In general, I consider
Harris to be among the
most usefully
provocative and
clarifying bioethicists
in the field, but I am a
bit perplexed by the
argument ascribed to him
here.



So I want first to
explain what I find
troubling in the
argument here, then to
examine what seems to me
its connection to
certain analogous
arguments one sometimes
hears technophiles make
in respect to the
so-called Precautionary
Principle, and then
finally to propose an
alternate peer-to-peer
frame which seems to
eliminate altogether any
reason to make such
arguments in the first
place.



Harris argument, as it
is reconstructed in the
Medical News piece at
any rate, is that since
[e]veryone in society
stands to benefit from
research, and indeed has
already benefited... it
should be economically,
politically, and
personally supported.



Medical research has
almost universally been
treated with suspicion
and even hostility
among those who regulate
it. But [w]hile history
has proved that
suspicion of doctors and
biomedical research is
well founded, the
article continues to
paraphrase, this does
not mean that research
is guilty until proven
innocent. Harris is
then quoted as saying:
"Vigilance against
wrongdoing is one thing;
the inability to
identify wrongdoing,
with the result that the
good is frustrated and
harm caused is quite
another."



Of course this is true,
but it would appear that
innocence is attaching
in Harris' formulation
disproportionately on
precisely the
institutions and
practices being
regulated to prevent
abuses on the basis of
suspicions that everyone
presumably admits are
well-founded.



It makes little sense in
my view to ascribe
hostility and irrational
suspicion to regulators
whose job it is, and for
good reason, to be
skeptical and
suspicious. The attitude
expressed here seems to
me curiously
complementary to the
hostility of many
technophiles to the


Precautionary Principle
which advocates the
conspicuously sensible
ideas that:

 

[1] We should always
be cautious in the
face of possible
harm;

[2] As assessments
of risk and harm
grow more severe
according to the
consensus of
relevant science,
the burden of their
justification
rightly falls ever
more conspicuously
onto those who
propose either to
impose them or to
refrain from
ameliorating them;
and

[3] The processes
through which these
justifications and
their assessments
properly take place
must be open,
evidence-based, and
involve all the
actual stakeholders
to the question at
issue.

Technophiles who value
speedier technological
development in the
expectation that it will
deliver sooner goods of
incomparable value,
sometimes like to imply
that advocates of
Precaution are
indifferent to the risks
that often inhere in
refraining to act, or
assess actual risks
unnecessarily
stringently, or exhibit
a kind of blanket
hostility to the
attainments of
medical-industrial
technocultures on which
they themselves depend
hypocritically for their
own standards of living.




While this is no doubt
true of some advocates
of Precaution - and
partisans on both sides
can of course always
find photogenic
specimens to trot out in
the support of their
views - it ignores the
extent to which the
Precautionary Principle
was introduced precisely
in response to damaging
corporate-friendly
government or
self-sponsored research
that selectively framed
and published its
results, and in response
to the deployment of
impossibly high
standards of certainty
to create the false
impression that widely
held, well-founded
suspicions and concerns
were in fact too
controversial to provide
a justification for
regulation.



Critics of Precaution
also tend to ignore that
many of the most
influential formulations
of the Precautionary
Principle (which has no
definitive or canonical
expression) confine
their attention to cases
of likely nonreversible
harm to the health of
individuals or to
environmental harms that
are likely to impose
remediation costs higher
than the benefits they
generate.



Few formulations of the
Principle are in fact
oblivious to the
ineradicable dimension
of risk that inheres in
all human conduct,
including decisions to
refrain from action. And
while I will grant that
it has not yet often
been mobilized in
arguments of this kind,
the Precautionary
Principle would seem to
me to

impel the
development and
deployment of emerging
technologies and
techniques to more
effectively address
global harms,
malnutrition and
ill-health, certain
existential risks that
have not hitherto been
susceptible of effective
response (for example, a
defense against asteroid
impacts, or a global
warning system to inform
vulnerable populations
of tsunamis and the
like).





I have argued
that the Precautionary
Principle is (or
certainly can and should
be) infinitely far from
the irrationalist
celebration of
stagnation and hostility
to civilization
technophiles sometimes
seem to want to paint it
as. It is, on the
contrary, a
democratizing
deliberative framework
for development, at once
impelling a fairer
distribution of the
costs, risks, and
benefits of
technological
development onto all of
its stakeholders, while
likewise enlisting the
wider collaboration of
these stakeholders in
the actual process of
research and the
assessment of its
results.



Precaution is not then a
repudiation of progress,
but the insistence of
social democrats that
progress, as we all now
know, requires both the
development of more
powerful technologies
and the wider
empowerment of people
through recourse to
these technologies.
Without both it is never
appropriate to speak of
a developmental outcome
as progressive in the
first place.



The force of Harris
argument depends on his
assumption that
[e]veryone in society
stands to benefit from
research, and indeed has
already benefited. But
this is surely
contradicted by his own
recognition that worries
about abuses are
well-founded. Clearly,
for one thing, the
victims of such abuses
are not straightforward
beneficiaries of
research in the ways
that non-victims are.



This seems rather
analogous to the
argument of some
opponents of Precaution
who in celebrating the
long-term benefits of
development they
themselves enjoy often
elide the reality of the
victims of development
over the developmental
spans in which they
actually lived.



