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BACKGROUND In broadest terms, Western Culture is a fusion of two traditions: the Greek and the Hebrew.
At the center of ancient Greek culture was the importance of reason. The Greeks stressed the pursuit of knowledge; a careful analysis of nature and human nature. Alexander the Great, for example, was asked by Aristotle to send back bits and pieces of nature from all over the world. These were studied and assigned a place within the rational categories of genus and species. What defined Greek culture were philosophy and science. Aristotle, the greatest of Greek philosophers, was also a scientist.
The center and core of Hebrew culture was monotheistic belief. The unique characteristic of human beings in this tradition was an ability to communicate with God. The emphasis in Hebrew culture was on God's role in history and on the moral requirements of human beings, related to God. The focus of Hebrew culture was on ethics and morality, on character and virtue.
These two broad influences have been in dialogue throughout Western history. One or the other may become dominant at certain times, but ordinarily the two background influences remain either in debate or in dialogue. Most academic persons today understand themselves as defined mainly by the Greek influence, by reason and science. But, the religious influence remains very much with us. The current debate in the U.S. about evolution and intelligent design is just one of many examples of the continuing interrelation between these two broad background influences.
Today, the two major cultural influences are frequently at odds with one another. The religious perspective today is sometimes irrational (i.e., creationism). But religion by definition is not opposed to reason. And certainly ethics and morality, so characteristic of the Hebrew tradition, are not opposed to reason and science. This is especially true in the area of medicine and related disciplines. The Edinboro Bioethics Institute is designed not just to provide a context for research in ethics and medicine, but to encourage a continuing dialogue between life sciences and ethics in the U.S. and Latin America.
There was a time in the medieval age, when the Hebrew emphasis was brought together with the Greek perspective; a synthesis of religion and reason in thinkers like St. Thomas Aquinas. The synthesis of both influences continues in the life and work of many intellectuals today who insist upon being both rational and religious, scientific and ethical. Historically, reason and revelation were kept in dialogue within the university. Religion and ethics, science and medicine should remain related in a contemporary university setting.
The medieval synthesis of reason and religion broke down in the 15th and 16th centuries with the Protestant Reformation's focus on faith alone and with a scientific revolution which gradually moved toward a science alone perspective. During the 17th and 18th centuries, Western Culture went through the Enlightenment period in which the Greek emphasis on reason and science became dominant, and religion was either rejected or marginated. During the Enlightenment there was a belief in reason alone as the path to all truth. There was a faith in science and science was believed to be the one way to understand.
Even during the Enlightenment however, religion and moral concerns, (the Hebrew influence) did not disappear. Romanticism rejected science's claim to be the only way of understanding. Mysticism flourished during this period along with individualism, symbolism, and poetry. We see a 19th century critique of the science alone belief in the work of thinkers like Nietzche and Dostoyeski. During the 20th century, debate continued between the most extremes versions of the two major traditions; the advocates of science alone and the advocates of revelation alone. In the 21st century, the relationship between science and ethics has become an overwhelming concern. Every advance in science raises new ethical issues.
The scientific revolution had its major impact on medicine in the latter half of the 19th century. In the 19th century, the medieval university model was modernized in Germany. The educational system was expanded into many different disciplines all of which attempted to apply a scientific approach: sociology, political science, history, biology, physics, astronomy, medicine, etc. Every new discipline was studied scientifically and linked to scientific research. Every university professor was expected to do more than teach. The different departments each had a laboratory where hard science was taught and scientific research was conducted.
It was the joining of hard laboratory science with medicine that created what we refer to today as Modern Medicine. Modern Medicine is German Medicine. It is not yet 100 years old in the United States. Abraham Flexner brought it to the U.S. from Germany and implanted it at John Hopkins in about 1912-13. In Modern Medicine, hard scientific reasoning defines reality.
Before Modern Scientific Medicine, a different medicine was practiced in Western Culture. Developed in Greece in the fifth century B.C., this medicine was based on reason and objective observation. Islamic scholars during the middle age, were influenced by Greek culture and established academic institutions which advanced both medicine and philosophy. The first western medical schools were Islamic institutions.
The background theory of traditional Greek medicine was humoral: i.e., the existence of four basic humors (black bile, yellow bile, phlegm, blood). The humors in balance defined health. Imbalance explained illness. Treatments tried to restore balance by bleeding, purging, and blistering. Before modern scientific medicine, it was hell to be ill. Purgatory was being treated.
