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The Stuff of Life

by Rick Lewis

Bioethics is the ethics of tampering with the stuff of life. (‘bio-’ is from the Greek bios meaning life). When the life in question is human life, it is often called medical ethics. In his introduction to this issue, our guest editor Jeffrey Spike lovingly delineates the different branches of bioethics and recounts the short but event-filled history of his subject.

Bioethics may be a fairly new field of academic enquiry, but its objects range from the very ancient to the very modern. Two big medical matters which we’ll examine in detail are euthanasia and xenotransplantation.

Euthanasia has always been with us, to a greater or lesser degree; mercy-killing is probably as old as human history. Historical precedent doesn’t necessarily make euthanasia right, and it has been the subject of argument since Hippocrates penned his famous oath for doctors. The ancient version of the Hippocratic Oath says “To please no-one will I prescribe a deadly drug nor give advice which may cause his death,” though the modernised version sworn by new doctors today drops that line.

There have also been from ancient times societies such as Sparta which killed off their weakest or sickest members. This is not the same thing, as in one case the concern is for the patient and in the other the concern is for the convenience of other people. Opponents of euthanasia sometimes drag down the debate by ignoring this distinction. They draw comparisons with the Nazis’ eugenics programme, but the Nazis practiced not mercy-killing but murder. We try to raise the level of debate with a thoughtful article by Robert Card on care at the end of life, and also with an interview with the famous British ethicist Mary Warnock. Baroness Warnock sits in the House of Lords, where she has recently been involved in debates over a proposed new law which would legalise assisted suicide. She is also in the middle of writing a book about euthanasia.

Euthanasia is a many-faceted moral issue; it involves a complex web of moral agents and clients. Assisted suicide, voluntary euthanasia, non-voluntary, each raise their own unique questions. Furthermore, it raises on the one hand questions of personal morality for the various individuals involved, and on the other hand collective morality in the realm of public policy, which is what Warnock is mainly concerned with.

Many of us, if we are lucky, will be spared ever having to make a personal decision about euthanasia. But even so, the debate gives us a chance to examine questions which are universal. What do we mean by quality of life? How can we measure it? Who is in the best position to judge?

In contrast to euthanasia, xenotransplantation is as new as new can be; it will emerge from the research labs shortly. Transplanting animal organs into humans is about as Dr Frankenstein as you can get. You can almost see the Gary Larson-style cartoon scientist shouting “Fools! I’ll destroy them all! Hahaahahahah!” as he waits for the height of the storm. Add into this the slim but genuine chance that xenotransplantation will result in a devastating worldwide plague and one can begin to grasp why it is regarded by some as a tad controversial. But in a time of acute organ donor shortages this technique could save many lives, so Laura Purdy and Ololade Olakanmi debate the pros and cons.

Other organ-donation dilemmas are also explored, and our short story is set in the wonderful world of pharmaceutical research and marketing. What if all these medical advances do dramatically extend human lifespan? Tim Madigan takes a look at the problems of growing really old and decides that it beats the alternative.

Talking of transplants, the late Chicago-based political philosopher Leo Strauss has been accused of transplanting something alien into the heart of the American political system. It has been said (most recently in the BBC documentary series The Power of Nightmares) that Strauss, influenced by Plato’s idea of the Noble Lie, wanted to promote something similarly false-but-uplifting in the USA. Two of his former students defend him against those charges.

Another political philosopher who features in this issue is John Stuart Mill, advocate of logic, liberty, and pleasure, for the good reason that it is his 200th birthday this year. Happy birthday, John!

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