conference proceedings of congress International Bioethics 1999. Bioethics and dignity in a pluralistic society

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Foreword

Ana Marta González
Director of group Interdisciplinary research Bioethics
University of Navarra

On 21, 22 and 23 October 1999, the First International Bioethics conference took place in Pamplona, organised by the high school of Sciences for the Family, with the partnership of department of Philosophy, of the department of Philosophy of Law, the high school of Human Rights and the department of Humanities Biomedical of the University of Navarra. These conference, in which prestigious North American and European specialists took part, were attended by around 150 professionals from the bio-health field - from medicine, pharmacy and nursing - as well as university professors from different specialities interested in subject. The geographical origin of these professionals was varied: mostly Spaniards, from all parts of the country; but also a large representation from Latin America - Mexico, Peru, Argentina, Chile, Colombia - as well as - although to a lesser extent issue- professionals from other European countries: Holland, Sweden, Lithuania...

These few data alone reflect a reality that any observer can easily corroborate: bioethics has become in a matter of a few years a discipline in which very diverse professional interests and people from the most varied backgrounds converge. The reason is to be found in the topicality of the issues it deals with, which constitute a fertile field of problems for professionals in the bio-health field in their daily work, and which at the same time represent a challenge for those of us who are professionally dedicated to the study of the legal and philosophical assumptions and implications of all these questions.

Experimental science and Philosophy; practical and theoretical aspects inevitably meet quotation in any bioethical reflection, to the extent that bioethics has become not only a paradigm of interdisciplinary communication within the university institution itself, but also a paradigm of "discipline-bridge" between university and society. Few issues simultaneously arouse the interest of academics and public opinion as much as bioethical questions. However, precisely because of this, and given that in our society science has institutionally assumed the responsibility of advising political power, the answers given by bioethics to the new questions posed by science and technology at every step have an enormous power to shape society. In this sense, it is clear that the human or inhuman nature of our society and, more generally, of the world will depend to a large extent on the answers given to these questions, since every decision taken in a developed country on this subject -whether it is a right or wrong decision- quickly becomes a point of reference letter worldwide.

It is this awareness that sometimes gives bioethical reflection an excessive urgency, an urgency that makes it run the risk of forgetting its scientific dimension in order to take it down the path of the ideological speech . This happens, for example, where the autonomy of the person is invoked as the only reason for equating what is technically possible with what is ethically possible. However, practical problems do not admit of such a simple solution. Not everything that can be done from a technical point of view can be done from an ethical point of view. Practical issues, especially when they have far-reaching social consequences, have to be looked at from many angles. And it turns out that all bioethical issues have a clear social dimension, because they decisively affect people's way of life, their life expectations, the subject of relationships they establish. In these cases, it is not fair to entrust the total responsibility for these decisions to the anonymity of "science", because we are all affected. It is not right to delegate to "bioethical experts" the decision on problems which, in the end, are our own.

Bioethical issues are everybody's business, not skill exclusively for specialists. Consequently, they must be dealt with openly, clearly stating all their personal and social implications. For this reason, the repeated appeal to the "autonomy of the individual agent" as the only reason for equating what is technically possible with what is ethically possible on the social level is an unacceptable simplification of the ethical discussion ; a discussion, moreover, which, under this budget, is doomed to disappear: your autonomy is mine: and that's all there is to it. It is clear that in such a society, of individuals closed in on themselves, communication is superfluous or trivial. Under these conditions, the state, the supposedly impartial arbiter of autonomous individuals, would be left with the difficult task - the impossible task - of reconciling individual autonomies to the satisfaction of all, that is to say, to the satisfaction of no one. For if there is no such thing as a truth of human coexistence, a truth that goes beyond simple reciprocal tolerance - of "live and let live" - no one has to admit that this particular solution, with which he could be immediately harmed, is the best among the various possible ones. If reasons are lacking, only force is possible: perhaps not physical force, but the force of the majority, to which the individual conscience would have to bend, or else oppose, but again without reasons. Respect for the individual conscience would be a gracious concession of the sovereign power of the state to the sovereign power of the individual.

On the contrary: only if there is a truth of human coexistence, to which each and every one of us has access in principle, and about whose concreteness we can compare views in the course of dialogue, only then can we begin to take seriously the socially shaping power of the freedom of each and every member of a society. Only then do we take freedom seriously.

It does not seem idle to me to devote this introduction to reflecting on these questions, if we take into account the topic which gives degree scroll these conference: Bioethics and dignity in a plural society. I leave it to Prof. D'Agostino to reflect on the role of dignity in bioethics, in order to focus for a few moments on the meaning of the expression "plural society". By it I mean the factual coexistence of people with different religious, moral and political ideas, as well as the coexistence of people of different ethnicities and cultures. In this respect, the first thing to stress is that, from an ethical point of view, the factual and legal recognition of human plurality is not in itself incompatible with upholding the existence of a truth of human action; a truth that some discover earlier and others later, and which, in any case, can only be accepted in freedom. From this point of view, then, social plurality is even a positive and enriching reality, which, far from being against the truth, is in itself an expression of plurality and human freedom, without which - by the way - one could not speak authentically of ethical truth. From agreement it seems appropriate to distinguish, at least conceptually, between "plurality" and "pluralism". In contrast to the simple recognition of social plurality, what is proper to pluralism would be to deny the existence of a truth of human action, in the idea that such a truth could not be compatible with the fact of social plurality. This is manifestly false. The fact that there is a plurality of ideas, of worldviews, of lifestyles, in no way prevents us from speaking of a truth of human action and coexistence, of a truth of man. It simply means that this truth may not be possessed by each and every human being once and for all; that it must be the object of a search, and of a common search. In fact, it is, when we are in serious dialogue, that is, when dialogue is more than a reciprocal concession of advantages.

In the context of a pluralistic society it is not only legitimate but also necessary for everyone to state as convincingly as possible what he or she knows to be true, with good reasons, in the hope that others will see it as true and, if not, to refute it, also with reasons. Which reasons are to be considered relevant and which are not in the context of a pluralistic society cannot be decided "a priori". The relevance of reasons for a particular person depends on many factors that no one is allowed to rule out in advance. If in any case we consider that a particular reason rests on a worldview that is completely alien to our own, the way forward is not to disqualify that worldview in its entirety, because that would be tantamount to disqualifying the person who has grown up with those schemes, on internship. Rather, the way is through patient and methodical discussion, in which all the aspects involved in a particular problem come to the fore: thus, for example, we come to have knowledge of social implications of our actions that we had not previously noticed. In this way dialogue can serve to nurture the prudence of our ethical and political judgements. To engage in dialogue in this way requires, of course, a great deal of ethics, as well as a certain intellectual rigour. However, these two dispositions are only awakened where there is respect for people and confidence in the possibility of reaching the truth. These are the principles that inspire authentically human coexistence. From here, building a just and peaceful coexistence is a path that is walked in very small steps: talking about concrete problems, not worldviews; striving to see the fragments of truth latent in the worldview with which the other presents itself to us. With that we can begin to dialogue and truly build a plural society, because plurality is not so much about ideas as it is about people.

It only remains for me to thank so many people for their efforts in bringing this publication to fruition. First of all, to the Interdisciplinary group of research Bioethics of this University, recently constituted. To all its members, belonging to department of Philosophy, of Philosophy of Law, to department of Humanities Biomedical, to high school of Human Rights, to high school of Family Sciences, and to all those - students, staff professor and not professor- who have contributed from the origin of an idea to its realisation internship and the transmission of its fundamental content: human dignity in the context of a pluralistic society.