Bioethics is Love of Life: An Alternative texbook

Darryl R. J. Macer, Ph.D.
Eubios Ethics Institute

Copyright 1998, Darryl R. J. Macer. All commercial rights reserved. This publication may be reproduced for limited educational or academic use, however please enquire with the author.

8. Universality of bioethics in love

At the end of this book we are left with the question, is love of life the key source of the bioethic that all people have? I challenge anyone to find another source of reasoning or emotion that is stronger than love.

While we cannot scientifically prove that love is real, that love shapes our life, and is the foundation to our personal and social development, it would be a naive person to claim that human beings are not moulded to a significant degree by the love acting in their life. In the exception which is to kill, people usually kill "to defend something they love, their land, their families, their view of life" (Williams, 1967). The power of love is great, shaping many actions, and in the end it has been shown to have the power to overcome hate and discrimination, as seen in the lives of crusaders like Gandhi and Martin Luther King in the 20th century.

Love is a common person's definition of ethics, and I think it should refocus our attention on where we should be looking to "develop" bioethics. In this book I have reviewed a range of literature, and historical studies, and the reasoning people have in surveys and interviews. People have been using ideas of bioethics over history, especially in religions, bioethics is the part of this behaviour, ethics, that relates to biological questions, and to all human relationships. It is time for improvement though. As King (1967) said, "humanity is waiting for something other than blind imitation of the past....We must be hammers shaping a new society rather than anvils moulded by the old. This will not only make us new men, but will give us a new kind of power...It will be power infused with love and justice, that will change dark yesterdays into bright tommorrows, and lift us from the fatigue of despair to the buoyancy of hope."

The major criticism of the use of love as the guiding principle of ethics is that it is not concrete, and leaves problems in deciding standards of value and defining situations. However, some of this concern is resolved if we consider love as an intelligent process of acting for the good of people, respecting persons and avoiding harm. There is room for primie facie principles to help decide cases, but these can be expressed in the language of love, and this may be the way that people do actually make decisions.

8.1. Love is a universal goal

I have argued that all people have a bioethic of behaviour, and we share many of the points used in the process of reasoning, although the decisions may differ. The first objection to this view that love is universally appreciated, is that it is apparent to anyone who looks at the problems of the world that the ethical principles people are using are not working very well. This does not mean that the ethical guidelines that are used by particular groups of people will not succeed in developing a better world, but it does mean that none has been able to be applied universally all the time, and it makes us ask whether love is the descriptive principle of bioethics?

Even as we approach the 21st century with renewed hope for a new phase of international relations following the collapse of the Soviet superpower and the demise of Cold War mentality that persisted for nearly half a century, the reality of the daily wars and conflicts don't allow us to forget that the world is made up of groups which claim to be different. The claim to be different from another group, often made by leaders of a particular social group or gang, which underlies many conflicts, does not mean that such groups are actually different, only that it is claimed that there is a difference.

Conversely, another popular belief is that we are seeing the emergence of a one-world culture, from developments in communication, transportation and trade. This links people together, so that they wear the same clothes (e.g. blue jeans), they eat the same kind of foods (e.g. hamburger culture and fast food chains), they read the same kind of newspapers or view the news on the Internet or cable television networks. There is also a trend for political groups to become larger and more integrated, as seen in the development of regional blocks, the European Union being the most integrated, making people predict the formation of a single world government more integrated than the United Nations of today. However, power struggles tend to split these large groups apart as well. Trade is being controlled more by multi-national companies, which requires the presence of international law and ethics to police, because their power is stronger than many governments.

The extent of diversity or similarity in universal ethics can be scientifically measured, and it is important to gather further data on these questions. As surveys and observations have shown and as discussed in chapter 5, people in different countries do share the same thinking, and reasoning (Macer, 1994). Basically that data suggests that the diversity of thinking within any one group is much greater than that between any two groups, therefore basic universal principles may be used in deciding these issues. The social environment that people grow up in, and the education strategies, are becoming more similar with time suggesting that a universal approach is even more possible now than it was a century ago. There is a universal diversity of views, and such data is a challenge to all of us to incorporate or explain into any description of the real world. Only when we accept that others are the same as us is there hope to stop the ethnic and religious wars that have plagued the world.

We can also ask whether universal ethics is even desirable? Different societies have different goals, as do different people. This diversity is to be valued, and the type of universal ethics that I discussed in this book is one that will maintain diversity. If our capacity for diversity was lost it would not succeed. Diversity is part of what we call being human. It is what could be called an integrated cross-cultural approach to ethics. We should never expect all people to balance the same values in the same way all the time, but the mistake that most make is to think that people in one group are the same. All groups are diverse, and we can never presume that our neighbour will reason the same way as ourselves. Love and respect for others demands that we should also give traditional societies a chance to adapt themselves to the modern life, rather than just merging them into the global modern order.

