The Power of Bioethics
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TR: You are held up as an expert on everything from assisted suicide to designer babies. You give great one-liners. But your ability can at times seem facile. Does this bother you?
Caplan: No–because it’s a skill I have, and I’m a quick study, and I can track a lot of stuff.
TR: Do some bioethics for us.
Caplan: There are people who have argued that tamoxifen [which may be an effective treatment for breast cancer] has too many side effects, such as ovarian cancer and eye problems. They think it might be unethical to use it as a prophylactic. I don’t agree. I think prevention is in some ways better than treatment. I’m not saying we should take every crazy risk, but I argued in favor of tamoxifen’s clinical trials.
TR: What are the principles that inform your opinions?
Caplan: I’m a consequentialist: I’m looking at outcomes. I’m trying to decide if a particular policy–such as allowing surgeons to do face transplants–would do more harm than good.
TR: That’s not much of an answer. What else would you do? Do consequentialists work from first principles?
Caplan: They can and do. Peter Singer [a Princeton University philosopher known for his view that acts should be judged according to whether they promote the preferences of feeling creatures, regardless of species] has his consequentialist utilitarianism, and he rigorously applies it. He says that if animals are smarter than retarded children, then experiment on retarded children. I’m not willing to trust any theory that far. In general, I’m not looking for fundamental truths when I discuss ethics. What matters is what is most practical at a given time. I ask, “What are the benefits and costs?” And I understand that the answer will change over time.
TR: Scientists often look down on bioethicists. Why?
Caplan: In the culture of science, the only thing that counts is the science. If you’re not doing that, it means you’re not smart or good enough.
TR: Do you ever wish you had become a scientist?
Caplan: I did go to medical school for a while, at Columbia. I liked it, but I don’t have the patience for the level of detail that makes good science.
Disclaimer: Arthur Caplan is on the board of advisors of BioAgenda, the nonprofit institute of which David Duncan is the editorial director.
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