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163 pp Price £6.99 ISBN 1-84195-007-6 (p/b)
Edinburgh: Canongate Books, 2000 .
In recent decades medical ethics has been dominated by the notion that doctors ought to do nothing for patients without their consent, but despite this doctors are given little help in determining just how to conduct a dialogue with patients whose value systems may be radically different from their own. While, as Tristram Engelhardt has shown in his latest book The Foundations of Christian Bioethics (Swets and Zeitlinger, 2000), it is relatively straightforward to construct a medical ethic for a homogeneous community of doctors and patients, it is quite a different matter to construct one for a secular profession practising in a pluralist society such as ours.
Although neither of the two short books being reviewed here is concerned primarily with medical issues, both illustrate how powerful are the moral dilemmas generated by medicine and medical technology and both take as their aim the exploration of what a shared ethic might look like. Both too are exemplary in the modesty with which their authors put forward their views, in the respectful lack of polemic with which each argues, and in the profound theological and cultural insight that each brings to the enterprise. By different routes the Protestant bishop, the Roman Catholic cardinal and the secular humanist arrive at something very close to common ground—that the specialness of humanity requires us each to respect others' autonomous choices.
Richard Holloway, Bishop of Edinburgh and the Scottish Episcopal Primate, brings to his highly readable Godless Morality seven years' experience on the Human Fertilisation and Embryology Authority (HFEA) as well as a deep understanding of the urban environment in which he, along with many physicians, works. He begins his book with an analysis of the roots of morality in the West, their attenuation in the modern world and the attempts being made to recreate common ground without recourse to God. He then moves in successive chapters to consider first our changing attitudes to sexual and gender morality in a world that encompasses the current reality of ‘the reproductive supermarket’, including the reality of genetic modification; then to the implications of acknowledging respect for personal autonomy especially as this applies to interpersonal relationships, including power relationships, and to the use of noxious substances; and lastly to the question of what it means to be human and what that meaning implies at both ends of life. In a closing chapter, ‘Deciding for Ourselves’, he returns to the moral confusions of the present day. His conclusion is optimistic: the moral traditions that no longer work were ones that we have built ourselves and so the chances are good that we can build new ones for the future.
While Holloway's book grew out of his time on the HFEA, the genesis of Belief or Unbelief lay in the remarkable series of free public lectures that Carlo Maria Martini, Cardinal Archbishop of Milan, has given in that city under the title ‘Lectures for Non-believers’ and which over the years have been attended by tens of thousands of Milanese. In 1996 an Italian newspaper invited Martini to join with the scholar and novelist Umberto Eco in a series of dialogues on the place of religion in contemporary society. This book, consisting of four pairs of amiable and respectful confrontations, is the result. While issues thrown up by medicine are less overtly addressed, these nevertheless run like a thread through the book. Four general topics are discussed—the place of ethics in the modern world and the importance, or the lack of it, of the Christian tradition; the ends of life and its meaning for our thinking about conception, abortion and euthanasia; the place of women, and by extension the role of authority in human relations; and the necessity in today's world of accepting respect for personal autonomy as a guiding principle for thought and action. For the first three of these topics it is the secular humanist Eco whose voice we hear first and Martini who responds to his challenges; only in the last dialogue does the priestly view take the lead. Both are men of the world (Martini has been mentioned as a possible successor to John Paul II) and both are profound scholars; each clearly respects the other. The result is a remarkable tour d'horizon that leaves one hoping that there might be more to come. Their book is less easy reading than Holloway's but none the worse for that. The reader comes away having had the fascinating experience of hearing two first-rate minds at work.
Like all thoughtful studies of ethics, especially of ethics for a society such as ours, neither of these books aims to provide simple answers. What both do is to lay out the issues that need to be dealt with and show how widely differing sets of views can find common ground. They serve as models of how such dialogues can be conducted without the bitterness and acrimony that so commonly afflict these kinds of arguments. They should be read by all those who think that their particular God-given views are the proper ones for us all.