A Physician First

The head of President Bush’s Council on Bioethics, a lifelong Catholic, shares his feelings on the future of bioethics with the Register.

DR. EDMUND PELLEGRINO is chairman of the President’s Council on Bioethics.

He is also a member of the International Bioethics Committee of (UNESCO the U.N. Educational, Scientific and Cultural Organization) and honorary member of the Pontifical Academy for Life. He has been involved in leading founding of many medical and ethics centers throughout the United States, including the Center for Clinical Bioethics and the Kennedy Institute of Ethics (both at Georgetown University), The Catholic University of America (as president), Yale-New Haven Medical Center, the University of Tennessee, the Department of Medicine at the University of Kentucky, and the Health Sciences Center of the State University of New York-Stony Brook.

Pellegrino, who was in Rome to give a course at Regina Apostolorum Pontifical University as part of the university’s intensive master’s program in bioethics this spring, spoke to Legionary Father Nikola Derpich.

Who were some models of faith for you as you were growing up?

During my childhood, my parents, and especially my mother, by their examples and teaching, made me aware that faith should be the center of my life, and the guide to my conduct and behavior. This was re-enforced by our regular attendance at Mass, and the many religious feasts which Italian-American families observed regularly and we children enjoyed so much. Later, at the Jesuit high school I attended, St. Francis Xavier and St. Ignatius of Loyola became models of inspiration. I was also inspired by the learning, spirituality and characters of the young Jesuit scholastics who were my teachers.

Was there a moment when you realized your calling to get involved in medicine and your Catholic faith had to go hand in hand?

There was no specific moment. I was interested in science from my first years of being able to read. My teachers fostered that interest, and gave me extra reading in the biological and physical sciences. In college, that interest led me to major studies in chemistry. My special interest was physical chemistry. In my senior year at college, I had to write a thesis on the way the body maintains its acid-base balance. My interests in chemistry were, as a result, turned to human physiology and biochemistry. This led to my decision to study medicine rather than obtain a doctoral degree in chemistry.

My home life and my studies in a Catholic college and high school made it a matter of course to relate all my learning to my Catholic faith. There was never a question of opposing science to faith. Roger Bacon, the Franciscan, and Albertus Magnus, the Dominican, both 13th-century cleric-scientists, became paradigms of how science and faith could be harmonized. The two reinforced each other. I was puzzled in my reading to find that some scientists were professed atheists.

In college, at St. John’s University in New York, philosophy and theology were required courses through the four-year curriculum. These courses cemented the connections between faith and reason. Ever since, I have become more impressed with the way faith and reason reinforce each other. That conviction has always been the focal point of my learning, teaching, research and writing.

When I entered medical school, the obvious moral nature of medicine made my education in philosophy and theology the foundation for my interests in medical ethics and the philosophy of medicine. My teachers in high school (the Jesuits) and in college (the Vincentians) encouraged my convictions about faith and reason. They lent me books that went beyond my class work in science, philosophy and theology. In college, long before “bioethics” was born, I was exposed to the 500-year-old Catholic tradition of “medical morals” by the readings which were brought to my attention.

What direction and trends in bioethics do you see for the future?

Prophecies are perilous. They are best left to the elderly since they will not live long enough to be proven right or wrong. Being elderly, I will answer your question about the future of bioethics. Three things seem certain to me: that bioethics will be with us for a long time; that it will become more complex; and that it will become one of the most powerful shaping and divisive of social forces on a global scale.

Bioethics will be with us as long as we continue along our current technological trajectory. If humans do not succeed in destroying themselves in an atomic holocaust, their technical ingenuity will pose ever more complex moral problems. As biotechnology gains increasing power over every aspect of human life, the need for ethical constraints will also increase exponentially. Can we preserve our dignity as humans and avoid being slaves of our own ingenuity? This is the central question bioethics must face.

Bioethics will become more complex as the range of biotechnology envelops the whole of our individual personal, social, public and political lives. No realm of human existence will be beyond human manipulation. The ultimate questions of ends, purposes, right and wrong, will increasingly fall within the purview of technology and science. More and more of the doors of technical control will be opened and more impetus will be given to the redemption of man by man. This complexity will befuddle the ordinary person, even the well-educated, person, who will be exposed to the modern temptation to turn complex questions over to the “experts.” The demon of technocracy is already being resuscitated as people turn in desperation to specialists for moral guidance.

Finally, the challenges to religion will become ever more direct and uncompromising. We are already in an era of militant atheism based largely in a substitute religion of reason without faith. All bioethics is built on some idea of man, his nature and destiny. This idea shapes what we think is right and wrong, good and bad. There are signs today of a widening gap in our ideas of what it means to be human. That gap will expand as people everywhere realize that they are being confronted with decisions about whether or not there is some source of moral authority beyond man’s personal will.

The challenge for the Church in these three trends is enormous. It has been clearly recognized by recent pontiffs, especially John Paul II. We must continue to engage modern technocracy, to do so on the most rigorous terms intellectually and by the fidelity of our own personal behavior to the teaching of the Gospel. At the same time we must comprehend and use technology wisely, well and in conformity with man’s true destiny.

Will that breach ever be healed?

We must never give up the hope that the breach will be healed or at least narrowed. Catholics, other believers and non-believers may exist peacefully with each other. There is a small but growing movement in contemporary culture to eradicate the Church’s presence in health care. The movements to secularization and moral relativism, as Pope Benedict XVI has recognized, will make healing the breach all the more difficult.

The Church has survived crises many times and it will survive this one. Believers must understand science and technology, accept what is suited to its methods and examine critically its claims in the moral sphere. Einstein said it well: “Yet it is equally clear that knowledge of what is does not open the door directly to what should be.”

A civil dialogue, without recourse to diatribe, is essential to the coexistence of believers and non-believers.

Catholics who want to proclaim the Gospel of life in their every day lives should engage in the dialogue to which I have just referred. Physicians, scientists have an obligation to do so in their professional lives. The rest of us can do so with our friends and colleagues. Above all, our personal behavior should reflect authentically the way Christian and Catholic belief makes a difference. This means that we must always approach those who disagree with charity rather than pious self-righteousness. Christians must in fact be Christian.

I have spent half of my academic career in non-Catholic and very secular institutions. I have been impressed by the desire of many of those who disagree with us to hear us. But we must respond with accurate knowledge of the faith and show genuine respect for the human dignity of the dissenter who questions us.

Legionary Father Nikola Derpich

writes from Rome.

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