more seriously the voices of the oppressed, both here and abroad. This is difficult for us to do. It's difficult for us to do partly because the voices of the oppressed, like the child crying in the night, often are cries of pain or fear or rage or exasperation or incredulity, and they appear irrational. We are not attuned to looking for a deeper level of rationality and a deeper level of truth in those cries of pain that seem irrational. How, then, can we learn to listen to the oppressed, to hear different rubrics, to honor different paradigms than the paradigms that are dominant in our culture? At this point, I think the Bible has much to offer us. Biblical authors knew how difficult it is for people to transcend their own traditions, and so at crucial points, they offered us little stories which we call parables. A parable is like a picture puzzle. This is my favorite definition of a parable. A picture puzzle which prompts the question, what's wrong with this picture? A parable is a story told that invites the listener to step into the story. A man had two sons, and immediately you think of yourself as either the man or one of the sons. And then as the story goes on and the picture unfolds, all of a sudden, something unexpected happens, something odd or unusual or out of the ordinary, and you are forced to ask, what's wrong with this picture? What happened here? Where am I now in this picture? Jesus told many parables. We have often wrongly taken these to be little stories that give us rules to live by. So for example, we take the parable of the Good Samaritan to be a story that tells us that we should help our neighbor when our neighbor is in need. I can't tell you how many times I have sat in church and listened to somebody preach to me about the parable of the Good Samaritan telling me to go and help my neighbor. Now for just a moment, put yourself in the position of Jesus' original audience and consider whether that is in fact what this parable is all about. Jesus is speaking to a group of Jewish people, and he begins. A man was walking down the road. They assume that he's talking about a Jewish man. They have no reason to think otherwise. Indeed, they probably identify with that man. A man was walking down the road. And so as the story unfolds, the listener thinks of herself or himself as that man who got robbed and attacked and beaten and is left lying at the side of the road. And the question is, what is going to happen to me and is anybody going to come and help me? The twist in the story comes. When the story goes on to say, a Samaritan is going to come and help you. Jews and Samaritans had been enemies for more than 400 years. And the idea that a Samaritan would help a Jew is a little bit like telling Ronald Reagan that it is the Russians who will help him when he is in need. It's a little bit like telling the black person in our society that it is the member of the Ku Klux Klan who will come and help you when you are in need. That's what it felt like to the Jews listening to Jesus tell this story. The point of the story is not to tell the listener to go and help somebody else. The point of the story is to challenge the worldview that says my enemy would never help me. My enemy is my enemy. Jesus is saying your enemy is your friend. Your enemy is your neighbor. The book of Job, taken in its entirety so we don't focus just on the question of suffering, but focus on the rebuke given by God to Job, is a parable. We heard the story. We know that Job is innocent and upright. The rebuke is totally unexpected. What you expect is for God at long last to come down and vindicate Job, not rebuke Job. The rebuke jolts the listener and forces a new perspective. In this case, the shift from the language of justice to the language of creation. The parable forces the listener to look at the paradigms that we bring with us, the questions that we ask, and to see that the order and coherence and regularity in human life may not be all that there is to rationality. In short, parables bring us face to face with the limitations of our paradigms, our ways of thinking about the world. They provide a way for us to hold each other tight, not by clinging to what we know, not by setting up rules and regulations and more procedures and more government bureaucracies, but precisely by opening up new possibilities and new questions. There's a monster in the closet and the ghosts are on the wall. So why do you keep on telling me there's nothing there at all? I know they're there. It's clear to me. I see them every night. And all I want is when I'm scared, you come and hold me tight. The ghosts are on the wall, and there may be a monster in the closet. Let us learn from the book of Job and hold each other tight by being suspicious of the neat, tight little systems that we have created and opening ourselves up to the parables of life. Thank you. Karen, I'll invite your colleagues to come again to the tables and the ushers to collect questions. And we'll begin our conversation number two. I would like to invite the panel members to comment first. And I'm not going to call on you. And you don't have to. Oh, Willard Galen is ready to go. May I have your attention, everyone, please? We're beginning our conversation. If I understood Karen's message properly, she is complaining that we're using the wrong paradigms and asking the wrong