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Chapter 1 The basis for evaluation of an ethical position
SECTION TWO GENERAL CONSIDERATIONS
Chapter 1 The basis for evaluation of an ethical position People use many different yardsticks to judge the ethical character of their actions. Very often, the basis for judgment remains implicit, even unexamined. Thus, there are appeals to immediate utility, religious authority, a sense of the appropriate (or a kind of "gut feeling"), vocational commitments, self-fulfillment and autonomy, the legally prescribed or proscribed, etc. All of these considerations legitimately have a bearing on the determination of what is ethically right or wrong. For instance, one cannot ignore the legal status of an action or omission in an overall ethical evaluation. Similarly, religious belief, for those who share the belief, will often aid persons in the discovery of the ethical dimensions of certain actions. In a culturally pluralistic society with differing expectations and histories, which one of these appeals will dominate in an ethical inquiry will vary and so will the evaluation based on it. However, there is a more general ethical criterion which these appeals illuminate and to which they point. That criterion is the human person integrally and adequately considered. "Integrally and adequately" refers to the sum of dimensions ofthe person that constitute human well-being: bodily health; intellectual and spiritual well-being, which includes the freedom to form one's own convictions on important moral and religious questions; and social well-being in all its forms: familial, economic, political, international, and religious. Actions (policies, laws, omissions, exceptions) that undermine the human person, integrally and adequately considered, are morally wrong. Actions that are judged to be promotive and supportive of the human person in the sum of his or her essential dimensions are Vol. 62, No.5, November 1994
morally right. It is this personal criterion in all its comprehensiveness that should be the basis of our judgments about the ethical character of various reproductive interventions. Several things should be noted about this criterion. In principle, it calls for an inductive approach based on experience and reflection. In addition, there are some things that we have already learned and generally accepted from experience (e.g., that violence begets violence). Furthermore, there are other things that so offend an inner sense of what is held to be proper or sacred that no experience is necessary to expose their moral character (e.g., the Nazi medical experiments). These only underline the principle: that to judge the moral character behind many human actions, experience of their comprehensive impact on persons is essential. Still further, some actions remain ambiguous because they involve both beneficial and detrimental aspects, because their impact on persons is unknown, or because they are variously evaluated. For example, some persons will see benefit to a single person or couple as dominant; others will view potential risks to society as a whole as taking precedence over individual benefits. Such moral ambiguity and pluralism calls for openness, caution, and a willingness to revise evaluations. This attitude has proved especially important with medical technology, in general, and with novel patterns of reproduction, in particular. The personal criterion used here requires the basic willingness to say "no" where we have said "yes"and "yes" where we have said "no." Finally, in applying the personal criterion, one must take into account that the human person is both individual and social. Hence, what is promotive or detrimental to the person cannot be Supplement 1
IS
assessed solely in terms of individual impact but must take into account overall social impact as well. Because the assessment of what is promotive or detrimental to the person, integrally and adequately considered, is a broad one, it must be recognized
28
Supplement 1
that a moral "yes" or "no" is not always an absolute. Such a judgment may represent only a pause on a path toward a consensus that has not yet been clearly spelled out. In this report we seek to move toward such a consensus.
Fertility and Sterility
Chapter 1 The basis for evaluation of an ethical position People use many different yardsticks to judge the ethical character of their actions. Very often, the basis for judgment remains implicit, even unexamined. Thus, there are appeals to immediate utility, religious authority, a sense of the appropriate (or a kind of "gut feeling"), vocational commitments, self-fulfillment and autonomy, the legally prescribed or proscribed, etc. All of these considerations legitimately have a bearing on the determination of what is ethically right or wrong. For instance, one cannot ignore the legal status of an action or omission in an overall ethical evaluation. Similarly, religious belief, for those who share the belief, will often aid persons in the discovery of the ethical dimensions of certain actions. In a culturally pluralistic society with differing expectations and histories, which one of these appeals will dominate in an ethical inquiry will vary and so will the evaluation based on it. However, there is a more general ethical criterion which these appeals illuminate and to which they point. That criterion is the human person integrally and adequately considered. "Integrally and adequately" refers to the sum of dimensions ofthe person that constitute human well-being: bodily health; intellectual and spiritual well-being, which includes the freedom to form one's own convictions on important moral and religious questions; and social well-being in all its forms: familial, economic, political, international, and religious. Actions (policies, laws, omissions, exceptions) that undermine the human person, integrally and adequately considered, are morally wrong. Actions that are judged to be promotive and supportive of the human person in the sum of his or her essential dimensions are Vol. 62, No.5, November 1994
morally right. It is this personal criterion in all its comprehensiveness that should be the basis of our judgments about the ethical character of various reproductive interventions. Several things should be noted about this criterion. In principle, it calls for an inductive approach based on experience and reflection. In addition, there are some things that we have already learned and generally accepted from experience (e.g., that violence begets violence). Furthermore, there are other things that so offend an inner sense of what is held to be proper or sacred that no experience is necessary to expose their moral character (e.g., the Nazi medical experiments). These only underline the principle: that to judge the moral character behind many human actions, experience of their comprehensive impact on persons is essential. Still further, some actions remain ambiguous because they involve both beneficial and detrimental aspects, because their impact on persons is unknown, or because they are variously evaluated. For example, some persons will see benefit to a single person or couple as dominant; others will view potential risks to society as a whole as taking precedence over individual benefits. Such moral ambiguity and pluralism calls for openness, caution, and a willingness to revise evaluations. This attitude has proved especially important with medical technology, in general, and with novel patterns of reproduction, in particular. The personal criterion used here requires the basic willingness to say "no" where we have said "yes"and "yes" where we have said "no." Finally, in applying the personal criterion, one must take into account that the human person is both individual and social. Hence, what is promotive or detrimental to the person cannot be Supplement 1
IS
assessed solely in terms of individual impact but must take into account overall social impact as well. Because the assessment of what is promotive or detrimental to the person, integrally and adequately considered, is a broad one, it must be recognized
28
Supplement 1
that a moral "yes" or "no" is not always an absolute. Such a judgment may represent only a pause on a path toward a consensus that has not yet been clearly spelled out. In this report we seek to move toward such a consensus.
Fertility and Sterility