What do we Need Bioethics for?

When I finished my doctoral dissertation in Bioethics fifteen years ago it was more than often that I had to explain to obviously surprised people what Bioethics is. Moreover, each time I had to explain that I am neither a physician nor a biologist, but an ethicist. Nowadays I am asked only scarcely-to be frank, it’s been years since the last time. You see, Bioethics now is an absolutely established field in the academic world, but more importantly it has earned its reputation among people as a condition sine qua non occupation for everybody involved in the so-called life sciences; as for ethics, Bioethics has been something like a fresh, revitalizing breeze: the most interesting debates in the field-and also the most intense-almost exclusively regard bioethical issues. People choose what to occupy their minds with out of either playfulness or necessity –that is, either because something attracts the thought as irresistibly charming, or because real life necessitates dealing with it. Sometimes, not very often, charm and necessity coincide, and their matching produces miraculously rich debates-this is the case of Bioethics. In this short essay I will try to provide a brief outline of my grasp of Bioethics, while at the same time I aspire to convey a little of the charm Bioethics exerts on anyone who happens to deal with it.

The rapid advances in the so-called life sciences-medicine, biomedicine, biotechnology, pharmacology, genetics, biologyand the corresponding technological achievements seem to be producing-with exponentially increasing speed-a new, brave world, a world where mankind enjoys unprecedented possibilities to control the event of life from before dawn to even after dusk, and also almost all the intermediate phases. The more tangible this new world gets, the more threatening appear the potential dangers related to the undeniable and almost exotic benefits this new reality promises; novel risks inherent to-the equally noveloptions that are available to us now, but also risks we have already dealt with in the past, but nowadays have become either more edgy, or even have taken a completely different form than the one they used to have. Beyond and above this, this new era of biotechnology strongly challenges the concepts and value systems by means of which we till now used to perceive ourselves and shape our relationship to other people: life has long ceased to be perceived as an event of emergence; now it can be designed and producedfrom miracle it has been turned into an achievement. Death, on the other hand, still maintains enough of the mystery by which it has always been surrounded, though its hegemony lately is being strongly challenged and its sovereignty seems no more immune and unshakeable-due to science and technology life nowadays may be extended beyond what half a century earlier was considered as its natural span. Next to this behavior, moral choice and character, until now exclusively dependent on the gene-set we are endowed with and the environment we may find ourselves in, now seem to be susceptible to alterations inflicted by means of genetic engineering on the one hand, and by interfering with our chemical equilibrium on the other. In the light of all these, our concepts sometimes seem inadequate and our value systems obsolete.

The setting we now need to place our lives in is a totally new one, unlike any other we have ever known in the past-it is of a different kind. And, exactly as everything totally new, this new setting cannot help looking a bit messy and also full of traps; it definitely requires proper arrangement, so as to allow the hopes to appear as magnificent realities in the foreground and cast away the dangers that silently lurk in the shadows. This is the mission of Bioethics: to understand, arrange, and optimize this new world. This is the first time in the history of mankind that man demands full control over technological progress, and this no doubt is an improvement: so far, we first used the fruits of technology and only then discussed whether they should be available or not. In this sense, the establishment of Bioethics is a tangible proof of the increasing moral maturity of our species.

Is it possible for Bioethics to succeed in its task? Of course it is, though not that easy. In order to achieve its goals, Bioethics needs before everything else to remain true to itself, to its initial design and very essence. In other words, it needs on the one hand avoid becoming an exclusively moral debate, while on the other it must remain a primarily moral one. By its nature, you see, Bioethics is a point of osmosis and cooperation for a variety of disciplines that are all necessary to its purposes: Bioethics needs medicine as it needs biology, genetics and pharmacology, law and theology, sociology and ethics. If any of these fields is excluded or lagging behind, the work of Bioethics will become impossible. How may, for example, any legalist-but also any moral philosopher-discuss the issue of euthanasia without a documented definition of death? Should we entrust to the clergy to decide whether patients in permanent vegetative state are living beings or not? How can we discuss human reproductive cloning without first being informed by biologists and geneticists on whether cloning actually has the power to create identical copies of an already existing human being? Bioethics was designed from the outset to be an interdisciplinary field, and only as such it may be useful and produce results. However, as much as it is of paramount importance that Bioethics remains a par excellence interdisciplinary field, it is equally significant that one should always bear in mind that Bioethics is primarily and above all Ethics. This is because as far as Bioethics is concerned the main question each time, maybe the only real question, always is whether something ought to be pursued and implemented or not. This, however, is the par excellence moral question, one that asks us to choose among alternatives on a sound moral rationale, to make a moral decision on no other basis than on assessing the particular moral value of each of the available options.

Brave new worlds need well-engineered navigation instruments-this is, of course, if one wishes not to trust his destiny only to fate. Our species many times in the past-even better, all the times-never missed a single chance to show immensely unprecedented recklessness, which became the cause of some of the bleakest moments in our history. It is only hopeful that today we seem firm in our decision to schedule our own course through this labyrinth of exotic achievements, high promises and impossible hazards trusting the best compass we have in our possession, Bioethics.