questions. Since the paradigms that we've been using over the last 15 years at the Hastings Center have involved the nature of human nature, autonomy, question of human dignity, the distinction between rights and responsibilities, the obligations to the individual versus the obligations to society, the nature of integrity, whether the human species is mutable or not mutable. Since these are all the wrong paradigms, I would like to hear from Karen, faced with this technology, as Louis Thomas expressed it this morning, with the kind of development and background that it has had, what are some of the right questions? I want her to put us on the right track. We've been going wrong for 15 years. What are some of the right questions we should be asking, Karen, and what are some of the proper paradigms? Can you hear me out there? OK. It's a very important question. If I think that our paradigms are wrong, then how do we get a right one? And what would a right one be? Let me tell you a story. The story is about a fisher person who went out day after day with a net. And you know how fishing nets are made. They're string or twine, and it's woven. So there are holes in it so that it becomes flexible. And usually the holes are all of the same size. So this fisher person would go out day after day and cast this net into the water. And at the end of the day would bring home a catch of fish. And after doing this for years and years and years, eventually, she or he concluded that the only fish in the sea were the ones that got caught in the net. The idea that there might have been fish that were too small and actually managed to swim right through the holes in the net was considered at one point, but eventually dismissed. And the idea that there might have been fish so big that as the net was thrown, they simply swam under or around it was also considered at some point but eventually lost. And so after a time, this fisher person convinced everyone that there were only fish of a certain size in the sea. That's my answer. I want to just make an amendment to that. Since the nets we've been using have been the nets of Plato, Aristotle, St. Thomas, St. Augustine, Kant, Descartes, Hume, and Spinoza, since those are the nets, I'm more than prepared to assume that we will be using the nets of Labox and Younger Kant's and Descartes. But since those are all the nets that we've been using, I'm not clear, and you'll have to take me through this parable a little more closely than the parable of the Good Samaritan. I do want to make it clear that I am not arguing against the use of logic and rationality. I hope that what I presented to you was a relatively clear, logical, and rational analysis of something. I'm not arguing against the use of those, which are the paradigms that we have used. I'm only suggesting that at the same time that we use those paradigms, we may be missing other paradigms that might indeed be available. I doubt very much that they will be available to you from Karen Labox, because Karen Labox is white, middle class, and Western, highly trained and educated, and therefore, to a certain extent, cannot help but think in the paradigms of Plato, Kant, Aristotle, and the like. But there are other paradigms available in the world that may come to us in a kind of inchoate form that we don't readily recognize, and yet they might contain a truth that would be important for us to take account of as we look at the very serious issues that are facing us about the ghosts on the wall around genetic technologies. Are you suggesting that from other cultures there are maybe more intuitive or imaginative kinds of thinking? We haven't really encouraged playfulness, except in the arts. Maybe we need some really new breakthroughs in the fields of ethics and related fields that will take into account this sort of thing? Yes, I am. And I will say that it's a pleasure to be speaking to you about this in an arena where hockey is played on occasion, and where there are beautiful banners and statues and wonderful brass music played. All of those other ways of knowing and being in the world do have things to teach us. I, as an ethicist trained in Western tradition, don't totally know how to make use of them. If I could sing or dance, I might simply have done that instead of giving you a lecture. But I can't, so I'm left with the skills that I have which are not many. But I hope that we might learn how to take advantage of some of those other ways of knowing and being. OK. This is Dr. Anfanson to share and mention the word learning. And it really isn't directly bearing on the topic. But I was thinking of a story that a man I worked with in Copenhagen told a number of times, Linister Mlang, a very clever man, and in bringing out how easy it was to learn, if you really put your mind to it. They had a cat, apparently, in the family. Used to go up on the second floor and jump on their bed and do its business there and then go away. And this happened month after month. So finally, every time they cut and they'd rub his nose and throw him out the second-story window. And after about a month, the cat would go up, grew up, and jump on the bed and do his business and rub his nose and throw itself out the window. I couldn't have told a better parable. I've never been in on a debate between parables before. Dr. Groepstein on the far left. I tend to look