Taking stock: the quandary of quandary ethics.

My wife and I have been in the process of moving from Houston to North Carolina. I've taken a newly created chair in religion and science at Davidson College, after having worked for many years in various positions at Rice University and Texas Medical Center. It's exhilarating to return to full-time undergraduate teaching. I'm responsible for interdisciplinary courses that challenge students to explore how religious perspectives inform, and are informed by, recent scientific and technological developments, in addition to other courses in applied ethics and in Catholic social thought.

A colleague once offered a sermon, albeit pre-Katrina, about an important rule to follow when making a move: Know what to leave behind, what to keep, and what to give away. As is the case with any academic, the move forced me to face closetfuls of books and files and to plow through mountains of material. In the process, I've had the opportunity to look back on the concerns that fueled my continuing interest in bioethics.

Some of the files, now quite dated, have been easy to toss. Others, although dated in their details, remain historically relevant. An example is my "Louise Brown" file, about the first successful in vitro baby. It is now twenty-seven years since she was born. In the interim, more than a million such children have been born, enough for proponents to label IVF procedures an obvious "success." That may be true in cases where an infertile couple conceive. Yet the generally low "success" rate of IVF, with the usual need for many attempts at the procedure, has led to the storage of hundreds of thousands of frozen embryos. That "surplus," in turn, has fused with the utilitarian instincts of some stem-cell advocates in ways that many Americans find troubling.

My file on fetal-tissue transplantation--with prophecies about forthcoming clinical applications that never materialized--reflects our cultural willingness to align ourselves eagerly with the latest technological imperative. One might think that recalling the earlier debate would prompt a sense of caution among today's stem-cell proponents, but their enthusiasm for utopian claims appears unabated.

On the other hand, concerns about opening the floodgates by legalizing physician-assisted suicide now seem over-wrought. There remain important moral reasons for continuing to oppose the practice, but fears about hordes of terminal patients ready to slide down the proverbial slippery slope have not been borne out. Since 1998, a reported total of 208 patients have ended their lives under the provisions of Oregon's Death with Dignity Act, fewer than thirty patients a year.

After many hours of discarding, relabeling, and reassembling my files, two powerful impressions linger. First, I'm left with the sense that bioethics as a field too often falls prey to the latest sensational headline. Sometimes bioethics arguments seem to be the stuff of tabloids, with "experts" reducing complex matters of human meaning and purpose to shallow sound bites, as exemplified by the Terri Schiavo case. Yet any philosophical or theological bioethics worthy of the name challenges us to draw on deeper reserves of tradition and wisdom than the facile reactions reflected in much of our public discussion. A merely technical progress is not a synonym for human betterment. Nor is the satisfaction of individual preference (even in the aggregate) a political theory sufficient to determine the requirements of the common good.

Pruning my files has also reinforced a second general concern. The "quandary ethics" dear to headline writers often crowds out less sensational issues that continue to pose moral challenges of a deeper, more enduring sort. For example, where do things stand in the public debate about access to basic health care for all? What about social guarantees for a fair and living wage amid the displacements of globalization? After all, issues of the common (indeed the global) good, of providing basic care to all in need, remain more important matters than the latest pharmaceutical innovation marketed to "health-care consumers." Our concern for the least among us more accurately reflects our ethical commitments than our armchair musings about cloning as a reproductive option or about efforts to "conquer" aging.

Despite my winnowing process, I've kept the majority of my files. Among the thickest ones, crammed with decades' worth of debates, failed promises, and missed possibilities, are papers on healthcare reform and the concrete requirements of social justice. I'm not sure when, or even if, we're likely to make progress on such fundamental issues of the common rather than the individual good. But writing for this magazine reminds me of where my priorities as a Catholic bioethicist should lie. My recent move has been rewarding on many levels.