8 H A S T I N G S C E N T E R R E P O R T January-February 2001

While Europe celebrated themillennium last year, thereason for there being one

was largely forgotten. That it might bewas evident years earlier, when theBritish government decided that itscommemoration of 2000 years since thebirth of Christ would be a “dome” withno relevance to Christianity. It is tempt-ing to wonder whether the MillenniumDome might have been less of a disas-trously expensive white elephant if ithad indeed celebrated Christ and hislegacy.

Just as important to the future direc-tion of some European societies hasbeen the further derogation, in the mil-lennial year, from the Judaeo-Christianprinciples that underlie, at whateverdepth, legislation and public morality.In their place, utilitarian argumentshave gained much ground, yet are oftenused crudely and ineptly. The most re-cent example is the debate surroundingregulations passed by the U.K. Houseof Commons that permit virtually un-limited research on human embryos.

Research on human embryos hadbeen legally limited to studying thecauses and treatment of infertility andof congenital disorders. Now, however,research licenses may be granted to in-crease knowledge about the develop-ment of embryos, or about serious dis-ease, and to enable such knowledge tobe applied in developing treatments forserious diseases. The pressure for such achange came from a research communi-ty which wishes to be unfettered in itsdevelopment and use of stem cells. Thepropaganda used was quite shameless:Mike Dexter, director of the UnitedKingdom’s largest medical research

charity, the Wellcome Trust, claimedthat six million Britons (over 10 percentof the population) would benefit fromstem cell research. Others talked ofcures for Parkinson’s disease,Alzheimer’s, diabetes, spinal cord injury,and cancer, within five years.

Yet however outrageous the claims,government ministers and Members ofParliament alike believed them. It wasfrequently said that MPs should notdeny the populace such enormous ben-efits. What they ignored was the similarhype over gene therapy just a decadeearlier—a decade which saw not a sin-gle cure as a result of gene therapy. Theclaims of enormous potential benefitswere not examined critically, nor werethere questions about the costs of apply-ing the research if it is successful.

Many MPs did not even consider thestatus of an embryo created for researchpurposes, or if they did, they dismissedit as a ball of cells. The idea that it wasworthy of special protection as a poten-tial human being was largely ignored, aswas the belief of some that the embryoalready has full human rights. Thewider risks to societal beliefs about thevalue of human life, if one devalues theembryo, were hardly considered.

So the principle that an embryo isworth protecting, and should not beused as a means to other people’s ends,was ditched, and the utilitarian analysiswas crude, overwhelmed by propheciesof benefit. The only safeguard put inplace is that embryo research should beinto “serious disease” (and how long is apiece of string?).

Another example of crude utilitarianthinking was the Court of Appeal deci-sion to allow doctors in Manchester to

separate the conjoined twins known asMary and Jodie. Because of their anato-my, and the inadequate performance ofMary’s heart, it was known that separa-tion would result in her immediatedeath. The judges appear to have decid-ed that it must be better to have one livebaby than to allow both to die, as theparents wished. The long-term risks insociety of deciding to kill one person inorder to save another were not enteredinto the utilitarian calculus.

The decision of the Dutch parlia-ment’s lower chamber to legalize volun-tary euthanasia could be seen in a simi-lar light. Respecting the wish to die ofthose facing unbearable pain or othersuffering is valued more highly thanmaintaining the injunction that one cit-izen should not deliberately kill another.Yet one must ask how much allowancewas made in that calculation for theNetherlands being relatively underpro-vided with hospice and palliative careservices.

It should perhaps be no surprise thatutilitarian calculations made in medicalsettings are relatively crude, since that ishow they are in other areas of publiclife. Limited calculations are at the rootof many odd decisions in our increas-ingly risk-averse cultures. Selling beefon the bone was banned in the UnitedKingdom to stop bovine spongiformencephalopathy from being passed on. Icalculate that average life expectancy inthe United Kingdom was thereby ex-tended by one thirtieth of a second; notmuch to set against further loss of busi-ness for farmers and butchers. Perhapsthe ultimate in risk-aversion is the in-creasingly common decision to ban tra-ditional games in the school playgroundfor fear of injury to children, withoutrecognizing the importance of thosegames in children’s development.

The lesson seems to be that it is dan-gerous to ditch long-held moral princi-ples in favour of utilitarian arguments,and doubly so if we have not developeda utilitarian calculus that can take ac-count of the costs of ditching them.

The Greatest Happiness?

by Richard H. Nicholson

old world news

RRiicchhaarrdd HH.. NNiicchhoollssoonn is a physician and ed-itor of the Bulletin of Medical Ethics.