at the subject that we're discussing primarily from a public policy point of view. It has been observed frequently that, at least in our political system, that we more often establish public policy by finding accommodation among paradigms than we do arguing about them. Generally speaking, the people who come together and support some particular way to deal with a contentious issue do not argue their rationales, at least not for very long. And I suspect that on the commission that Dr. LeBach served so well on that this was the case. They did not resolve their fundamental principle differences, but rather they found ways of accommodating, simply finding the least common denominator in terms of the conflict produced. I'm not clear what Dr. LeBach has in mind as a convergence that would be achieved by the approach that she's suggesting. What groups, whether within our own political system or around the world, third world, or where have you, what groups are likely to come together or to be brought together to converge in their approach to this problem following the approach that she used to get? First, let me say that I think the commission that I served on did quite a good job of arguing about its paradigms, but there were probably some that went so deep that we did not even recognize that we operated out of them. Now you ask, what would it take then to have a group sufficiently diverse that there could be a genuine conflict of paradigms and that some other kinds of voices could be heard? I venture to say that there are not many countries in the world in which one would even hold a conference on the very issue that we are talking about today. These are relatively elitist questions that we are here considering. If you were to take seriously the voices of the oppressed around the world, including those right here in our own culture, one does not need to go beyond the boundaries of any major city in our country, certainly not beyond the boundaries of the country, to hear the voices of those who have been relatively voiceless, who have not had power, most of those people would come before you with cries of pain saying these are not the issues for us, and that might be an important voice for us to hear. Again, that does not mean that the work we do on these issues is unimportant, but it does mean that as we do our work on these issues, we need to be, as one person put it, parable, we need to be open to and challenged by the stories, the voices that don't seem quite so logical and rational to us, and that's what I am urging on us here today. Of course, in order to do that, I have to urge it on us with a certain amount of rationality, so I undermine my own point in some ways by my methodology. It's very difficult to convince a Western audience with anything other than the kind of rational argument that you are calling for. Well then, as I understand it, your feeling is that it is not only the wrong paradigms, but the wrong issue that is being addressed. Well, we may. And I'd have to point out that if one uses the term elitist and says that the kind of approaches that we make are elitist, then of course one has to respond that it is only this kind of society that produces this kind of problem through its scientific activity, and it is this kind of society that presumably has to cope for it and assume responsibility for finding appropriate solutions. Yes, but even as we assume that, we also assume the givenness of our society and where it is. And I am asking, is it possible that we make a mistake when we do that, that we think of ourselves as an entity onto ourselves that has the freedom to operate out of where we have come historically rather than as interrelated with the entire world, dependent on the entire world and needing therefore to have all of our paradigms take of that international context in view. Now I think we have some differences among panelists as to what the international context here might be. We heard this morning that science itself is an international endeavor. Now we're hearing that maybe some of these problems are really peculiar to a very small portion of the world. I do tend to think that some of these problems are peculiar to a small portion of the world, and maybe we wouldn't even be confronting them if we hadn't along the way made some decisions about what we could do based upon what we know using our Western paradigms of knowledge as central to our decision-making. Joan Goodfield, please. I'm tempted to resolve this issue by throwing the word paradigm straight out of this building. Happen to love it. And I think that it was introduced, if I am not mistaken, very precisely by Wittgenstein for a very precise purpose. It was then appropriated by Thomas Kuhn for an equally precise purpose to talk about the changing shifts in states of thinking between one scientific epoch and the next. And then combined with a whole lot of other factors, it was appropriated by almost everybody else from then on for a large number of totally inappropriate purposes. Karen, I could leave that one with you if I will, but that's not how I want to leave it. I'm not certain that even in posing it in these ways, you may have in fact made the whole resolution of this particular problem more difficult simply by using this word. We have too many things associated with it. But I think one of the things that I do want to