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Each year, the Center for Bioethics and Culture asks me to prognosticate about the coming 12 months in bioethics.  My record was pretty good for 2010. But the CBC refuses to let me rest on my laurels.  So, once again, I enter the prognosticating fray—stating what I think will happen, not necessarily what I want to happen.

First: Obamacare.  From my predictions:

  • A bill repealing Obamacare will pass the House of Representatives, but will go nowhere in the Senate;

  • At least one court will declare the individual purchase mandate unconstitutional, probably two. (Two judges have already ruled that the law is constitutional.) All cases will be appealed. At least one appellate court will find the individual purchase mandate unconstitutional, setting up a decision by the Supreme Court in 2012. (After this article was written, this prediction came true: A Virginia federal judge ruled against the individual purchase mandate, stating that it “exceeds the Commerce Clause powers vested in Congress under Article I [of the Constitution.]”)

  • Even though the law does not have a severance clause keeping it in effect even if part of the statute is found to be unconstitutional, since the mandatory purchase provision does not go into effect until 2014, the courts will permit the government to enforce other Obamacare provisions and prepare regulations for the individual mandate during the appeal process.

  • The House of Representatives will refuse to fund the regulatory process needed to implement the law. That will spark a huge political fight when the Senate refuses to go along. The president will threaten to veto any bill that inhibits the law’s implimentation. This could lead to a government shutdown. In the end, the parties will compromise, which will slow down, but not prevent, Obamacare from moving forward.

  • Certain changes will be made to Obamacare around the edges. But these will not be substantive.

  • The ultimate fate of Obamacare will be decided in 2012. First, by the Supreme Court’s decision regarding the individual purchase mandate—without which the economics of the law won’t work. Second, Obamacare will also be a prime issue in the 2012 presidential election, its ultimate fate decided by which candidate wins. But you’ll have to wait for next year’s prediction to see how that all will turn out.

What about stem cell research?
The Court of Appeals will reverse the trial court and allow Obama’s ESCR funding policy to remain in place. The Supreme Court will not take the case. However, if I am wrong (yes, it happens), and the Court of Appeals affirms the trial court, the Supreme Court will take the case.

The Dickey-Wicker Amendment that forbids federal funding of destructive embryo research will be renewed for 2011. However, that prediction is predicated on the Court of Appeals ruling as I predicted above, or if the ruling has not been issued when it is before Congress. If the Court of Appeals overturns Obama’s funding policy, there will be a big fight. In that event, either Dickey will not be renewed or ESCR will be exempted from its provisions.

The Human ESCR Trials Will Show No Dramatic Results: These are small safety studies and there will neither be a big breakthrough nor a catastrophe resulting from the experiments.

Scientists will announce success in their ongoing attempts at human cloning. This will spark a demand for federal funding of human cloning research. A bill will be so introduced, but it will not pass.

Induced pluripotent stem cell research will move away from creating stem cells and to “direct reprogramming,” that is, turning one kind of cell into another without requiring the stem cell stage. This has been done with animal cells, and will also succeed in human cells. This success will blunt the fervor for ESCR.

Adult stem cell success will mount. But you didn’t need me to tell you that.

Assisted suicide?  The professional fate of Medicare head, Donald Berwick?  Octomom? If you want to know what 2011 will bring, you will have to hit the link above to find out.

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