The Science Journal Nature Thinks NICE Is Nice—Naturally

When I was researching Consumer’s Guide to a Brave New World, it hit me that the ethical values of many scientists cut against the grain of most of the citizenry.  Actually, that didn’t just hit me—I quote a major scientist making that very point.  From my book (citations omitted):

…[T]he scientific establishment seems to be increasingly insular from the rest of society.  It is thus unsurprising—if disturbing—that Bruce Alberts, president of the National Academy of Sciences hubristically told a reporter for the National Journal, “We [scientists] care a lot about how other scientists think about us, and we don’t care a lot about others who are not scientists.”…

Making this even more worrisome, the moral views of the scientists who are supposed to decide these issues on our behalf often do not comport with the general moral sensibilities of society.  “Most scientists adopt utilitarian perspectives on ethical and political questions, and they use their values to estimate costs and benefits.” Thus, the NAS’s Alberts admitted that the moral views of the general public sometimes prevent research that scientists’ general utilitarian outlook would cause few qualms.  For example, in the 1970s, a public outcry halted the practice of using condemned prisoners in experiments, whereas according to Alberts, “If it was purely up to the scientists, they might accept the idea of doing experiments on death row [because] the person will be dead in six months anyway.”

And now the science journal Nature provides further proof to the point by supporting the utilitarian rationing board NICE, that is doing so much harm to the weak and vulnerable in the UK.  From the Nature editorial:

In the highly polarized debate over US health-care reform, opponents of increased government involvement in the system frequently caricature Britain’s National Health Service (NHS) as the disaster they want to avoid — an impenetrable snarl of red tape that keeps ailing pensioners on years-long waiting lists for even the most essential procedures. And at the heart of their nightmare is the UK National Institute for Health and Clinical Excellence (NICE), portrayed as a bunch of callous government bureaucrats ruling life-saving medications as off-limits to dying patients.

Globally, however, NICE is widely regarded as a world leader in comparative-effectiveness studies: research that aims to show which of the available medical options is most effective at treating any given condition, and which is worth the money — what US reform opponents might call ‘health-care rationing’. Faced with an overwhelming yet incomplete medical literature, most medical professionals welcome NICE’s best-practice guidelines on everything from early testing for breast cancer to child nutrition.

I doubt that—at least in the USA.  But notice: NICE explicitly adopts a quality of life ethic in making its rationing decisions.  That is a view that rejects human equality by definition, not to mention human exceptionalism, views that I don’t think the American people are willing to swallow—as illustrated by the resistance to Obamacare and its supporters many pretenses that the plan would not impose a rationing regime. Excuse me for not being surprised that the Science Establishment thinks that this is a splendid approach.

Sure the big brained and the bioethics community are hot to trot for rationing, since many—I would say most—accept explicit or implicit utilitarian approaches as the best way to provide for the greater good. But I can’t help but think that NICE-type boards, the foundations for which are being laid in Obamacare legislation, would also mean greater power for bioethicists, which, as I reported previously, is already being advocated in high places like the Hastings Center blog.

Add this as just one more reason why we can’t let “the experts” have the final say.