Bill Gates: From Bioethics To Eugenics

One of the iconic moments from my Who Is Bill Gates? documentary is the clip of Gates at the 2010 Aspen Ideas Festival discussing a proposal to increase funding for public education by diverting money from end-of-life care for the elderly and terminally ill.

Lamenting the skyrocketing tuition rates for college students, Gates tells the Aspen Institute’s Walter Isaacson that, “That’s a trade-off society’s making because of very, very high medical costs and a lack of willingness to say, you know, ‘Is spending a million dollars on that last three months of life for that patient—would it be better not to lay off those 10 teachers and to make that trade off in medical cost?’

Then, squirming around in his seat and looking over at the audience, Gates acknowledges that there may be some objection to this line of thinking: “But that’s called the ‘death panel’ and you’re not supposed to have that discussion.”

A decade ago, when Gates made those remarks, it would be difficult to imagine an idea that was more out of touch with general public sentiment than the idea of “death panels” to free up money to hire more teachers. It was shocking enough to the general public that even the socially inept Gates realized that talking about it was verboten.

But what many sitting in the festival audience that day may not have realized is that the idea of trading health care for the elderly for public education funds is not Gates’ own novel proposal. In fact, this “death panel” discussion has been around for a long time and that discussion was spearheaded by a relatively obscure—but incredibly influential—branch of philosophy known as bioethics.

Bioethics, for those not in the know, concerns itself with the ethical questions raised by advancing knowledge and technological sophistication in biology, medicine, and the life sciences. This often leads to serious academic debates about subjects that seem like bizarre, improbable, science fiction-like scenarios involving the ethics of using memory-enhancing drugs or erasing memories altogether.

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