Editorial - Taking a Deeper View

This is a very laudable objective. It comes at a time when Waikato University is developing a model for teaching and learning in bioethics across all levels in New Zealand schools. Recognition of the need for ethical and social scrutiny of scientific developments by young New Zealanders is a positive development. But we are immediately faced with difficulties. Are ethical principles relevant information? If so, which ethical principles will our students be taught to use in these circumstances, and how will they be defined? And even more difficult how will they be applied?

Principles (from the Latin principium [plural principia]) are literally a beginning, or first part. Moral and ethical principles help to initiate and focus discussion and provide a very real filter through which we can both enrich and understand scientific debate as well as the impact of developments in technology and biotechnology on people and societies. Different principles enable us to consider differing elements of complex issues, and help to build a comprehensive understanding of how those complexities impact on the individual and the common good.

The challenge in using principles stems from either their acceptance or lack of acceptance by the parties in a specific debate, which is in turn related to how these principles are defined. Certain moral and ethical principles seem to be lost sight of in current bioethical debates, while the understanding of other principles that are deemed acceptable is far from uniform. For example, the ethical principle of respect for autonomy, while well established in ethical theory and very broad in its scope, clearly means different things in different cultures. Generally speaking, in Māori culture identity and human flourishing is linked with the well-being of the group or the tribe, whereas in Pakeha culture identity and human well-being is understood in a more individualistic and autonomous framework. Consequently difficulties arise in the application of principles to practice and in the resolution of specific issues because people have different starting points and different understandings of what the principles mean.

One of the difficulties we face in modern society is the perception that there is no need to evaluate an action by reference to any criterion beyond our own opinions, preferences and choices. Simply put relativism rules! Any voices which speak of moral absolutes are potentially marginalized to the point of suppressing the right to freedom of expression. In this issue of The Nathaniel Report Dr Ron Hamel of the Catholic Health Association of the USA, giving the Catholic Foundation Lecture in Wellington recently, says the emphasis on the autonomous individual elevates choice as the defining characteristic of the person, and gives individual choice a status that is extremely problematic. The choice of the autonomous person is often regarded as trumping all other considerations. In other words, the very act of choosing something makes it right regardless of what is chosen. We see this most clearly exemplified in some arguments regarding abortion, physician assisted suicide, and euthanasia. What is chosen is not central to the choice, the decision making process, or the moral argumentation (if there is any). The fact of choosing eclipses all else. This leads inevitably to relativism and to a privatisation of issues - relativism because idiosyncratic preferences and the choices based upon them are all that matter, and privatisation of issues because there is little or no consideration of the consequences of one's choices upon immediate others and upon the common good.

Dr Hamel highlights a profoundly troublesome feature of Western society. His analysis reveals what can happen if one ethical principle the principle of individual autonomy is elevated to a position of dominance over all other principles, and interpreted as being purely about personal choice. This consequence of disconnecting moral and ethical principles from any idea of an absolute and universal truth highlights the difficulties that will arise when, in accord with the new curriculum, teachers raised in a relativistic culture take on the task of teaching their students to analyse and respond to bioethical issues. If teachers use an approach underpinned by the primacy of personal choice, will they open their students' minds (the traditional role of the teacher), or close them?

We have an even more immediate challenge to address, for which the insights of Dr Ron Hamel are very pertinent and timely. In New Zealand we are poised on a new threshold with regard to how we should act in relation to pre-born human life. The Advisory Committee on Assisted Human Reproduction is currently working on embryo research and the use of frozen eggs and gametes from deceased, comatose, and unresponsive persons, and has announced its intention to publish a discussion document in November 2006.

Embryo research includes the use of human embryos as a source of embryonic stem cells. Most forms of embryo research destroy the embryo. Those who would have this research carried out stress the usefulness of embryos in possible medical advances, together with the ight of parents to choose what happens to their embryos. Human embryos are defined as —clumps of cells. These attitudes draw the following comment from Dr Hamel:—

But what I find even more troubling and potentially dangerous is the devaluing of human life in debates about embryonic stem cell research and cloning. Proponents of these technologies either accord no value to beginning human life or not enough value as to prohibit it from being destroyed. Of further concern is that proponents of these technologies are willing to destroy early human life for our purposes. Early human life is considered to have little or no value in itself, but is accorded instrumental value. It is or may be useful for us. It can be destroyed to benefit us (and in the case of cloning, it can be created and destroyed to benefit us). This attitude seems to cross a new threshold.

After embryo research and the use of human gametes the Advisory Committee on Assisted Human Reproduction will move on to address pre-implementation genetic diagnosis, embryo donation, and other issues. As Catholics we have something to say about all these issues, and in a democratic society we have a right to put our views forward. We should not accept labels such as fundamentalist or conservative, because they are ways of marginalizing what we have to say. Our position goes beyond a single focus on the demands of autonomy and the tyranny of individual choice. It takes a wider, deeper view of the human person, including the person as a social being, as Dr Hamel explains so well.

In the embryonic stem cell debate, the moral status of the embryo is surely a primary consideration. But this is not the only consideration. A fuller theological understanding of the human person would also want to underscore our social nature and the duties we have toward and responsibilities we have for one another, including nascent human life and those who suffer from disease and disability. This includes what we become as individuals and as a society in and through the choices we make. What will be the impact on us and on those who come after us if we accept the destruction of nascent human life? What will be the impact on us if we acquiesce to using nascent human life for our purposes? It would want to consider what we owe one another in our various social interactions, that is, what justice requires of us. The meaning questions go beyond the moral status of the embryo. They encompass such other things as how we understand illness, disability and death, our finitude and how we deal with limitation as well as the drive to overcome it, our obligations to others and to future generations to seek and provide cures for disease and disability, the common good, scientific progress, and the pursuit of knowledge. Attending to these issues could result in richer more adequate deliberations, responses and policies.

I encourage you to read Dr Hamel's lecture, and to allow his insights to re-form how you think about the major bioethical issues in our society. I encourage you to make submissions to the Advisory Committee on Assisted Human Reproduction on the many issues it will soon begin consulting the community about. Most of all, I encourage you to think more widely and more deeply about these issues, using all the wisdom of Catholic social and bioethical teaching about the human person and society.

Advisory Committee on Assisted Human Reproduction website: www.newhealth.govt.nz/acart

Rev Michael McCabe, PhD
Director
The Nathaniel Centre

©
2006