focus on what you say, because I'm still thinking rather deeply about what you said, is well in fact what you're getting at is not a suggestion to heave out rationality, logic, the methodologies, objectivity, the whole lot with which we have traditionally up to this point been so successful with the things we've wanted to do. But whether in fact you're forcing me to ask a question that I had tended to ask from time to time, and that is institutions like Hastings aside and people like Will Galen, his colleagues aside, and occasions like this aside, why are we on the whole so incredibly embarrassed about talking about values? As I pursued research on the book I did on recombinant DNA over and over and over again, I found that not only scientists found it easy to handle with questions of what we know and what we don't know, what we can do with what we know and what we don't know, and whether we should do with what we know and what we don't know, that they were really only happy handling those kinds of questions, but funny enough people outside of science, generally in society, within this society, in my own society, were also extremely embarrassed about talking about values, and I want to know why. I remember one particular occasion in England when we were discussing some issue about putting in some new health organizations in some, you know, deprived area and we had a sort of, there was a little local meeting and one of the doctors, bless his heart, got up and said, look, I know, but before we get on to this, shouldn't we really talk about what we're trying to achieve and what our values are, you know, in trying to achieve these ends? And it was as if he'd told a dirty story and the chairman said, oh, that's fine, that's okay, but let's get on to the next item, which is finance. Now, why is it that we are either embarrassed or feel uneasy with or can't handle or prefer not to talk about values? I'm not going to go so far as you, I think, Karen, in arguing that a substitution of the one for the other, but can you just take that one from there and perhaps enlighten me on this? Well, first on the question of the use of the term paradigm, one doesn't in a speech read all of one's footnotes. I am aware of the problematic nature of that term and I struggled about whether to use it. I finally decided to use it precisely because it has entered the public arena and it's a shorthand way of saying something that I couldn't find any other better way to say. And I don't think that the term values is a substitute for that, though I have very little hesitation about talking about values and would be happy to talk about which things we ought to value more than which other things in this arena. However, my concern is that even as we do that, we may ignore the deeply held kinds of modes of thought that we get trained into that structure are very ways of thinking about values and holding values and it is those deeply held structures that I mean when I talk about paradigms here. So the two terms are not synonymous, but I do agree with you. We need to have a lot more value discussion in this entire area. Should we value some things more than others? For example, justice around the world over and above even the cure of disease here at home. That's a value question that we really could encounter directly. Thank you. I have a question for Dr. Thomas that connects up a bit with this discussion. The question asks, could you extend your views on the importance of knowing what it means to grow old? Are you advocating a liberal arts education for our increasingly technically oriented society? And I might put a post script to that question. Would you advocate a broadened base of reflection and do you see this working well within a liberal arts context? I'm connecting up with Karen's remarks now. I think it'd be nice to start by taking pains to provide a better liberal arts education for the youngest generation and work up from there. I'm concerned about, and I think it fits in to some extent, the last part of the discussion at the table. And I'm worried about one area in which I think I find myself in disagreement with Karen, although it's not quite clear to me when I'm gonna ask her a question, which has nothing to do at all with aging. I gather that you're worried about where science may be taking us and you're worried about where the elitist scientists may be taking us without enough of us being consulted about the direction in which we are being taken. But I wonder whether this is really an anxiety about science or about technology. The term genetic engineering itself, which I think all of us have reservations about, certainly implies for sure that we're talking about a technology. We're talking about the kind of thing that you'll do after you've understood the underlying mechanisms of something in nature after you've finished asking a lot of questions that begin with how does it work or that begin with what if you're now are in a position to ask only one kind of question and that is how do you use it? What do you do with it? Can you sell it or can you aim at it something or can you detonate it? Can you kill with it? A technology. I'm worried about the confusion between these two totally different fields, science and technology. And I wanna be sure that scientific inquiry into nature can continue to go on without having parts of the