This Traditional Medicine was practiced for more than two millennia under the influence of a medical ethics which enjoyed the strong support of Judaism, Christianity and Islam. Traditional medical ethics originated with the ethical principles of doing good for patients (beneficence), not doing harm (non maleficence), not taking human life, not violating patients sexually, keeping patient information secret, etc. Once Modern Scientific Medicine was created, the traditional ethics was joined with new ethical components in the form of rules and practical norms. Modern Scientific Medicine was founded on research with human subjects and the moral rules and norms were meant to guarantee that patients and subjects were not violated, used, or treated as things.
From the very beginning, the German government established detailed and rather sophisticated moral directives, all of which completely failed as soon as the traditional background philanthropic commitment, (love of the patient) was set aside and a eugenic metaphor, (improvement of the race) was put in its place. Modern Scientific Medicine began with a horrendous ethical failure, the Holocaust. That ethical failure of scientific medicine resulted from an attempt to remove literally and figuratively the Hebrew influence from science and medicine. The discipline of Bioethics was created as one of many responses to this tragedy. The discipline quickly expanded throughout the world because of the importance of its objective; to protect the most vulnerable human beings from a recurrence of the earlier ethical failure. The ethical failures of the Holocaust can not be ignored or forgotten without trampling on the dead bodies of million of innocent persons.
After World War II, Modern Scientific Medicine ceased being described as German Medicine. It became American Medicine because the U.S. government invested enormous amounts of money in medical science. A whole new city outside of Washington was created for scientific research in medicine, the NIH. New medicines and technologies, new treatments and interventions were generated in a continuing stream. Each new scientific development created new ethical questions. In the post-war period, additional ethical rules and regulations were put again into place; The Nuremberg Code, The Department of Health and Human Services Rules and Regulations, The FDA Regulations, The WHO Regulations, The Helsinki Declaration, The Belmont Repot, etc. These ethical rules and regulations continue to be updated periodically.
The new rules and regulations however, were not totally successful. It was assumed that American scientists would not violate human subjects or mistreat medical patients. "Only Nazi doctors and researchers did such things". Then Henry Beecher, in the NE JOM published a list of 23 research violations which were shockingly similar to what had happened in Nazi, Germany. During this period of the 1960's, the new discipline of Bioethics was established.
The lesson of both the Nazi and the American ethical failures is too important to be ignored. For all persons involved in the field of medicine, and for academics doing scientific research it is necessary to pay attention to the relationship between science and ethics. The lessons of history for university professors and medical professionals are clear: watch what you are doing; watch what is going on around you; watch your background assumptions; watch the broad cultural context in which you are doing you work and living your lives; pay attention to ethical rules and regulations.
University faculty and medical professionals are believers in science. They have to be. But do they remember the past? Are they aware of the assumptions which they bring to their work? Do they keep the Greek and the Hebrew background insights in view? Is their science always in dialogue with a reality that is not revealed by science, i.e., their ethical responsibilities, the principles of beneficence, non-maleficence, the rules and regulations for doing scientific research and practicing scientific medicine? Are they looking at the broader picture? Do reason and science, ethics and morality have a place in their lives? Do both the Greek perspective and the Hebrew perspective continue to influence them?
Two ancient strands of thought shape Western Culture and therefore shape the thinking, lives, and work of western people.
PURPOSE
The Bioethics Institute at Edinboro University gives concrete form to the relationship between science and ethics. It is an Institute dedicated to promoting this relationship in society, in the university community, and within the many university disciplines connected with hard science. Issues of medicine are related to many university disciplines, because health in today's western culture is a dominant concern. Health, biological research, medical treatments, are today what salvation, religious belief, theology were in medieval times. (Salus, the Latin word for health, and salvus, the Latin word for salvation happen to be derived from the same Latin root).
For a university to promote science and at the same time to ignore the associated ethical concerns would be academically irresponsible. The ethical issues related to university disciplines are everywhere in evidence. The disciplines may be more or less overtly connected to health, but all have a scientific dimension and all have to be concerned about ethics.
Historically, the impact of a university on the surrounding community was a result of the whole university's focus on ethics. Civility is one ethical term for this historical influence of the university on the broader social reality. Bioethics is a more recent term for the relationship between science and ethics. Bioethics keeps the Greek and the Hebrew traditions in dialogue. The Edinboro Bioethics Institute aspires to contribute to civil communities both in the U.S. and in Latin America by creating an academic environment where students and scholars can do research in bioethics which will advance the discipline and contribute to their communities.
psl 3/2006
The Edinboro Bioethics Institute is Edinboro University's way of being true to this University's historical involvement with the discipline of Bioethics, and the University's commitment to advance both influences on Western Culture. The Edinboro Bioethics Institute reflects the commitment of Edinboro University of Pa to continue and to advance the bonds between medicine and morality, between science and ethics. At the same time, the Institute will continue the work of Dr. James Drane in developing the discipline of bioethics especially in Latin American countries.