Practicing ethics: where's the action?

Practicing Ethics: Where's the Action? When I first joined The Hastings Center twenty years ago, I was a young biochemist working at the National Institutes of Health, researching problems that had solutions, albeit about bacterial physiology. Thanks in part to my involvement with Hastings, I am today a humanist pursuing questions without final answers about human nature and human good, and I can boast only of having at last become old enough to be entitled to my somewhat traditional beliefs and concerns. "Nestor of bioethics," remarked one of my faculty friends when I told him of this speech for this occasion. Because I want to speak mainly about the present and the future, I will not Nestor you with tales of the good old days. But it would be useful to remind ourselves of a few salient facts. First, the late 1960s were a turbulent time for American society, but a sleepy time for the study of ethics. Academic philosophy busied itself with other things, and no one had ever heard of "ethicists." Second, the effects of the so-called biological revolution were only just beginning to be felt: oral contraceptives and psychedelic drugs were in use and the first heart transplant had just been performed, but legal abortion, fetal tissue implantation, prenatal genetic diagnosis, human in vitro fertilization and embryo transfer, surrogate motherhood, gene synthesis and gene splicing, hospices, and orders not to resuscitate were things of the future, though some of them were already foreseeable. Third, those of us who gathered to found The Hastings Center, though we came from a variety of cultural and professional backgrounds, shared a concern for the human meaning of these and other anticipated new biomedical developments. Some of us inclined toward hope, eager to have the benefits of new technologies, but with protections against error and folly. Others of us inclined toward fear, repelled by certain prospects of biomedical intervention and concerned that even the well-intentioned uses of the new powers over the human body and mind might inadvertently diminish our humanity. But though we were variously moved, moved all of us were by moral (or religious) sentiments and concerns. If I remember correctly, only one of the founding Fellows made his living teaching philosophy, and he would come to meetings only if they did not require that he violate the Sabbath. It goes without saying, but it is important to note, that none of us came into bioethics through either the study or the practice of bioethics as it is now practiced and studied. That was then. This is now. Today the ethics business is booming. There is ethics action everywhere. Most medical schools offer courses in medical ethics; in colleges and universities undergraduate ethics courses abound; and some philosophy departments offer PhD.s in bioethics. Many hospitals have established ethics committees, mainly but not exclusively for dealing with decisions regarding termination of treatment, while institutional review boards must rule on all sorts of experimentation with human subjects. Courts of law are increasingly asked to settle ethical conflicts, while blue ribbon commissions, national and local, analyze issues and issue guidelines to govern practice. Many other research institutes have followed The Hastings Center into the field, and the literature - professional and popular - grows, it seems, exponentially. And ethicists are in vogue: they get positions in medical schools, are quoted in the daily papers on every hot topic, and appear frequently on television and talk shows. The Hastings Center has been and remains a major force in these developments. Since its beginning it has led the action on all these fronts, shifting its energies as the times have changed, but being never far from the middle of things. For those who practice ethics - especially biomedical ethics - Hastings, more than anywhere, is where the action is. In looking toward the future of The Hastings Center, we do well to examine the present. …