In response to:

'Bioethics': The Case of the Fetus from the August 5, 1976 issue

To the Editors:

Peter Singer was among the first to draw public attention to the fact that philosophers have turned away from simply sharpening their pencils in language-analysis. “The death of ethical and political argument over important public questions was only temporary,” he wrote in an article entitled “Philosophers Are Back on the Job” [The New York Times Magazine, July 7, 1974].

Now in his review article “‘Bioethics’: The Case of the Fetus” [NYR, August 5], Singer finds that a great many people never ceased doing that job. He finds himself in strange company: professionals of various sorts and others who are not philosophers. He cries silence in a loud voice, and hopes the job will be left to philosophers who know how to deal with ethical questions. It would be news to Singer that philosophers have rarely been kings, and are certainly not going to be granted the status of chief policy analysts in democratic society.

So at least I read his listing with some distaste the occupations and social roles of the members of the National Commission for the Protection of Human Subjects of Bio-medical and Behavioral Research, whose report and recommendations on fetal research he reviews. So also his remark (in connection with my book The Ethics of Fetal Research, jointly reviewed) that I am to be classed among “religious people interested in ethics”; “bioethics” unfortunately has not depended more prominently on “the work of those interested in ethics simpliciter.”

I myself would like to see a philosopher simpliciter. That would be a dream walking. More noteworthy is the fact that Professor Stephen Toulmin, a distinguished philosopher at the University of Chicago, worked closely with the National Commission as an advisor on its report on fetal research policy, and is continuing to do so on other important questions to be taken up: research on prisoners, psychosurgery, etc. Moreover, a number of nationally known philosophers participate in the interdisciplinary discussions and publications of the Institute of Society, Ethics and the Life Sciences (the Hastings Center), in the teaching programs in bioethics at Harvard University, at the Kennedy Institute’s Center for Bioethics at Georgetown, and elsewhere in this country where these questions are being actively investigated.

It comes as no surprise that the author of Animal Liberation brings to his analysis of fetal research one test alone: Does such experimentation cause pain or suffering? Perhaps having one arrow in his quiver makes Singer an ethicist simpliciter. Still I doubt if many philosophers would agree with him that ethical reflection has no more to say than that, Singer is correct, however, in calling attention to the fact that the Commission gave negligible attention to the issue, which surely belongs among the principles of any sound ethics. Nor is pain to the fetus a consideration our Supreme Court would allow state legislators to mention even as one possible additional reason for prohibiting one method of abortion—it having recently ruled unconstitutional the attempt of Missouri to intervene by statute among available procedures, by prohibiting saline based solely on expert testimony that such procedure entails greater risk to the welfare of pregnant women.

Here there is space for only one counter-example—a well-known ground-clearing feature of philosophical discussions of ethics. At one point in their deliberations the Commission did discuss pain as a wrong-making criterion. Karen Lebacqz (one of those religious people interested in ethics) framed the following case, to ask whether there are other “harms” experimentation might do.

Take a child who is in his last gasping breath dying of cystic fibrosis. You know this child is going to be dead within ten minutes. You could inject this child full of pain killers so that it would feel no pain, and all of us I am sure would be horrified at the suggestion that it would then be all right to start dissecting that child and taking his organs out [or doing invasive research]…. I do not think it is enough to say that because someone does not feel pain and because they are about to die, that it is okay just to do whatever you want. (Transcript of fifth meeting, April 11-13, 1975, p. 281)

A pain-utilitarian would have to say that benefits-to-come would warrant human experimentation in such a suppositive case. The Commission did not, and in this I judge they were correct—despite the openness to criticism of other things in its report. It is true, of course, that in formulating ethical regulations governing experimentation, the fetus was understood to be a “human subject”—even in the face of the fact that physicians in medical practice often do not view the fetus as also one of their patients. Readers of The New York Review should know that the prestigious American College of Obstetricians and Gynecologists recently restated that traditional medical ethics, within the parameters of the Supreme Court’s 1973 abortion decisions. To be a patient is to claim more than protection from suffering. That too, of course.

Paul Ramsey

Harrington Spear Pain

Professor of Religion,

Princeton University

This Issue

November 11, 1976