In a discourse between bioethicists Arthur Caplan and Robert P. George, they expound upon the false duality of “normativity” versus “scientism”. This exchange is quoted in Public Discourse under the title “Stem Cells: The Scientists Knew They Were Lying?” by Sherif Girgis, which can be found at this link and further discussed in Bioedge found here.

Wikipedia states “scientism is the idea that natural science is the most authoritative worldview or aspect of human education, and that it is superior to all other interpretations of life.”  The distinct impression one obtains from this discourse is that “scientism”, generally used as a pejorative term, is a widespread belief among scientists. In fact, scientism is a term used primarily by philosophers of science to criticize scientists.

Caplan, a generally liberal bioethicist from the University of Pennsylvania, and George, a conservative bioethicist from Princeton University rarely agree. But they seem to find common ground in agreeing that scientists, relying on scientism, are limited in making ethical determinations. They therefore need normativity imposed on them presumably by bioethicists (I admit I draw some of these conclusions which are implied rather than stated explicitly). They single out equally renowned bioethicist Ezekiel Emanuel, who Caplan identifies as an “an exemplar of scientism”.

A New York Times article, found here, regarding the current state of dialysis in this country was worth reading. However what was even more interesting (to me) was the range of comments that were subsequently submitted. The article recalled that dialysis as a treatment for end stage renal disease was first instituted in the 1960s as a life saving treatment which was intended to get patients back on their feet and return to the workplace. Today, it is used primarily in the elderly population and often in conjunction with other major co-morbidities, at times to stave off the grim reaper for a short time. The author questions whether this expensive intervention is in the best interest of the patient, or the best allocation of scarce resource dollars. 

Many of the comments agreed with the suggestion for a second look, given the limited benefits and the enormous costs of the expanded base. Others wrote that limiting life sustaining treatment was an immoral act; that targeting the elderly was patently unfair; that if we started limiting this service, it would be the first step down the slippery slope; and of course the ever present voice that we could have unlimited care if only we cut defense spending or foreign investment. 

What continually astounds me is the view that limits are unacceptable, yet we cannot expect taxes to rise and we should be prepared for decreases in government health care budgets. So who is supposed to pay? Somehow the rights of individuals always trump that of the society. No one can put a price tag on a life. If my demented 90-year-old mother can live another month with dialysis, she should be entitled, so the argument goes. As medical care has continued to expand with ever more expensive drugs and equipment, costs have risen dramatically. There are still, as we know , millions without any coverage as well as the insured who are being asked to pay larger premiums, as one would expect, to keep up with the rising costs.  Small businesses and state governments are struggling with these increases to the point of crisis. It would seem that distributive justice would dictate first, access to all and then fair distribution of services that we can afford. Any way we cut it, there are limits. Why should any group be exempt?