Sezione Medicina

from Leadership Medica n. 2/2001

One of the subjects which has been often approached during the recent history of bioethics relates to establishing which moral code should represent the basis of, or at least a background to, bioethics. Indeed, it is obvious that it is not possible to solve some of the ethical dilemmas that the development of biomedicine causes man’s conscience to face, unless we identify, to this end, some criteria, standards or principles.

Rapporto tra etica e bioetica Adriano Pessina

Indeed, when we refer to moral dilemmas we simply wish to point out that it is not easy to establish, here and now, what is right or wrong. But, although rarely treated as a major theme for discussion, or as the subject of critical reflection, the moral perspective of human actions already exists in every free and conscious choice we make. In this regard, Positivists were right when they stated that morality first of all consists in the cultural environment (and therefore also in the language) with which each man takes part in the life of the society he belongs to.
Morality therefore becomes a problem, namely a philosophical problem, only when we start to question the reasons which lead us to consider a certain behaviour as right or wrong. But for the most part we are all used to living and evaluating things in accordance with the criteria, principles and values we have “sucked with our mother’s milk” so to speak. Whoever wishes to give reasons of his/her actions and explain their significance needs to refer to a range of meanings and values which he/she expects to be shared by, or at least shareable with other people.
The familiarity which each man has with ethical terms simply involves that, in principle, within the moral perspective there is no estrangement among men, because conflicts, divergences, different evaluations refer to “what is the right thing to do” and certainly not to the concept that, if something is right, then it has to be done.
This remark is not meant to lessen the awareness of the existence of conflicting, or even opposite, ethical evaluations, but only to point out the raison d’être for philosophical reflection. Indeed, although on the one hand it is true that we need not be philosophers in order to act morally well, and that from this point of view philosophy appears to be “useless”, on the other hand it is clear that it is peculiar to philosophical research to attempt to explain and justify, ever since Aristotle’s times, what should be regarded as good and which are the various good things that man is called to achieve.
The dialectic procedure of philosophy, which does not acknowledge any authority other than the evidence achieved through argumentation and confutation of the theses opposing the one which is being supported, discourages those who, on the other hand, are accustomed to proceeding by accumulating data, and would like to have at hand “undisputable” issues backed, once and for all, by general consent.
But in the field of philosophy, the theory of mere consensus has never been paid much heed to, since the role of philosophy is first of all that of being “critical”, that is a never-ending verification of the convictions which man expresses with regards to the meaning of life and of his actions. Whereas a careful evaluation of the history of philosophy would make it possible to detect not only conflicts, but also deep and complex concurrences, possibly expressed in different ways, it should be pointed out that this history has developed in terms of discussion because it has always maintained a certain degree of trust in man’s reason and in his ability to find truths which last in time and guide human existence in its fundamental aspects.
But when philosophy is not content with being an ancilla (whether it is ancilla theologiae or scientiarum or tecnologiae), it somehow becomes an uncomfortable presence.
A certain intolerance towards the participation of philosophers in the bioethical debate, which is no longer restricted to doctors’ or jurists’ considerations, also arises from the fact that we find it difficult to appreciate the distinctive features of philosophical research, which appears to shift the main points of the question and postpone the time for a choice or a decision, by relating these to a system which many people find abstract and unnecessarily complicated.
Except for the case in which the indications provided do not comply with the doctor’s or the scientist’s personal convictions, and he withdraws behind the concept that each person should decide according to one’s conscience: and in this case moral conscience is merely regarded as a subjective verdict, and not, like in philosophy, as the ability of a subject to identify what is really right in that particular situation. Still, this subjectivist shortcut is the most powerful evidence of the need for philosophy and for its critical approach: indeed the alleged subjectivist choice is much more influenced by convictions absorbed from the surrounding environment than we would actually expect. But when we intend to make a moral choice, we wish to choose not only for ourselves but, as Sartre would put it, “on behalf of all mankind”.
This involvement of mankind in moral choices is the issue which really requires reflection: in an age in which reason has led to an acceleration in discoveries and demands quick decisions, the long time taken by philosophical reflection becomes ever more necessary, even though often misunderstood. If we do not want to reduce the bioethical commitment to a formal procedure directed by the customs of prevailing cultural influences, or by the standards set by individual societies, then we really need the specific contribution of philosophy

Adriano Pessina
Docente di Filosofia Morale e Bioetica Università Cattolica di Milano