Catálogo de publicaciones - libros

In the case of Re the UK Court of Appeal decided that it was permissible to separate two conjoined twins (both of whom would die within a matter of months if they were not separated) because this would give one of them a good chance of survival (whilst involving the almost certain death of the other) despite the objection of the parents.

The development of moral consciousness in advanced societies has gradually formed two levels of reflection and language within the moral realm: the morality of everyday life, and ethics or moral philosophy. The different moralities active in everyday life attempt to provide direct guidance for action. Ethics also guides conduct, but only indirectly, since its task consists in reflecting on the rational foundations of morality: foundations that are ultimately normative (Cortina 1986: chap.1).

New biomedical techniques, in particular those such as pre-implantation genetic diagnosis, cloning and germ line interventions, which make the “selection” and “manipulation” of human life possible, are among the most controversial bioethical topics under public discussion. They highlight fundamental differences not only between various interests, but also between basic moral convictions, world-views, and conceptions of the human being. It often seems impossible to reach a consensus among the representatives of divergent positions, and indeed insurmountable disagreements appear to predominate. In other words, a plurality of interests, assessments, convictions, world-views and conceptions of the human being stands in the way of a social consensus on the research and application of these biomedical techniques.

Medical history always has a presence in contemporary ethical debates. A number of medical ethicists have presented their understanding of the historical origins of medical ethics as a discipline (e.g. Jonson 1998; Carson 1997; Baker 1993–95). This story is important to them because it is intimately linked to their identity as professional ethicists. Most of them believe that during the twentieth century medical ethics awarded patient autonomy its proper place in medicine for the first time in history. Historical evidence also plays an important role in the discussion of particular ethical issues such as euthanasia and genetic diagnosis and/or treatment. In these debates the devastating experience of twentieth century totalitarianism, particularly German National Socialist medicine, still casts its shadow on today’s moral debates.

During the last two decades of the twentieth century, a cultural transformation of modern medicine began to take place in the industrialised countries of the western world. On one hand scientific and technological development accelerated, surpassing its previous limits. On the other, unconventional medicine reappeared after a long post-war period of silence, and its use has become more and more widespread during recent years (Eisenberg 1993 and 1998; Fisher 1994; Thomas 1991). Is it not strange that in an era of technological miracles and heroic medical performances people are again using either traditional or even exotic healing practices? Why do they do so if science advances in leaps and bounds, and applies its new techniques in practice? Is this a symptom of the fall of the rational world-view? What does it indicate? While Erich Fromm could still claim in 1973 that science is considered the highest value in industrial societies, that it is associated with moral correctness (Fromm 1997), at the beginning of the new millennium opinion is much more heterogeneous. In accordance with the sociological description of a postmodern society, different or even contradictory value systems coexist side by side and claim the right to their own existence. On the streets we are confronted with bizarre combinations of traditional and technological elements in human behaviour and appearance. To be individual in one’s style has become a new sort of cultural demand.

The title of my article carries a significant theoretical difficulty. In what sense can we speak about cultural diversity and “ethics”? In the work “Modernity – An Incomplete Project” Habermas recalls the idea of Max Weber fundamental to this topic who “characterised cultural modernity as the separation of substantive reason expressed in religion and metaphysics into three autonomous spheres. They are: science, morality, and art” (Habermas 1987: 148). That is why as soon as we start using the word “ethics” which from the time of Aristotle has meant a theoretical (secular) way of discriminating “good” and “evil”, we are immediately in danger of losing “cultural diversity” as soon as other forms of moral evaluation are neglected.

The new genetic anthropotechniques turn human life into a biotechnological mega-project. The implications reach much further than those of the older cultural-philosophical insight, that people have always had a ‘technical’ relationship with their body. The ‘body-techniques’ of Marcel Mauss determined the non-naturalness, or the character of the functions of the human body. Although the body was perceived as part of a never-ending cultural transformation, this transformation encountered its limits in the of the biological body, and in spite of their drastic effects on people’s behaviour, these cultural techniques remained . The current signature of anthropotechniques makes this biological borderline disappear: the techno-naturalistic symbiosis renders the determination of borderlines redundant. Every limit becomes a limit. A radicalised objectification of the body is now the precondition for analytical interventions : the genetic code is viewed as an ensemble of entities that are totally distinct in principle, and which can subsequently be rearranged and recombined in the context of a novel view. As such the transformation of the anthropological profile in its entirety becomes possible.

Differently situated people understand things differently. One part of ‘situatedness’ is contributed by embodiment. Life as a particular embodiment means not only having experiences that are not shared by people with a different body, but also understanding these experiences in a way that is shaped by this bodily reality. The point of standpoint epistemology (Harding 1991, Hartsock 1998) for example, is that by virtue of their common situation, certain groups of individuals – women, blacks, the poor – will share a privileged perspective on the experience of oppression, one that differs from the perspective of a differently situated group – men, whites, the rich. A situated perspective will give rise to characteristic perceptions and interpretations, including perceptions and interpretations of moral issues. Ultimately this will modify a person’s moral evaluations and judgements.

The aim of this paper is to reflect upon some fundamental issues in bioethics and how they may be related to the topic of limits. Of course, one might ask if there is any ethical item that cannot be related to the topic of limits. Ethics could even be defined as the art of setting and justifying limits in order to instil a sense of reasonable, acceptable regulations. Without limits everything and everyone would lack coherence and identity. On the other hand there seems to have been an important cultural change in attitude towards many forms of limitations which are no longer automatically accepted as the lines at which we have to stop, or at least must ask permission to go any further. They are seen more or less as borders that can be crossed in order to discover areas of completely new possibilities, broadening the range of human activities and conferring the power to transform the original structure of nature. As far as I can see the ethical evaluation of limits depends more on assumptions linked to general worldviews and less on the construction of an ethical argument in specific situations. It makes a difference whether the ethicist is fundamentally seen as the border guard between the areas of the permissible and the forbidden, or whether ethics first of all has the task of surveying a partly unknown territory where we are not sure of the precise demarcations. In the modern understanding of nature, normative standards must be justified and can no longer be deduced from the description of a natural framework implying pre-existing moral rules.

Since the late twentieth century the Euro-American mass media have given a great deal of coverage to debates over topics such as abortion, euthanasia, fertility treatment, surrogacy, organ donation, genetic screening and access to medical treatment. Topics outside the medical field such as genetically modified crops, investment policies, child labour and environmental issues have also been thoroughly aired. Since the debates have been primarily concerned with the ethics of such practices it could be argued that their prominence represents an increase in awareness of ethical issues. However, the voice of sociology and the other social sciences is rarely heard in these debates. Is this because (i) the social sciences have little to say on these issues, or is it because (ii) though it has much to say, the voice of the social sciences has had little impact, and is this, in turn, because (iii) the social sciences are not usually associated with the study of ethics and ethical issues?