“A New Ethic for Medicine and Society

(This article is presented as a resource for those interested in the 
history of the pro-abortion movement in the United States. Taken from 
CALIFORNIA MEDICINE September 1970, it illustrates that even as 
abortion was being legalized and abortionists were denying that they 
were killing children, in reality they were well aware of what they 
were doing and justified it with the claim that "this schizophrenic 
sort of subterfuge is necessary because while a new ethic is being 
accepted the old one has not yet been rejected.")


A New Ethic for Medicine And Society

The TRADITIONAL WESTERN ethic has always placed great emphasis on the 
intrinsic worth and equal value of every human life regardless of its 
stage or condition. This ethic has had the blessing of the Judeo-
Christian heritage and has been the basis for most of our laws and 
much of our social policy. The reverence for each and every human 
life has also been a keystone of Western medicine and is the ethic 
which has "caused physicians to try to preserve, protect, repair, 
prolong and enhance every human life which comes under their 
surveillance. This traditional ethic is still clearly dominant, but 
there is much to suggest that it is being eroded at its core and may 
eventually even be abandoned. This of course will produce profound 
changes in Western medicine and in Western society.

There are certain new facts and social realities which are becoming 
recognized, are widely discussed in Western society and seem certain 
to undermine and transform this traditional ethic. They have come 
into being and into focus as the social by-products of unprecedented 
technologic progress and achievement. Of particular importance are; 
first, the demographic data of human population expansion which tends 
to proceed uncontrolled and at a geometric rate of progression; 
second, an ever growing ecological disparity between the numbers of 
people and the resources available to support these numbers in the 
manner to which they are or would like to become accustomed; and 
third, and perhaps most important, a quite new social emphasis on 
something which is beginning to be called the quality of life, a 
something which becomes possible for the first time in human history 
because of scientific and technologic development. These are now 
being seen by a growing segment of the public as realities which are 
within the power of humans to control and there is quite evidently an 
increasing determination to do this.

What is not yet so clearly perceived is that in order to bring this 
about hard choices will have to be made with respect to what is to be 
preserved and strengthened and what is not, and that this will of 
necessity violate and ultimately destroy the traditional Western 
ethic with all that this portends. It will become necessary and 
acceptable to place relative rather than absolute values on such 
things as human lives, the use of scarce resources and the various 
elements which are to make up the quality of life or of living which 
is to be sought. This is quite distinctly at variance with the Judeo-
Christian ethic and carries serious philosophical, social, economic 
and political implications for Western society and perhaps for world 
society.

The process of eroding the old ethic and substituting the new has 
already begun. It may be seen most clearly in changing attitudes 
toward human abortion. In defiance of the long held Western ethic of 
intrinsic and equal value for every human life regardless of its 
stage, condition or status, abortion is becoming accepted by society 
as moral, right and even necessary. It is worth noting that this 
shift in public attitude has affected the churches, the laws and 
public policy rather than the reverse. Since the old ethic has not 
yet been fully displaced it has been necessary to separate the idea. 
of abortion from the idea of killing, which continues to be socially 
abhorrent. The result has been a curious avoidance of the scientific 
fact, which everyone really knows, that human life begins at 
conception and is continuous whether intra- or extra-uterine until 
death. The very considerable semantic gymnastics which are required 
to rationalize abortion as anything but taking a human life would be 
ludicrous if they were not often put forth under socially impeccable 
auspices. It is suggested that this schizophrenic sort of subterfuge 
is necessary because while a new ethic is being accepted the old one 
has not yet been rejected.

It seems safe to predict that the new demographic, ecological and 
social realities and aspirations are so powerful that the new ethic 
of relative rather than of absolute and equal values will ultimately 
prevail as man exercises ever more certain and effective control over 
his numbers, and uses his always comparatively scarce resources to 
provide the nutrition, housing, economic support, education and 
health care in such I ways as to achieve his desired quality of life 
and living. The criteria upon which these relative values are to be 
based will depend considerably upon whatever concept of the quality 
of life or living is developed. This may be expected to reflect the 
extent that quality of life is considered to be a function of 
personal fulfillment; of individual responsibility for the common 
welfare, the preservation of the environment, the betterment of the 
species; and of whether or not, or to what extent, these 
responsibilities are to be exercised on a compulsory or voluntary 
basis.

The part which medicine will play as all this develops is not yet 
entirely clear. That it will be deeply involved is certain. 
Medicine's role with respect to changing attitudes toward abortion 
may well be a prototype of what is to occur. Another precedent may be 
found in the part physicians have played in evaluating who is and who 
is not to be given costly long-term renal dialysis. Certainly this 
has required placing relative values on human lives and the impact of 
the physician to this decision process has been considerable. One may 
anticipate further development of these roles as the problems of 
birth control and birth selection are extended inevitably to death 
selection and death control whether by the individual or by society, 
and further public and professional determinations of when and when 
not to use scarce resources.

Since the problems which the new demographic, ecologic and social 
realities pose are fundamentally biological and ecological in nature 
and pertain to the survival and well-being of human beings, the 
participation of physicians and of the medical profession will be 
essential in planning and decision-making at many levels. No other 
discipline has the knowledge of human nature, human behavior, health 
and disease, and of what is involved in physical and mental well-
being which will be needed. It is not too early for our profession to 
examine this new ethic, recognize it for what it is and will mean to 
human society, and prepare to apply it in a rational development for 
the fulfillment and betterment of mankind in what is almost certain 
to be a biologically oriented world society.

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