It is quite difficult to
imagine that Harris
would rephrase his point
to suggest that people
have a moral obligation
to participate in risky
research just to ensure
that corporations profit
more and more swiftly
than they otherwise
would, whether or not
the people taking on
these risks benefit
themselves. But I want
to know precisely why
the obligation he
proposes would not
amount to this more
pernicious demand in
actual practice.



Now, while he does
propose that people have
an obligation to
participate in research
for the common good,
even when this imposes
risks and harms to their
own well-being that
might not otherwise seem
compelling, Harris is
thankfully not actually
advocating that this
moral obligation
likewise justifies any
kind of legal compulsion
to so participate.



But he frankly nudges
uncomfortably close to
doing precisely that.




According to the Medical
News article, Harris
contends that
compulsion is, in
principle, justifiable,
and in certain
circumstances, may be
justified. And he
suggests that a change
to the Declaration of
Helsinki, which sets out
the ethical grounds for
research, is warranted.



In making his case, the
article continues on,
Professor Harris points
out that other
activities in society,
such as vaccination the
wearing of seatbelts,
and jury service,
require the loss of
personal autonomy for
the public good.



It is not exactly a
matter of indifference
that in each of the
examples offered up
here, an arguably rather
negligible loss of
autonomy corresponds not
only to public goods but
discernible benefits to
the individual herself.
Compelling individuals
to participate in risky
medical research might
quite evidently impose
incomparable costs
without anything like
comparable benefits.



Harris concludes his
case in a moral register
that is much less
problematic: "The
argument concerning the
obligation to
participate in research
should be compelling for
anyone who believes
there is a moral
obligation to help
others, and/or a moral
obligation to be just
and do one's share.
Little can be said to
those whose morality is
so impoverished that
they do not accept
either of these two
obligations."



This seems to me an
uncontroversial claim,
but I sense in it a kind
of frustration and even
resignation that helps
account for why Harris
might hesitate to
confine his argument to
the mobilization of
nonbinding moral
injunctions.



I think Harris would be
altogether wrong to
succumb even slightly to
the lure of compulsion
as a way to secure the
benefits of medical
research (about which I
happen to agree with him
entirely). And I think
it would be wrong for
him mischaracterize as
hostile or irrational
the reasonable
expectations of harm and
abuse that both inspire
the regulation of
research and the
hesitancy of many
individuals to
participate in some
forms of it, as a way of
justifying such
compulsion.



But, frankly, I also
think he is wrong to
despair that beneficial
research might not be
undertaken in the
absence of moral
injunction or legal
compulsion in the first
place.



By way of a conclusion,
permit me to sketch an
altogether different
(and, if I can be
forgiven this, rather
utopian) sense of the
disposition of things.




Although it is difficult
to descry such a thing
in the midst of American
militarism and
fundamentalisms (of both
the market and
theological varieties),
I am inclined to believe
that the networked
civilizations of the
developed and developing
world are well on their
way to finding
themselves in a quite
self-conscious global
project to empower
morphological freedom
and ameliorate (and to
the extent possible even
eliminate)
nondiscretionary
suffering and death. The
science seems too
proximate and the
benefits too palpable
for many to resist for
long.



However well we fund and
regulate medical and
other scientific
research to these ends,
however, it remains true
that the effects of
therapeutic and
enhancement procedures
on particular
individuals, in
unpredictable
combinations, and over
the various longer
time-scales involved are
simply impossible to
anticipate as well as
anyone would like.



This has the consequence
that every citizen in
the democratizing world
should be regarded as
not only a legal subject
but an "Experimental
Subject" as well.



Experimental Subjects
are bearers not only of
the usual bundle of
rights legal
citizen-subjects have
properly come to expect
in social democracies
(and which certainly
should include at least
basic healthcare
provision), but should
likewise be bearers of a
Stakeholder Grant
providing them the means
to participate -- in as
competent, informed,
accountable, and
consensual a way as
possible - in
experimental therapeutic
and enhancement medical
procedures as well.



Unlike Harris, who seems
to want to impel or even
compel individuals to
participate in medical
research for the public
good, I would argue that
we should recognize the
extent to which
everybody is already
participating in such
research, as consumers
in a vast globally
distributed long-term
experiment in
combination therapy.



It seems to me that as
Experimental Subjects in
the global
medical-industrial
complex we all of us
already incarnate
indispensable data
points in what amounts
to a vast peer-to-peer
project to advance
medical and scientific
research.



What I propose is simply
that we should all
actually recognize our
indispensability,
recognize the literally
revolutionary force of
this insight, and then
demand to be paid for
the privilege of so
participating.



I would also propose
that since we are all
expected to relinquish
quite a bit of
traditional control over
the circulation of
personal information
about the effects of our
ongoing participation in
this global experimental
culture, we should not
only demand payment but
likewise demand that
these results be
distributed absolutely
freely and transparently
to encourage thereby the
kind of innovation and
accountability that best
ensures that the costs
and harms we undertake
will be minimized and
the benefits we enable
available to all
(including ourselves).




Since Harris suggests
himself that
[f]inancial incentives
to participate in
research are fully
justified and preferable
to compulsion, I hope
he would be sympathetic
to this viewpoint. My
only cautionary note in
joining with Harris in
such a recommendation is
to insist that the mode
of financial
incentivization that
seems to me most likely
to bear fruit would be
one conjoined to a
democratizing
peer-to-peer model of
research, rather than
any of the customary
market apologist models
which we all well know
by now would too likely
devolve soon enough into
the usual demand of
your money or your
life.