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France: a focus on the new reproduction.

France: A Focus on the New Reproduction

European bioethical discussion in 1987-1988 was centered on new procreation techniques such as artificial insemination and in vitro fertilization. Father Patrick Verspieren, in his compilation of the principal texts of the Catholic Magisterium Biology, Medicine, and Ethics[1] renders an account of Catholic writings from the declarations of Pius XII to the recent Instruction of the Congregation for the Doctrine of the Faith on "Respect for Human Life and the Dignity of Procreation" and the development of thought on these matters within the Catholic Church.

The Instruction has been much commented upon in Christian and non-Christian circles. It has afforded various European research centers the opportunity to place (or to place again) on their agenda the status of the human embryo. On May 15 and 16, 1987, for example, the Catholic Institute of Lyons organized a research conference on this question, the proceedings of which were published as The Status of the Human Embryo.[2]

In Master of Life[3] the late Professor Charles Lefevre of Lille University reaffirms the principle that moral law must be grounded in human experience and dignity. The Instruction is to be welcomed in the measure it addresses the situations faced by those for whom it speaks.

The same attention to concrete situations and persons enlivens the reflections of a one-day study session organized in May 1988 by the Brussels Bioethical Study Center. The conference proceedings, "Ethics and Techniques of In Vitro Fertilization,"[4] explore the hypothesis that technically assisted procreation, if governed by strict rules of respect for the human person, can in fact help to strengthen, rather than weaken the bonds between sexuality and procreation.

The possible positive use of these methods, however, should not lead us to a naive triumphalism regarding them. Jurists' reflections on the possible perverse effects of using such techniques carry us from ethics into the domain of law. Jean-Louis Baudouin and Catherine Labrusse-Riou, for example, demonstrate in Creating Man: By What Right?[5] the necessity of reciprocally questioning the progress of biomedical science and the juridical tradition that upholds direct consanguinial descent as a law-framed relationship.

That perverse tendency to give priority to technique over ethics or law is endemic in technical-scientific development. Co-authors of Mankind, Nature and Law[6] Labrusse-Riou and colleagues seek to show how mankind and nature, each the object of technological manipulation and therefore of law in a commercial society, can and must also be subjects of law. Another collaborative work brings together the contributions of Gilbert Hottois, Jacques De Vooght, Ramond Rasmont, and Paulette Van Gansen at Brussels University who considered the ethical stakes involved in their interdisciplinary research on philosophy, sciences, and applied biology. Science and Ethics[7] is primarily an analysis of the social impact of scientific development.

Western philosophical tradition requires such analyses to be supported by more basic, systematic reflections on ethics in general and medical ethics in particular, yet such syntheses are rare. Nevertheless, several attempts at systematization have been made recently. Medical Ethics[8] by Claire Ambroselli traces the history of medical ethics as it was shaped by the Nuremberg code. Through that story she examines the difficulties we now experience as we confront the growing power of medicine and biology with a moral philosophy the contents of which are in crisis.[9]

Jean-Francois Malherbe's Toward an Ethics of Medicine[10] places the doctor-patient relationship at the center of the ethics of medicine. More generally, he argues that the structure of reciprocity in which we are already situated and in which we must participate forms the basis of ethics.

Attempts at systematization are today presented with a new challenge: AIDS. There are essentially two types of literature on this problem. Works explaining the nature of the disease and in most cases opening on to the formulation of a more or less global preventive message are certainly the most numerous. Less common are essays on the psychosociological or political implications of the disease. Among these, two publications are worthy of particular attention: "AIDS: Rumors and Facts, Conversations with Emmanuel Hirsch,"[11] by Emmanuel Hirsch, as well as a remarkable analysis of the public and/or private nature of the disease by Eric Conan, "AIDS in the Public Domain."[12]

Ethical reflection on AIDS is almost nonexistent. The few studies are limited to invoking the deontologic principle of confidentiality or to briefly analyzing juridical or institutional repercussions of the disease. Interdisciplinary research by the Brussels Bioethical Study Center has tackled the broadest ethical aspects of this epidemic. In Citizens, Medicine, and AIDS,[13] Jean-Francois Malherbe and Sergio Zorrilla first examine the phenomenology of the intersubjective universe of AIDS. They then confront the crisis that this disease has created for medical ethics and justify, in the event, the importance of the principle of equilibrium that forms the basis of medical ethics today: that is, the equilibrium between the individual right to control information concerning oneself and the right of society to protect its members from dangerous individuals. Lastly, they show how this phenomenon must be situated in the context of the crisis through which both individuals and contemporary society are passing. This book is accompanied by a small medical dossier and a lexicon. References [1]Patrick Verspieren, Biologie, medecine et ethique, textes du Magistere catholique (Paris: Le Centurion, 1987). [2]Institut Catholique de Lyon, Le Statut de l'embryon humain (Lyon: Collection Fondation Marcel Merieux). [3]Charles Lefevre, Matre de la vie, naissance, mort, ethique (Paris: Le Centurion, 1987). [4]Ernest Loumaye and Jean-Francois Malherbe, eds., "Ethique et clinique de la fecondation in vitro," Louvain Medical 107:7 (1988). [5]Jean-Louis Baudouin and Catherine Labrusse-Riou, Produire l'homme de quel droit? Etude juridique et ethique des procreations artificelles (Paris: P.U.F., 1987). [6]Bernard Edelman, Marie-Angele Hermite, Catherine Labrusse-Riou, and Martine Remond-Gouilloud, L'Homme, la nature et le droit (Paris: Ed. Ch. Bourgeois, 1988). [7]Gilbert Hottois, Jacques De Vooght, Raymond Rasmont, and Paulette Van Gansen, Science et ethique (Brussels: Connaissance du reel, Brussels University Press, 1987). [8]Claire Ambroselli, L'Ethique medicale (Paris: P.U.F., 1988). [9]See also Charles Lefevre's specifically Christian reintroduction of the Greek notion of "happiness" in his Impossible bonheur? (Paris: Nouvell Cite, 1988). [10]Jean-Francois Malherbe, Pour une ethique de la medecine (Paris: Larousse, 1987). [11]Emmanuel Hirsch, "Le sida: rumeurs et faits: grands entretiens realises par Emmanuel Hirsch" (Paris: Cerf. Recherches morales, 1987). [12]Eric Conan, "Le SIDA dans l'espace public," Esprit 3-4 (1988), 63-70. [13]Jean-Francois Malherbe and Sergio Zorrilla, Le citoyen, le medecine et le sida, l'exigence de verite (Louvain-la-Neuve: CIACO, 1988). Jean-Philippe Cobbaut is a research fellow at, and Jean-Francois Malherbe is director of the Centre d'Etude Bioethiques in Brussels, Belgium.
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Title Annotation:aids for conception
Author:Cobbaut, Jean-Philippe; Malherbe, Jean-Francois
Publication:The Hastings Center Report
Date:Jul 1, 1989
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