intellectual community begin saying there are some things that human beings should not know. That there are some kinds of knowledge that we are not yet grown up as a species sufficiently to have in our minds. Because if that underlies some of what you haven't said, Karen, then we have a real good fight on our hands. Because I don't think there is a kind of information or a level of knowledge about how nature works that we not only that we can't handle but that we shouldn't be going after. I think it's a very urgent matter for us to understand as much as we can possibly learn about the human genome and how it works in all detail. And not because we're gonna use it or sell it or make long armed human beings, but so that we can gain some understanding of where we are and begin fathoming what I view as the utter strangeness of nature. I don't understand it at all. And I'm pretty sure that the next, the generations for maybe a millennia ahead are not going to understand it. But if we keep at it, we may reach a level of comprehension of where we are that will at least allow us to grow up enough so that we can stop killing each other. We've got to learn how the human mind works. I don't wanna see what I sense to be an anti-science intellectual movement get off the ground either in this country or abroad. And I think it's most likely to, it is a hazard that lies ahead for as long as we mix up technology and science. For as long as we mix up what we call genetic engineering or the threat ahead of us of genetic engineering or two heads are better than one kind of thinking on the part of our politicians, as long as we mix that up with pure scientific inquiry for its own sake. I'd like to respond to that if I may. First, on the subject of aging, I'm doing it as fast as I can. Second, I am not worried about where science may be taking us. My concern is not about the consequences of what we do or whether one thing is gonna lead to another. If I did not make that clear, then let me say that unequivocally now. I am not concerned primarily about consequences. I am concerned about how we think about the enterprise as we go into it. And on that subject, I would raise a question about whether a very common paradigm in scientific endeavor, namely the so-called distinction between pure and applied research, or as it is being put here, I think, between science on the one hand and technology on the other hand, is really a viable distinction. So we may indeed disagree on that issue. Third, are there things we should not know? Absolutely not. We should know everything we can possibly know, but we should not make the mistake of thinking that everything we know is all that there is in reality. In fact, what I'm arguing for is not that there are things we shouldn't know, but that there are a whole lot of things that we should know that our very scientific paradigms are making us not know. They are making us closed to some forms of knowledge that I think we need to be open to. Are there things we should not know? Absolutely not. Let us know everything we can, making use of all the mechanisms there are, and then let us not forget that in everything we know, we have not as yet gotten reality to conform to our paradigms. Okay, go ahead. Doing good, doing good, Bill. I just want to say that I agree with Karen and disagree with Lou. I think Lou is making too easy and too fine a distinction between basic science and technology. I think in many areas, and especially in the area, number of areas in biomedical science, as it applies to human subjects, this distinction breaks down almost as you seek your knowledge. But what I did want to say, Lou, is I wish I shared your optimism that by knowing more about how we are and how we act, we will in the end in some time become stop killing each other, but we can't wait for that knowledge. We have to stop doing it now. And I'm not certain right now. And I'm not certain, and I would love, you know, I'd love you to enlighten me on this, I'm not certain that science at this moment can help us enough, except in by telling us all the dreadful things that will happen if we do, drop the nuclear bomb and go on like this. I mean, I keep coming back to what Einstein said, that these things get resolved eventually, and I suspect this is what Karen is driving at. Not at the drawing board, and not in the syllogism and not in the panel, but somewhere in the human heart. I can't put it more exactly than that. I don't understand it, but it's there. That's where it has to begin. I have a question from this morning that connects up, but I have to precede it with a narrative. I watched a television program about healing among Mexicans who had settled in Southwestern United States, and the psychiatrist who treated them, approached them with Western methods and got nowhere until that psychiatrist went into Mexico, into the mountain villages, and learned something about the paradigms, or whatever you wanna call them, the outlooks that existed there. Now, that might be an example of stretching a perspective that we would get through studying other cultures. The question, Dr. Thomas, was about the witch doctors. You called them. And keeping with the shamanist tradition, treated not only physical illness, but illnesses of the troubled soul as well. How do contemporary medical practitioners measure up to this standard, or should