For
a long time there have been debates as to which ethics should regulate bioethics.
Namely, we have asked ourselves whether we could identify a specific ethical
approach in order to describe bioethics as an independent discipline.
Whoever questions which ethics should regulate bioethics assumes
that there may be different ethical codes and that therefore a choice is requested,
so to speak. If we remain on a descriptive plane, there is no doubt as to
the fact that, in the history of Western thought, various complex philosophical
theorizations of the moral phenomenon have appeared.
From Kant onwards, a firm belief that it is possible and right to distinguish
between ethics and morality has also established itself. Within the field
of so-called analytical philosophy, the notion of meta-ethics has also been
introduced, and researchers’ attention has shifted from human action to the
language of valuation. These are well known issues, which have an impact on
the question of the epistemological statute of bioethics.
However, on one side, it is obvious that it is not sufficient to simply choose
which ethics should underlay bioethics, if only because it is necessary to
indicate on the basis of which criterion, and why, we are selecting one approach
rather than the other. On the other side, the idea that the existence of different
philosophical approaches justifies the statement that it is impossible to
establish a single and common (but not necessarily univocal) thought on moral
life is rather questionable. In actual fact this task is difficult, but in
principle it is in any case necessary. When we debate as to what is right
or wrong for man, we are all involved, both in the problem and in its solution,
for the simple reason that we are human beings.
If we analyse the values suggested by the various moral philosophies, we soon
realise that, even though with different accentuations, there are many points
of contact. The values of freedom,
autonomy, love, solidarity, respect and tolerance are values that are often
defended from points of view that differ from each other. All this does not
surprise us. Good and evil are notions that express a relation between what
man is and what proves in keeping with his human condition, and it is therefore
understandable that concurrences exist in all those theories that focus on
the human condition, although differences are also understandable.
The moral question is, in essence, a question involving the hierarchy of the
different values and it is on the criteria on which this hierarchy should
be based and justified that theoretical and also practical conflicts arise.
In the field of philosophy, as we know, these conflicts are not unusual.
Besides, whilst some disciplines may view constant debate as a
weakness, others may consider it as their modus operandi. Indeed, philosophy
builds its knowledge on dialectics, that is confrontation with the thesis
of a real or supposed theoretical opponent. Now, if the purpose of bioethics
is above all a cognitive one, that is concerning itself with deciding what
to do, rather than practically getting people to act in a given way, the dialectical
aspect does not represent a problem.
Indeed,
it will be up to other sectors, such as deontology, jurisprudence or training,
to convert into operating terms that which has been acquired in the cognitive
field. But if we regard bioethics as a practical discipline,
which is therefore aimed at influencing behaviours, the dialectical aspect
becomes a negative one, which weakens effectiveness. Still, even if we accept
this latter concept of bioethics, we still have available space for a purely
theoretical research (deciding what is right and what is wrong), which should
precede the applicative phase: who is to handle this sector? Many, including
the writer, feel that the most adequate notion of bioethics is that which
entrusts it with a cognitive purpose, rather than a practical one. Juvalta,
already in his time, talking about moral philosophy, ascribed to it the task
of justifying moral rules and not that of implementing them.
Bioethics, being a public utility, at the service of argumentative reason,
may and must content itself with producing the perspectives which are to guide
activity and planning of technical and scientific development: it will be
other parties’ job to derive from such conclusions any practical and legislative
consequences; however, it should be reminded that, if bioethics is to be deemed
a scientific discipline, it may be practiced by whoever adopts its methodology.
It is not a question of entrusting the decisions concerning the development
of technoscience to some sort of experts’ committee, but of spreading the
procedures of bioethical discussion also, and first of all, to the very places
where scientific research and biomedicine are practiced. Creating a widespread
awareness about the problems associated with the increased power of man means
contributing to the democratic process. However,
in order to achieve this, it is necessary to set out a bioethical approach
that is not equivocal and that knows what practicing philosophical reflection
involves, in addition to so-called common “sense” (which is often only the
result of social pressure in a particular age or country of the world).
The question of the epistemological statute of bioethics is further complicated
by the usual reference to its interdisciplinary nature. This may however involve
two very different concepts. In one case, it is said that bioethics has to
handle issues arising from the convergence of different cognitive sectors,
ranging from biomedicine to cybernetics. Yet, in the other case, it is thought
that bioethics itself represents a set of problems: of a medical, biological,
ecological nature, and so on. Now, if we accept the latter approach, we end
up by emptying bioethics of any regulating dignity and by creating confusion
among the different planes. Biomedical and scientific problems concern bioethics
for the very reason that they are not only biomedical or scientific problems.
Indeed, bioethics is not a container of various disciplines. A set of disciplines
does not make up a meta-discipline. Without
the data supplied by individual disciplines, there is no point in bioethics:
without the contribution provided by bioethics, as a moral philosophy, accumulation
of data coming from the various disciplines is not sufficient to identify
or attempt to solve the moral questions arising from technoscientific practices.
These considerations are known to many researchers in the field of bioethics,
but they are often forgotten by many of those who claim to practice bioethics
whilst in fact contenting themselves with making choices in the name of their
professed common sense. A metaphor suggested
by Popper says that, if knowledge is a sea and the various disciplines are
fishing nets, we need to accurately decide which nets to use. Indeed, depending
on the nets, you may catch small fish or large fish, or return ashore empty-handed.
Adriano Pessina
Cattedra di Bioetica Università Cattolica di Milano