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Italy: old problems, new books.

Italy: Old Problems, New Books

The growing interest in bioethics in Italy is clearly witnessed not only by a proliferation of public conferences and meetings, but also by an increasing number of articles in professional journals, no less than in newspapers and magazines for the general public. This is in part a consequence of an increasing interest in "applied ethics," though this interest itself has been strongly stimulated by bioethics (other sectors of applied ethics are much less cultivated in Italy). Moreover, ethical and juridical discussions are strongly interconnected in Italy, since Italian law (in the tradition of Roman law) presupposes that the legal assessment of facts be based on the application of pertinent general norms, which in turn are justified on the ground of more fundamental juridical principles. This typically deductive approach explains why the justification of the "right" law or legal principle often takes the shape of an ethical argument, and investigates the moral principles implicit in the existing legal system. An array of ethical and juridical doctrines have come into confrontation in the preparation and in the critical discussion of various initiatives. intended to introduce legal regulations regarding several aspects of biomedical practice.

Two further factors have shaped the tone and topics of current debate in Italy: the publication, in 1987, of the "Instruction on Respect for Human Life in its Origin and on the Dignity of Procreation" by the Vatican Congregation for the Doctrine of Faith, and the twentieth anniversary of Pope Paul VI's encyclical Humanae vitae. Together, these events have reinforced the (often polemical) trend of debates. Their joint impact is evident in the publication not only of new titles directly related to these topics, but also of new editions of earlier books of a more general character.[1] With this general framework in mind, it will be easier to survey recent Italian publications and to understand why we shall not mention topics such as euthanasia and AIDS, which have been seriously (but much less widely) discussed.

It seems advisable to begin with books. Only one volume deserving special mention appeared in first edition in 1988, Artificial Insemination: Moral Questions in Legal Experience, by Maurizio Mori, teacher of philosophy of law at the University of Milan.[2] Very rich in discussion of the international literature, this work is characterized by Mori's rigorous application of strict logical analysis, and conceptual clarifications. Its originality consists in trying to escape the impasse of opposite and reciprocally incommensurable moral outlooks by investigating whether the present Italian legal system implicitly supports one or the other of them. Mori concludes that there is a presumption in favor of the legitimacy of artificial insemination, and of IVF in particular, and that no objections of specifically "moral" character are really cogent. The section on artificial insemination is an excellent example of respectful and honest philosophical discussion.[3]

Other important volumes are second editions of already well-established general textbooks, such as those by Leone, Sgreccia, Spinsanti, and Tettamanzi. As textbooks, these have the advantage of being systematic and general, covering almost all the recognized fields of the discipline, but by the same token, they devote less space to critical discussion. Given the institutional affiliations of their authors, they present the most orthodox doctrine of the Catholic Church, though with different degrees of explicitness and flexibility, and with different weight given to various philosophical and theological arguments.

Biomedical Ethics by Sandro Spinsanti, who teaches bioethics at the University of Florence and is the director of a special department for "human sciences" at the Fatebene Fratelli hospital in Rome, is easily read, clear, and an essential introduction to the field; it honestly presents the different alternatives, rather than taking a firm position on the most controversial issues, and is characterized by a general attitude of equilibrium and wisdom.[4] Elio Sgreccia, professor of bioethics at the Faculty of Medicine of the Catholic University in Rome, on the other hand, provides a handbook in the precise sense of the word. His Handbook of Bioethics[5] is systematic, expository rather than critical, and aims at completeness. It is conceived as a work for consultation among health care professionals more than as a book to be read in full, at least by nonspecialists.

Bioethics[6] by Dionigi Tettamanzi, who teaches moral theology at the Seminary of Milan, complements Sgreccia's handbook. Its style of presentation is less close to classical Thomistic method, and more centered on present-day approaches, documents, doctrines, and arguments. You Shall Not Kill[7] covers much more than strictly bioethical issues. Authored by Lino Giccone (a teacher of moral theology at the Alberoni College of Piacenza), it is explicitly conceived in the best spirit of Catholic moral theology, taking the Bible and Church tradition as sources, but is also remarkable for its rigor and depth. Finally, we should mention Outlines of Bioethics by Salvino Leone,[8] a doctor, which also adheres to Catholic positions. It is valuable for its clarity, concreteness, and conceptual precision.

