Imagine if the presidential candidates were willing to talk frankly about the things that affect us most: not just guns and butter, but also life and death and the hard choices our next President will have to help us make. It would be a revealing debate, with questions like these:
For Barack Obama: Democrats have long argued for greater reproductive freedom. Do you think that should include the right to choose the sex of your child? The same genetic tests that screen for terrible diseases could in theory target many other predispositions. What if prospective parents could screen for short or shy or gay or blond? This is a largely unregulated universe of treatment; should it be?
For John McCain: About 8,000 people may die this year waiting for organ transplants. Do you think the free market should include kidneys? You've said human rights begin at conception. But fertility clinics create excess embryos that are frozen and often discarded, which you've favored using for research. So are some embryos more equal than others?
And for both: Would you forcibly quarantine people during a pandemic? Should police at a crime scene be allowed to ask everyone in the area for a DNA sample? Scientists around the world are building robots with real brain tissue; inserting a fish gene for cold tolerance into tomatoes; breeding bacteria that can eat oil spills. Should we be worried that we often learn what is happening in the labs only when the results come out of them?
I understand why the candidates don't want to go near these issues. "Sympathy and subtlety," notes Tom Murray of the Hastings Center for bioethics, "are seasonings rarely applied to political red meat." We have reached a point in our political discourse when candidates are punished less for flatly lying than for changing their minds. You can caricature your opponent, airbrush your record, come close to just making things up and suffer less than if you're caught with a belief that has evolved. The political term for flexible is flip-flopper.
And yet the issues before us require both a hunger for truth and a humility about recognizing it, because progress can sprint right past our ability to process it. Blood transfusions were considered creepy before World War II. Transplant a heart? That's not just a pump, critics said; it's the seat of your soul. You hardly ever hear the chilly term test-tube baby anymore, because what was once odd and unnatural is now a routine salvation to millions of childless couples.
So now we fight over stem cells in a war full of cautionary tales. Most Democrats, and some Republicans, have pushed for full federal funding of embryonic-stem-cell research, an issue so hot it tipped some close 2006 midterm races. But since then, the biggest breakthroughs have come in techniques that do not use embryos at all but instead reprogram adult cells. Do proponents look reckless for putting all their emphasis on embryos, which even some prominent scientists find morally troubling? Or prescient, because the basic knowledge gleaned from embryo research is what may help make it unnecessary someday?
At the moment, McCain seems determined to keep us confused about where he really stands. He has voted to fund research on leftover fertility-clinic embryos, but his website says he favors experiments that "do not involve the use of human embryos" at all. His party platform calls for an outright ban on all embryo research, public or private. Meanwhile, a McCain-Palin ad lauds the pair as the "original mavericks" for supporting "stem-cell research to help free families from the fear and devastation of illness." But that's not courage; it's camouflage. Everyone favors adult-stem-cell research: the only fight is over experiments that destroy embryos.
Joe Biden was no better in his coarse challenge to Republicans who promise to help parents of children "born with a birth defect." "Well, guess what, folks?" he said. "If you care about it, why don't you support stem-cell research?" Well, they do; just not all the forms that he supports. You can argue that embryo research should proceed anyway; you can argue about where federal funds should go, or whether embryos should be created specifically to experiment on them. But no one is served when politicians blur their positions or distort their opponents' or pretend the issue is simpler than it is.
Among the demands of presidential leadership in the 21st century is this: Are you prepared to lead this conversation as an honest broker? Balancing risks and rewards is a medical challenge; redefining what we mean by being human is a moral one. And figuring out where to draw the lines must be a political one.