Recreating Medicine: Ethical Issues at the Frontiers of Medicine

Pence argues concisely, if sketchily, for increasing the pace of medical progress in areas where he believes ethical issues are unnecessarily slowing the way. Some topics discussed by Pence, who teaches medical ethics at the University of Alabama-Birmingham medical school, are more controversial than others. No doubt few will find fault with his call for greater patient control over medical records in cyberspace, and many Americans have already accepted the moral permissibility of in vitro fertilization and even of payment for surrogate mothers. On topics such as these, Pence seems to be merely mopping up, seeking to quell remaining doubts. But he goes on to take more contentious positions: advocating payment to families for their dead relatives' organs, or endorsing cloning and genetic enhancement of children. Pence does a good job of undermining weak arguments: he notes, for example, that critics hold new techniques of reproduction to ""Olympian standards"" of virtue and safety from which the old sexual one is generally exempt. Yet he blithely ignores some arguments that many find equally compelling. For example, he dismisses the premise that ""loss of human embryos morally matters"" without even engaging the case that it does. Further, he displays a philosophical bad habit he himself denounces, that of overlooking one's ""first step."" Thus he takes for granted, and does not bother to defend, the truth of utilitarian ethics and the coherence of a distinction between public morality and private theories of the good. For readers who accept those premises, Pence may be persuasive; for others, he misses the deepest objections. (May)