The aforementioned books are essentially of a philosophical or theological character. Expressly legal questions are addressed in the collective book, Artificial Procreation and Intervention in Human Genetics,[9] which discusses the report of the "Commissione Santosuosso," the committee charged by the Italian Ministry of Health with making proposals for legally regulating artificial procreation.[10]

Clearly, the bulk of scholarly production in the field of biomedical ethics comes from Catholic authors and circles. This is readily understandable, given the historical and institutional prominence of the Church in Italy. However, this dominance has also begun to produce a lively reaction by the so-called "secular" front, which seems on the way to organizing itself with the declared view of confronting the "Catholics." The most significant product of this tendency certainly is Mori's Artificial Insemination (which is, however, free of any polemical flavor), but two monographic journal issues also deserve mention. One is the special issue devoted to bioethics in Prospettive settanta,[11] the other is an issue of Biblioteca della liberta.[12] The latter is especially valuable, containing a very thoughtful article by U. Scarpelli on "Bioethics: In Search of the Principles," followed by an interesting critical discussion by Castignone, Jori, Lecaldano, Mori, and Quinzio. Scarpelli proposes basing bioethics on an "ethics without truth," having tolerance as its fundamental principle, which admits only those limitations deriving from the duty not to harm others.

The development of different approaches to bioethics is certainly very positive in itself; however it would be very sad if the Italian intellectual climate should become poisoned by a renewed fight between "Catholics" and "seculars." The radicalization of the positions would repress free thinking by Catholics, most of whom are very far from identifying themselves with extreme tenets, no less than by non-Catholics, most of whom are still ready to consider in a "non-intolerant" spirit the principle of tolerance. Both sides should take equal responsibility to avoid this danger. References [1]Among the publications directly occasioned by the Donum vitae, let us mention Il dono della vita, edited by Elio Sgreccia (Milano: Vita e pensiero, 1987). As to those related to the twentieth anniversary of Humanae vitae, the booklet of Dionigi Tettamanzi, Un'enciclica profetica. La Humanae vitae vent'anni dopo (Milano: Editrice Ancora, 1988) contains a reprint of articles published by the author in the Vatican newspaper Osservatore romano and in the Italian Catholic newspaper Avvenire. [2]Maurizio Mori, La fecondazione artificiale: questioni morali nell'esperienza giuridica (Milano: Giuffre, 1988). [3]Maurizio Mori is certainly one of the most significant scholars in the field of Italian bioethics. He recently edited a collection, Questioni di bioetica (Roma: Editori riuniti, 1988), and contributed several very good articles to monographic issues of various journals, some of which he has included in his book. His "Per una bibliografia italiana sulla bioetica" (Prospettive settanta, IX [1987/1], special issue devoted to bioethics) is the most comprehensive bibliographical survey of Italian studies in bioethics to date. [4]Sandro Spinsanti, Etica bio-medica (Cinisello Balsamo, Milano: Edizioni Paoline, 1988, 1st edit. 1987). Spinsanti is among the most sophisticated and productive specialists in bioethics in Italy, his particular field being illness, suffering, hospital care. Besides his original works, we should mention the collection recently edited by him: Documenti di deontologia e etica medica (Cinisello Balsamo, Milano: Edizioni Paoline, 1985), which presents the text of thirty-three official documents concerning deontology and medical ethics. [5]Elio Sgreccia, Manuale de bioetica (Milano: Vita e Pensiero, 1988); 2nd revised and enlarged edition of Bioetica. Manuale per medici e biologi (1986). [6]Dionigi Tettamanzi, Bioetica. Nuove sfide per l'uomo (Casale Monferrato, Alessandria: Edizioni Piemme, 1987). [7]Lino Ciccone, "Non uccidere". Questioni di morale della vita fisica (Milano: Ediz. Ares, 1988, 1st ed. 1984). [8]Salvino Leone, Lineamenti de bioetica (Palermo: Medical Books, 1987). [9]Procreazione artificiale e interventi nella genetica umana (Padova: CEDAM, 1987). [10]A book concerned with the same topic, issued in 1986, also deserves mention. Giovanbattista Ascone and Lilina Rossi Carleo's La procreazione artificiale (Napoli: Edizioni Scientifiche Italiane, 1986) takes into consideration different proposals for legislation in this matter, formulated in Italy and in other countries. A few more details concerning the "Commissione Santosuosso" may be found in the paper by Maurizio Mori, "Italy: Pluralism Takes Root," published in the Hastings Center Report, June 1987. [11]Prospettive settanta, IX (1987/1), Napoli, Guida Editori. [12]Biblioteca della liberta, XXII (1987/99). Evandro Agazzi is professor of philosophy at the Universities of Fribourg (Switzerland) and Genoa (Italy). He is also president of the International Academy for Philosophy of Science, and of the International Federation of the Philosophical Societies.
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Title Annotation:medical ethics
Author:Agazzi, Evandro
Publication:The Hastings Center Report
Date:Jul 1, 1989
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