In medicine, 'yuk' is not a useful guide
Daniel K. Sokol IHT Monday, May 17, 2004
Medical ethics
LONDON Julia Black's recent documentary "My Fetus" showed an abortion for
the first time on British television. With a swoosh and a spurt of blood,
the vacuum pump sucked out the four-week-old fetus from the womb.
.
A few months ago, transplant surgeons in Britain, France and the United
States declared themselves ready to graft the face of a corpse onto a living
recipient. In January, Armin Meiwes, the "German cannibal," was cleared of
murder for killing and eating Bernd Brandes, a 43-year-old engineer who
freely offered his life and flesh to satisfy Meiwes' unusual appetite. That
same month, a renowned medical ethicist suggested that infanticide may be
acceptable.
.
At first sight, these events are worthy of the most gruesome horror film.
They engender a powerful sense of revulsion, an immediate "'yuk" response.
For some, however, these acts may not be morally wrong at all. So who is
right? And what should we make of this familiar "yuk" response?
.
Earlier this year, Professor John Harris, one of world's most respected
medical ethicists, argued that infanticide may, in limited circumstances, be
justifiable. According to Harris, it may be morally desirable to kill a baby
if it is severely disabled or premature. Yuk! Killing babies is morally
hideous, let alone illegal. Julia Millington, the political director of the
ProLife party, called Harris' suggestion "absolutely horrifying." Clearly,
obviously, undeniably, Harris is wrong.
.
In a time when we are bombarded with bizarre stories, many of us rely on
this intuitive response to form opinions on new ideas and technologies. But
on reflection, where is the argument behind our "'yuk" response? Expressing
horror is not, in itself, a valid argument. It is merely displaying a
disapproving attitude. "I don't like it" may be a good reason when choosing
your favorite color, but it is not enough when discussing the morality of
abortion or face transplants. Harris' view cannot be dismissed solely on the
basis of our repugnance.
.
History is strewn with examples of misplaced disgust. When chloroform was
first used in the 19th century, relieving patients from the excruciating and
often life-threatening pain of surgery, many people vigorously protested
against the satanic invention. Since God inflicted disease as a punishment
for our sins, any attempt to remove the pain was deemed blasphemous.
Besides, chloroform was profoundly unnatural, the dissenters argued.
Similar arguments were used to criticize the advent of in vitro
fertilization in the late 1970s. When, in 1968, the first successful heart
transplant took place in South Africa, thousands of people gasped "yuk" in
horror, not at the idea of transferring someone's heart into another's body,
but at the color of the donor's skin. Countless other now common procedures
also generated "yuk" responses in the past.
.
These examples from history show the evolution of what society considers
permissible. They also illustrate the danger of our "yuk" responses. However
powerfully felt, they can reflect prejudice and ignorance. They can blind us
from the real reasons behind our objections, preventing all attempts at
reflection. It is a mistake to rely on our gut feeling alone when assessing
the morality of an act. Instead, this "yuk" response should force us to
think hard about what is permissible, even if it appears disgusting.
.
"Man is a credulous animal, and must believe something," wrote Bertrand
Russell. "In the absence of good grounds for belief, he will be satisfied
with bad ones." In an age of consensual cannibalism, Frankenstein foods,
cloning and other peculiar scenarios, our gut reactions must be followed by
a more composed phase of questioning and reasoning.
.
Even if we staunchly disagree with an idea, a technology, or a new medical
procedure, we must embrace the opportunity to reflect on our own position
and not hide behind the treacherous comfort of "yuk."
.
Daniel K. Sokol is a medical ethicist at the Imperial College Faculty of
Medicine, London.
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