|Abstrakt: ||The Problem of the Value and Quality of Life
in Bioethical Disputes
The present work is devoted to the presentation and analysis o f bioethical disputes with
a particular emphasis on the fundamental problem o f the quality and value o f life. Statements
concerning the value and quality o f (particularly human) life can be found frequently
enough in bioethics, but they are not always properly articulated and justified. Bioethics
is a discipline that came into being in the 1970s, and it deals with problems that are
vital from a cognitive and practical point o f view, and which resulted from the development
o f the biomedical sciences and technology. The wide range o f its subject matter, its
interdisciplinary nature, and the v ariety o f tasks it is supposed to fulfil make it into
something more than ju s t normative ethics, or still another academic discipline which is
interested in discovering the truth for that tru th ’s sake. In the context o f bioethics, various
ideological disputes and conflicts come to the surface, and the way these conflicts are resolved
has an impact on the lives o f many people.
The book is composed o f eight chapters. Chapter One is an introduction to bioethics
- it shows the subject matter o f that discipline, the conditions o f its rise, its main ideological
positions, and its unique character.
Chapter Two is devoted to the presentation o f various positions concerning the value
o f (particularly human) life. Having surveyed these positions, the author concludes that in
natural sciences the notion o f life is given a neutral (descriptive) sense, while in social
sciences that notion has an axiological aspect. The acceptance o f the idea that life is a value
is an act o f choice dependent on philosophical and moral views. In addition, the differences
between various positions concern the question o f what features are to be recognised
as morally significant so as to ascribe a relative or absolute value to life.
The problem o f the value o f human life is inseparable from the question o f accepting a certain
model o f humanity, which is why, in Chapter Three, the reader will find a discussion on the
criteria o f humanity and the methods o f establishing the limits o f humanity. The criteria o f
humanity may be formulated on the basis o f the biological, medical, philosophical, sociological,
psychological knowledge, and its basic assumptions may have a religious nature.
The variety o f the criteria o f humanity, and the disputes over their classification show
how different from each other the convictions that people deem obvious or rational may
be. There is no single, universally accepted, criterion. None o f the already existing criteria
is capable o f reflecting the unchanging essence o f humanity, nor can it be used to resolve
all kinds o f moral problems.Chapter Four shows the nature o f the dispute about the admissibility o f abortion - it
is not only the criteria o f humanity that play an important role in this dispute, but also other
assumptions (concerning the human rights, the measure o f freedom accorded to women,
views on the importance o f tradition, or power). An analysis o f the legal means o f protecting
the foetus, the principles o f potentiality, and model positions on abortion leads to
the conclusion that it is difficult to reach a compromise on the admissibility o f abortion,
and our taking a specific side in this conflict depends on our moral intuitions.
The methods o f artificial procreation, their genesis, present conditions and possibilities
o f development are shown in Chapter Five. An unequivocal and even-handed assessment
o f the medically assisted procreation is difficult. The very possibility o f creating
human life in a planned way causes many fears. Technological progress raises hopes for
a constant improvement o f the quality o f life, but, at the same time, it may fuel fears for
human life being treated merely instrumentally. Because o f its purpose (the procurement
o f a child to an infertile couple) the simple model o f artificial procreation raises fewer
objections and fears than the complex one.
The sixth chapter o f the present work deals with the problems o f the therapeutic and
biological revolution that has taken place in recent years (including the research on medicines,
transplant surgery, genetic engineering, the cloning o f human beings). People’s
morality changes in step with the technological progress and the use o f technology in
medicine - people want to live on at any price, even at the cost o f a deteriorated quality
o f life, or at the cost o f giving up moral scruples. At present, there exist two contradictory
tendencies in medicine. The former attaches great importance to life (but not health), which
is confirmed by transplant surgery, high risk therapies, and heroic therapies. The latter places
emphasis on the quality o f life, which can be seen in its approval for genetics, genetic
engineering, cloning. The possibilities o f saving life and healing are very great at present,
but, as it often turns out, the saving and prolonging o f o n e ’s life is connected with the
lowering o f that life ’s quality. On the other hand, while caring for the quality we may end
up denying life as an absolute value. Shall we ever be able to reconcile these two tendencies,
and avoid going to extremes in our evaluation? This question cannot yet be answered.
Chapter Seven is devoted to the problematics o f death in culture and in medicine. What
we find here are selected problems o f thanatology - concerning our attitude towards death,
ineffective and effective therapy, the right to death, euthanasia. The author shows that owing
to bioethics the long silence on the subject o f death has been finally broken. It is exactly
bioethics that may contribute to the modern man’s changing their attitude towards death
- dominant in bioethics is the tendency to tame death and to break with the convention
o f a death “run w ild ” . There is no consensus, however, on how to achieve this, as is
witnessed by the controversy over euthanasia, over the limits o f effective therapy, laying
down the conditions o f good death, and giving assistance in dying.
Chapter Eight contains a comparison o f two contrasting approaches - the value (sanctity)
o f life ethics, and the quality o f life ethics. The assumptions o f these approaches and
the consequences they may lead to are shown and exemplified by the attitude o f the Catholic
Church and P. Sin g er’s ethics.
Finally, the problem o f the status o f bioethics, and the dominant tendencies in the pursuit
o f this academic discipline are discussed. The author takes up a sceptic stance as regards the
possibility o f reconciling these fundamental tendencies on the basis o f a general methodology.
She also warns the reader against having unrealistic expectations of that discipline, in her opinion
bioethics cannot be expected to provide unequivocal solutions to the most fundamental controversies.
On the other hand, the author recognises that bioethical reflections are reasonable
and sensible - they help in fostering people’s moral awareness, and, by the same token, they
raise hopes that humanity will not find themselves in a state o f rational amorality.|