“Scientific progress alone would be a hollow victory without the moral or ethical progress that must accompany it and ensure the humanization and humanity of our development and use of science.”
The canary used to detect poisonous gas in coal mines is a vivid metaphor for those who detect danger in our society and environment. (See my poem: We Are the Canaries. TW). When this doctor and specialist in medical law and ethics from The Centre for Medicine, Ethics and Law at McGill University, Montreal, was invited to give a speech in Lubeck, Germany, she wanted to get the attention of her audience and realizing she was wearing yellow and black, she flapped her arms like a bird and said:
“I am an ethical canary or rather that the allocation of resources to health care is such a canary: How we deal with the allocation of resources to health is such a canary; How we deal with this issue will test the ethical air in our societal mineshaft. And if the ethical healthcare canary is sick, we need to worry about the ethical tome of our society as a whole.”
Her hosts from the Drager Foundation told her they were endowed by the company that developed equipment that replaced canaries in mineshafts. A good coincidence and still the image lives and touches many of us who have never seen a coal mine. Coincidences multiply, as I write, CBC 2 plays a tune called ‘The Hot Canary’ and I await news of my grandchild’s birth. My daughter refused “canaries” for her unborn child, both amniocentesis and ultrasound. She said she did not know what she would do with the information if it told her something unusual.
The Ethical Canary explores many ethical issues and their place in contemporary society; the author presents them as a collective with commonalities, as concerns that we all must face, individually and as a society. To define what is ethical is not easy; we have a secular pluralistic society where some may base their ethical decisions on various religious beliefs and others cleave to the modernity of reason and rationality. But neither science nor technology is neutral; both are conceived and controlled by human beings with emotions and diverse experiences. Both are available to people around the world with vastly different cultural values. This is where Dr. Somerville, an Australian now living in Canada, tries to bring some basis for ethics that most in our society can share or respect.
“If, therefore, the contemporary search for ethics is the search for values on which we will base our societies, we must all, especially as citizens of a global commons, be engaged in it.”
Some of the problems are well known to us. Abortion rights mean vastly different ideas, even within Canada. The right or non–right to abortion after rape or an unwanted pregnancy, abortion because amniocentesis has signalled a female child or one with physical disabilities or because the mother is considered in danger all provoke highly charged emotional reactions.
Male circumcision and female genital mutilation are legal and accepted in some cultures and religions. Medical practitioners perform both in some parts of the majority world – claiming that it is safer and healthier when done in a medical environment. Yet both practices are opposed by many in our society. Do parents’ right supersede society in not only these customs but in treatment of seriously ill children? Some parents for religious reasons do not want blood transfusions given to their children; they are often overruled by court decisions favoured by the medical profession. What are ethical solutions? Another increasingly familiar and contentious issue is the intentional termination of oneâ€™s one life or that of a terminally ill or incapacitated relative; alternatively there is also the process of terminating life support without patient or family consent – a blanket practice in some Canadian hospitals. Somerville warns us that, “we must consider the impact of legalizing euthanasia not only at an individual level, (which has been the focus of the debate in the media), but also at the institutional, governmental and societal levels, and not only in the present but for the future”.
In a country where we persist in electing governments that cut all services except the bloated military, the ‘security’ and business support sectors, the author raises the problem of our ethical response to shrinking health care budgets and insurance payments. Who makes the decision to deny a treatment to some, but not others? She also looks at new drugs and their costs and access to treatment. One example is the case of women who have a genetic predisposition to breast cancer and their wish for paid access to tests in the USA and later to new expensive drugs. She also questions the dynamics of healthcare systems where politicians, bureaucrats, lawyers, doctors, other medical workers and patients often have conflicting needs and values. And often money trumps all.
There are more complex issues waiting in the wings yet to be considered as major concerns by most of our society, yet the ramifications of the new techniques of genetic manipulation and cloning are immense now and unimaginable for the future. Do we want to create disease-free babies? Intellectually-enriched children? Do we condone the selling of organs for organ transplant by the poor or involuntary organ sales from prisoners? What about the replacement of human parts with animal parts? Is it OK with pig parts but not chimpanzees? Should we encourage genetic manipulation if it cures disease? Should embryos be used for cloning, a process that kills the embryo? There is a whole raft of related implications to consider.
If science can do it, some feel that it should or will happen. The author compares our present state of new biological power with the grasping of nuclear power in 1945. She quotes the atomic scientist, Robert Oppenheimer, who said: “In some sort of crude science which no vulgarity, no humour, no overstatement can quite extinguish, the physicists have know sin; this is a knowledge they cannot lose.”
It seems that we are facing the same dilemma again, and look where that one got us. We need to educate ourselves about these issues –this book, tough dealing with complex issues is well–written and easy to follow and understand. And we can do well by holding in our minds and heart, Dr. Somerville’s guidelines for values to apply when we accept our responsibility to control and direct new science and technology: “These values are that we must have profound respect for life, in particular human life, and we must act to protect the human spirit – the intangible, invisible, immeasurable reality that we need to find meaning in life and to make life worth living – tat deeply intuitive sense of relatedness or connectedness to the world and the universe in which we live.”
Before I finish this review my partner has finished a book he started, not knowing the book I was reading. He read the witty and perceptive novel, The Cloning of Joanna May, by UK writer Fay Weldon, which she wrote very prophetically as it turns out, in 1989. The villain who works in the nuclear industry clones his wife & gets his just desserts in the end.
And as I finish this review, I celebrate the birth of a healthy child to my daughter and her loving partner.