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Quality-of-Lifers Will Need Quantity-of-Lifers

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James P. Pinkerton, who writes a column for Newsday in New York, worked in the White House of President George H.W. Bush

George W. Bush may have gone through the motions of agonizing over his stem cell decision, as Newsweek accused him of doing, but he had no choice but to let such research continue. The momentum in the direction of quality of life, as opposed to quantity of life, was not about to be reversed. Yet in the future, some further shifting may be needed.

Newsweek reports in its latest issue that the president had made up his mind to proceed with federally funded stem cell research back in early July. Indeed, the magazine asserts that while the National Institutes of Health suggested proceeding with just 30 stem cell lines, the White House upped it to 60. Why? Newsweek suggests that Bush wanted to empower enough stem cell lines so that he wouldn’t have to confront the issue again.

Newsweek could have it wrong, but other evidence suggests that Bush’s once-strong pro-life stance has become flabby, at best. In his speech Thursday night, the president said that destroying an embryo “destroys its potential for life.” Potential life? That’s a cardinal violation of pro-life dogma, which holds that even a few-cell blastocyst in a test tube is life.

Yet Bush is a product of his time, an era that has de-emphasized the quantity of human birthing and emphasized the quality of human life once it is born.

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The traditional Judeo-Christian injunction was to “be fruitful and multiply.” In the days of high infant mortality, that was good advice; a large quantity of babies could guarantee that at least a few would survive. Today, such concerns have abated, but tradition-minded conservatives, opposing contraception and abortion as violations of religiously inspired “natural law,” are keeping alive policies that end up emphasizing quantity over quality. It’s this group--let’s call them “quantitarians”--that led the fight against stem cell research.

Ranged against the quantitarians are those who see science as the key to improving the “quality of life.” These “qualitarians” are inclined toward family planning and fewer pregnancies; yet when those children are born, their qualitarian parents want to maximize the kids’ life chances by any means necessary. Hence, qualitarians support stem cell research.

The qualitarians have recent history on their side. In the last century, birthrates have plunged, but so has infant mortality. And it’s a self-reinforcing cycle; as the number of children per family falls, the determination to keep each child alive increases. Meanwhile health care costs rise rapidly, as well as support for almost any medical treatment that could improve one’s life prospects.

The president himself would seem to be part of that tendency; he is one of six brothers and sisters (one of whom died as a child), and yet is father to just two children. Now, having supported stem cell research, the fitness-fanatic Texan need have no qualms about personally enjoying high-tech medical treatments over what could be a long lifetime.

So the qualitarians, victorious in their vision of low quantity/high quality of life, seem to have everything figured out. Except for: Who’s going to pay for all this quality living? Today, about 3 million Americans are 85 or older; by 2050, according to the Census Bureau, that number will near 20 million. Figures such as those give Social Security actuaries gray hairs.

Yet what will happen to the trust fund if stem cell research delivers huge breakthroughs? People will live higher quality lives, which is good, but they will also live longer, which is expensive.

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So what to do? One possibility is to increase the retirement age, forcing seniors, in effect, to pay for their own life quality. Other solutions might require a return to the days when quantity was king: giving birth to more workers or importing them from other countries, so that somebody will be paying for the upkeep of long-living stem cell alumni. The qualitarians may have their vision of the good life, but when the demographic crunch comes, they’ll need the quantitarians. In the long run--getting ever longer--the preservation of quality requires the generation of quantity.

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