2002 Award Recipient - Reed Bell, Sr, MD


Kohrman

Reed Bell, Sr, MD, Pediatrician and Pediatric Endocrinologist has practiced and taught pediatrics at the community level for 35 years (1957-1992). He served as Medical Director of Sacred Heart Children's Hospital, Pensacola, Florida (1969-1980), chairing the fully accredited Pediatric Residency Program affiliated with he University of Florida School of Medicine.

Dr Bell became actively involved in Bioethical issues when invited to serve on the newly formed Bioethics Committee of the AAP in 1981. He chaired the Committee in 1986 and was instrumental in the formation of the Bioethics Section in 1987, which he chaired (1991). Dr. Bell was the founding Director of the Office of Substance Abuse Prevention NIH, (1986-1987). He also served as Medical Director of Florida's District I, Chidren's Medical Service Program (1989-2001).

Reed Bell's Acceptance Speech:

Thank you for this recognition, and the invitation to share my thoughts and experiences.

I have chosen to re-visit Dan Callahan's Hastings Center Report of 0ctober, 1981, entitled "The Minimalist Ethic"1. I believe it to be critically cogent to past and present ethical discourse. At that time (1981) the burgeoning bioethical issue was Baby Doe's Infanticide. The preceding decade had undergone rapid changes in personal, social and bio-medical ethics consequent to the sexual revolution and the Roe vs Wade decision. Callahan asked: "Are there any reasonable limits to the 'new' and prevailing ethos of individual self-autonomy?"

The moral values individual self-autonomy in ethical decision-making. This principle of 'Doing Ethics' was a simple proposition; i.e., one may behave as one chooses and it is moral as long as one does not coerce and/or do harm to others.

This ethical decision-making process was termed the Pluralistic Proposition2, i.e., those acts that are personal and private and neither harmful nor coercive to others should be left to individual 'choice'. Morality becomes simply a matter of the individual's 'choice' independent of any moral judgment of that 'choice' as 'good or bad', 'right' or 'wrong', thus, the privatization of morality or Moral Relativism as an expression of radical individualism.

In the language of individual "rights" that frames the self-autonomy principle of 'Doing Ethics'; the only judgment permitted is to assess coercion and/or harm to others. If no coercion or harm is discerned, we must suspend moral judgment. And, if we fail to suspend that judgment we are guilty of abridging the individual's right to privacy and self-determination. Callahan termed these 'new' values the 'Minimalist Ethic' and questioned their validity as well as their adequacy to sustain a viable culture, in particular, during "hard times".

The question now became: What, if anything, is the community entitled to define as coercive and/or harmful to others? The so-called "right-to-privacy" as unlimited personal autonomy frees the individual from moral regulation and from communal standards. The rhetorical question becomes, "Who are you to put your values on me!"

But, what are the consequences of this Pluralistic Principle2 of 'Doing Ethics', the guide to ethical discourse, in particular, the morality of valuing Human Life and Human Relationships? For example, sexual behavior, the status of marriage as institution and the role of the family in the nurture, protection, provision and care of children? Indeed, what about the real life consequences of random, recreational sexual behavior for youth? for the community?

Coercion and/or harm to others as the sole test of the morality of a person's 'choice' provide no substantive basis for judging morality. As obligate moral beings acting in a social context we are admonished to be non-judgmental. 'Choice' becomes the basis of ethical decision-making and the issue is placed outside the spheres of human reason, moral persuasion and legal restriction. Since one's personal morality is as good as another's, the community should not adopt moral standards or legislation. Truth is deemed relative, ethics situational, and the Law neutral.

The ethic of moral autonomy provides no support for other important values-core, positive values that require limited self-autonomy. For example: duty, self-sacrifice, responsibility, altruism, the 'common good', transcendent values rather than private values, and, future needs rather than present desires.

Callahan depicted our culture as: "striving to sanctify the moral autonomous individual as the ideal, denying communal goals, ultimate ends become procedural safeguards, and ignores human meaning and purpose, or assigns these matters to hidden private lives." He asked: "Is individual self-autonomy an adequate ethic to sustain a valid human society? Or does the lack of personal moral limits to individual autonomy constitute individual as well as social pathology?"

He concluded: "Self-autonomous ethical decision-making produces a morality that enthrones the transcendence of the individual over the community as the autonomy of the self is the highest human good and voluntary informed consent is the contract model of human relationships." Finally, he posed the seminal question for our cultural experiment of radical self-autonomy: "Does it represent a slide into moral indifference, callous self-interest and wanton violence?"

'Hard times' started here in Boston 9-11-2001 and 'hard times' are here for the foreseeable future. Is the "Minimalist Ethic" adequate to sustain a viable culture, a civil society? In my communitarian view, radical self-autonomy courts the 'tyranny of the self' as it flirts with license, even chaos, rather than true freedom - its purported goal. After all, no one has a 'right' to do 'wrong'.

Will Gavlin3, in 1982, argued for a more Communitarian rather that Libertarian approach. He pointed out that individual 'rights' depend on their social significance and man's obligate duty and responsibility.

True autonomy requires a limit to individual rights in order to protect the society - the only place where the concept of 'rights' of the individual has any meaning. In essence, individualism and individual freedom are an illusion except in the social context, and we have a constitutional 'right' to regulate behavior on moral grounds - the only legal issue is to what extent.

Science is truly startling in its successful quest for facts regarding the natural world but what of our quest for values and valuing? In my view, events over the past 30 years have advanced the "Minimalist Ethic" in an increasingly 'Utilitarian Ethos' with manifest hedonistic proclivities. As a 'Natural' consequence our children face the harm of declining individual and cultural values. Who, in our present day, would dare voice 'Super-Natural' consequences under the moral authority of 'Nature's God'?

Value 'choices' - ethics and morality, our behavior - have deep meaning, significance and very certain serious, consequences. This Bioethics Section of the AAP will play a vital role as to the 'best interest' of children. I wish you discernment and true wisdom in voicing a 'Valid Ethic' balancing 'Rights' with 'Responsibilities', 'Freedom' with 'Community.' Godspeed in your quest for a civil society in this obligate, moral universe. I bid you a 'fond farewell'.

Bibliography:

  1. Callahan D. Minimalist Ethics. Hastings Center Report. October 1981.
  2. Callahan D. An Ethical Challenge to Pro-Choice Advocates: Abortion and the Pluralistic Proposition. Commonweal. Nov. 23, 1990, Pages 681-688
  3. Gaylin W, Macklin R. Who Speaks for the Child: The Problem of Proxy Consent. The Hastings Center Institute of Society, Ethics and the Life Sciences Plenum Press (1982), Hastings-on-Hudson, NY.

 

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