Ethicists tread the moral maze

October 25, 1996

Public concern over euthanasia, foetal pain, assisted fertilisation and gene therapy has left western ethicists working overtime to draw the elusive line between "right" and "wrong".

But there will be no answer to the riddle of how we should run our lives until the experts can agree on the limitations of their nascent discipline, according to speakers at a conference on bioethics last week.

Ed Lepper, lecturer in philosophy at Buckinghamshire College, told the gathering of ethicists at the University of Central Lancashire: "There is considerable dispute about what consensus should involve and if we should be seeking it at all. Also, we must agree what the aims of bioethics are and what constitutes progress."

Dr Lepper is of the school that does not support attempts to reach universal agreement on what constitutes "acceptable ethical practice" in medicine.

"There is a tendency to look for over-arching moral theories to apply in all contexts rather than allowing for cultural differences," he said. "But if we seek consensus, this might prevent us from acknowledging and dealing with cultural complexities and change."

He added: "Different points of view are necessary for new ideas to form and for the development of ethics. The important thing is to be flexible on issues and to safeguard the views of people with different views to the majority."

Dr Lepper recognises that his priorities clash with the public's hunger for an all-encompassing code prescribing human decency. He said: "Consensus makes us feel safer. If we all subscribe to the same view-point, we feel good, and then when we are confronted by moral problems, we can build on a common foundation."

But this, he insists, does not justify a move to fossilise public opinion in legislation. "We could have something less earth shattering - more a general agreement [incorporating] a wide range of ideas."

Supporting this notion is Mylene Botbol-Baum, ethics researcher at the University of Louvain, Brussels, who strongly opposes any EU attempt to establish a European consensus on euthanasia.

She said: "There is a big difficulty in finding common principles. Even within Europe we have such different cultural backgrounds that political consensus today would be a lie - a Prozac measure - to avoid confronting the public's problem with dissension."

Dr Botbol-Baum would prefer member states to tackle the debate independently. Eventually, she hopes each country will allow hospital doctors to form a code of practice allowing them to help patients die with dignity after careful deliberation with the patient.

"It would work like many other medical privileges but would not force doctors to evaluate between the law and the suffering of the patient," she said.

Derek Sellman, lecturer in nursing at the University of the West of England, joined Dr Lepper and Dr Botbol-Baum in supporting diversity in opinion on ethical quandaries.

"Moral uncertainty is inevitable but we all value autonomy," he said. "Diversity keeps us busy and intellectually active. If we did find consensus, it would not last. We would find ourselves saying: 'Morality is dead; long live morality'."

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