they? And I think the question relates to this whole area of what we are talking about. I see the connection, at least. Would you like to comment on it? Are the shamans not able to teach Western scientific doctors anything anymore? In a moment, I'm gonna bounce this over to my left, where someone who knows about the area can talk. I should only say that from what I read about shamanism, the pre-shaman training was even more difficult than pre-medical training is today. It required that you either have a long series of unaccountable epileptiform convulsions, and then go off into the wilderness and spend 40 days at death's door, and then come back, behaving, I must say, in some of the accounts rather like a contemporary schizophrenic, but ready to be licensed to practice. I think it's easier now to become a psychiatrist, but I'm not sure what the data show as far as the outcome. Dr. Galen, would you like to comment on it? Dr. Thomas sort of stole my answer. I was going to say that it's easier for us to get licensed, so therefore we have a lot less efficient people than the witch doctors do. I will say, though, that among my psychiatric colleagues, since we are not a scientific profession, and we know that, the rule is that nothing succeeds like success, and if dancing around my patients, nude, would cure their schizophrenia, I'm ready to take my clothes off any time. Excuse me. This is for Dr. Labax. Many of those who employ the scientific method have developed a healthy skepticism which they imagine to be universal, their own hermeneutic of suspicion. How would you jolt these people into broadening their methodological doubt? That's an excellent question, and I'm glad to know that there is a hermeneutic of suspicion. I think what I would do is encourage that and encourage that it be taken to, as radical, a depth as one can, so that we are not only suspicious about the particular methods, but really raise questions about the hypotheses that we are trying to answer with those methods and then raise questions not only about the hypotheses, but perhaps even about the entire way that we have gone about the endeavor. But I'm glad to know that there is a hermeneutic of suspicion. I hope that it will continue to grow, and I hope that it will be informed by the voices of those who have not always been heard in the past. Thank you. Could I just make one caution about the presentation? I was debating whether to answer it because I've talked to Karen so much and I know that she's thinking of alternatives rather than a kind of dialectic of opposites. But I think that she may have created an impression which I don't think is her as she can correct me on that. There is a tendency, a strange and dangerous tendency, for a granted intellectual elite of Western to romanticize primitive medicine. I will tell you that the people in Africa do not romanticize primitive medicine. They want penicillin for their children. They want streptomycin. Now, if you're saying that there are some truths that may have been overlooked in these areas, it is very, very easy for those of us who have good medicine to perhaps do exactly what Karen would not want us, to rationalize our failure, to attend to schistosomiasis, to attend to philoriasis, to attend to those things by saying, after all, they have prayer, meditation, leechy nuts, parasites, and those things. It's the same thing that happened in another way. The intellectual liberal community attacked the ability of prisoners to join research populations. This was all a white middle class and say we should not allow that there are, until the prisoners' association sued the civil libertarian group saying, we did not assign you as our arbiters of what we should have. So I would just caution against the kind of romanticizing of poultices, prayer, and meditation. I do not mean that there may not be something in all three of those things, but at this point when we have been terribly remiss in supplying those very, very good technological, not scientific, I'll defend technology too, those very good technological aspects of modern medicine, when we have been negligent in supplying it to the impoverished, I'm a little wary about romanticizing the primitive methods that are there, so. I'm going to bring this session of conversations to a close. One question came in that can be answered briefly. I don't know that Jeremy Rifkin would appreciate this question, but the person who asks it says, who is Jeremy Rifkin? Jeremy Rifkin is the author of the book Alginy, and Rifkin seems to have undertaken a one-person campaign to urge us to think in different ways about what we are doing in the whole field of genetic engineering. Rifkin has been credited by some people with being the person behind the recent call for a ban, and some would even say that the entire thing was solely his brainchild. I don't think that that's altogether true, though I have read his book and I do understand that he is a crusader and that the book has significant flaws in it, though I think it's basic intent to get us to ask questions is a good intent. Thank you, Karen. One announcement would the firing line participants, the panelists, please come to the table up in front here immediately after this session, and we'll adjourn until the brief concert at 20 after three is the time for refreshments now and for further conversation out there.