Sunday, April 8, 2007

Recapturing The Soul Of Bioethics?

From The Evening Bulletin (Philadelphia) By Fr. Tad Pacholczyk
Modern bioethics seems to be going through a kind of identity crisis. With ethicists available for hire, drug companies and biotech firms have easy access to 'experts' who can provide them with the veneer of respectability if they decide to head in the direction of unethical science. Erwin Chargaff, a pioneer in the field of biochemistry, once quipped that, 'Bioethics didn't become an issue until ethics started being breached. Bioethics is an excuse to allow everything that is unethical.'

One common approach to allowing the unethical is to claim that, 'We have already made certain choices, and now we really must move on to the next step - we must yield to the inexorable progress of science.' Rather than examining and rejecting certain poor choices that may have been made in prior years, and trying to regain lost ground, bioethicists today unwittingly continue to grease the slippery slopes by their lack of courage in disavowing some of the unethical practices they have aided and abetted in the past.

"...Until ethics started being breached"? That would seem to take us back a ways, even before the Fearsome 'Sixties, before Vatican II, before Nietzche, before Vatican I, before Jesus (and Peter and Paul/Saul), before Aristotle (and Plato and Socrates), before Moses, before Abraham, before Noah, before Babel (the Tower, not just the Movie). To the beginnings of our humanity, and of human culture. Quite a lot for "modern bioethics" to answer for.

That said, there is the germ of an idea worth discussing in Rev. Tadeusz Pacholczyk's little diatribe, if we can manage to avoid artificially inseminating it.

What Father Pacholczyk, quoting Chargaff, calls "yield[ing] to the inexorable progress of science" (obligatory reference to the Church's extended difficulties with Galileo mentioned only in passing here), others have termed the "technological imperative." And there is something to the point that most secular, and some religiously-oriented but liberally-inclined bioethicists have been rather more energetic in providing rationales for the application of new scientific and technological developments than in re-examining the moral basis for accepted practices, whether their "acceptance" is recent or more remote.

That does not strike me as particularly surprising, given any plausible sociological account of the rise and function of contemporary bioethics, or of the individuals who have been drawn to working in this new field. (I remain not entirely convinced that it yet constitutes a "discipline" in the full sense.) One of the principal forms of bioethical analysis is to locate something familiar in the seemingly new and novel, and to provide some context (historical, social and ethical) for better appreciating and situating what at first glance may appear unprecedented. This would seem a worthy and helpful enterprise, so far as it goes.

Bioethics should also--and this is where I agree, in some not so small part, with the present critique (although not particularly with the applications or implications drawn in the referenced article, or others like it)--provide a critical vantage for looking back as well as forward. There are critical respects in which we have made moral progress in recent decades, particularly in areas of greater inclusiveness and more egalitarian practices. (I'll have to leave that last, contentious "we" undefined here, except to say that I identify as a political progressive and as a somewhat observant Reconstructionist/ left-Conservative Jew, and not as politically conservative or religiously orthodox or fundamentalist.)

Past practices that struck many as morally acceptable in their time do now require critical re-examination. Things we learn from new technologies may cast new light on past understandings and behaviors, for both good and ill. To take one example, following the lead of Father Pacholczyk's articles as to general topic (new reproductive practices) but taking it in a distinctly different direction:
Biblical reproductive practices dating back to Abraham, Sarah and Hagar, and to Jacob and his two wives and two concubines, do provide a sort of Biblical precedent for reproductive surrogacy (not to speak of alternative family composition). But they also --and to me, far more tellingly--serve to remind us of the complex and highly problematic family dynamics associated with such practices (which need not employ much in the way of advanced technology). The complexities of contemporary family life may also allow us to return to our traditional sources, encountering them with greater understanding, immediacy, and insight into nuances that we had come to overlook.

The Book of Genesis remains one of my favorite works, and the one I return to most often. This is not because I take its creation account literally (I do not) or believe that it prescribes proper behavior, then or now (anything but!). Yet its power to engage me in the messy realities of human personality and behavior is without equal, as is its capacity to pose eternal questions of ethical behavior and of life's meaning and purpose. I do not look for answers, but for questions; not for an endpoint but for guidance on my journey.

At its best, bioethics (like reading the Bible, and like the quest for ethical guidance) cannot be mechanistic. Interpretation is required, and inevitable, and the interpretive process cannot be context-free. There is room--indeed, a necessity-- for dissenting voices, from others or from within oneself. There will be a time at which those alternative voices must be heard, even if that time is not in the present exigency. Those voices can remain available if properly preserved for respectful future study, rather than being rejected and discarded.

My own view is that bioethics, done properly, is a form of social criticism, in the sense articulated by Michael Walzer (see particularly his Interpretation and Social Criticism). Much of American bioethics, in the period after its founding generation, has become too narrow and insufficiently critical of the social, economic and political institutions within which illness and health care are embedded. The once "prophetic voice" of bioethics has largely given way to more "regulatory" and "bureaucratic" voices over the past generation, and now must find its way back in.

In that sense at least, if not in others, I join Father Pacholczyk's call for "Recapturing the Soul of Bioethics."

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