If we pursue global unity we should still recognize cultural plurality. We could define cultural plurality as social and political interaction within the same society of people with different ways of living and thinking. If we accept plurality we reject bigotry, bias and racism in favour for the respect for traditions of all in society, but this ideal is seldom met. There is usually some type of ethnocentrism which prevents plurality.

Therefore universalism in the sense that everyone thinks the same way and balances ideals of action the same way is not possible. Nevertheless, there are numerous benefits if basically similar values, or principles, can be used by all people and societies, and harmony and tolerance are two. All would agree that tolerance of cultural diversity is generally welcome. The limits to tolerance are already broadly outlined in international covenants such as the Declaration of Human Rights, and the International Treaties against abuses of human rights. One of the practical issues for social justice is whether groups with little power are oppressed, in which case the international community may attempt to restore order. There are also international treaties on environmental protection outlining some of the limits of damage to the common environment that will be tolerated by other countries, such as the convention on ozone-damaging chemicals, and on deep sea dumping. We also have economic treaties, such as GATT, defining the limits of unfair trade. However, as was discussed in the previous chapter, economic priorities conflict with environmental protection, and we need better resolution of this conflict in practical bioethics.

One of the common goals shared by many people is to make a world with more harmony. If we look around we can only see limited examples of harmony, but we cannot even dream of making a perfect world, that is God's realm. There will always be some people who do not seek harmony. One of the principle failings of many ethical systems is that they ignore the selfishness of human behaviour. Human beings often disregard ethical norms and standards, and will continue to do so. Does this mean that it is pointless to try to develop universal ethics with a goal of a more harmonious world? No, but what it means is that we must be realistic, recognizing our spiritual, social and biological limitations. As Jesus said, "Blessed are the peacemakers", but he did not say that we could expect human society to be at peace in its current self-seeking state.

Some economic and social systems have been successful in limited circumstances, but they have all had problems. This is no criticism of the desirability of universal ethics, and neither is it a reason not to try. The economic and social inequalities of the world have been a feature since recorded history. Religious systems have a long record of social survival in history, but they have all been misused by selfish people. The system of economics often has more impact on the policy decisions than the ethical and religious norms that people follow. Wars may be fought over religious differences, but often they are based on poverty. In an ever more crowded world we can expect more, unless inequalities are lessened and nationalism and racism are squashed. The environmental crisis has added its cry to that of human suffering, and as it becomes recognized that uncontrolled consumerism is not sustainable on the planet, we need to look for a fresh and integrated approach to ethics.

We also need to shift the philosophy of many human activities including science to pursuit of love (in the broad sense). Francis Bacon made love of knowledge the great human and social value. Under Baconian philosophy, the long-term aim of inquiry is to contribute to human progress, but the immediate aim of inquiry is to produce objective knowledge, together with explanations and understanding. The search for truth is considered to be of intrinsic human value when pursued for its own sake, or of pragmatic or technological value when pursued as a means to the realization of non-academic, human, social ends. The idea that the philosophy of science should be based on the pursuit of wisdom rather than the pursuit of knowledge has been put forward by various writers (Maxwell. 1984). The philosophy of knowledge would say that the proper aim for rational inquiry is to acquire objective knowledge about the world. While there may be secondary uses of this knowledge, the first priority is to achieve the purely intellectual aim of acquiring objective knowledge of truth. The claim is that it must dissociate itself from the goals and values of common social life, so that claims to objective knowledge can be subjected to rational assessment. This is inconsistent with bioethical decision-making.

Proponents of the philosophy of knowledge may acknowledge the importance of moral and social problems associated with science, but seldom do they call into doubt the integrity of science itself or their philosophy. As a human being they can be concerned, but as a scientist their task is to concern themselves exclusively with problems of fact, truth and knowledge. Instead of priority being given to the tasks of articulating problems of the life, with problems of technology being secondary, it is the reverse. A philosophy of wisdom is that it may avert further human disasters that have come about as science has been used, if we can develop socially influential traditions of inquiry and education devoted to the promotion of cooperative, rational problem-solving in life.

People make claims that science is ethically neutral. This implies that scientists do not have responsibility for the production of knowledge. However, this belief confuses the findings of science, which are ethically neutral, with the activity of science, which is not (Bronowski, 1963). Some pursue the neutrality argument, by claiming that the moral burden lies with those who choose to implement knowledge for all purposes. We may not be able to predict the abuses of pure knowledge, however, scientists are still moral agents and must think in advance of the possible abuses. They may not be solely responsible, but they share responsibility with all of us. All human activity needs to be subject to ethical discretion, and if love of life is the underlying ideal then activity should be guided by this. Technology has been the most powerful agent of change in the recent past, therefore, we can clearly see the need for universal ethical maturity, and understanding.

There is a popular belief that there is a conflict between science and religion, but the questions that they discuss are different. As Karl Popper said in the falsifiability hypothesis, a scientific theory (and question) is one which can be disproved. Only a theory for which we can design an experiment to disprove it is scientific. Many questions are not of this nature, especially those which involve life or love, so we can only suggest answers, as I do here to confirm that our bioethic is the love of life. As Martin Luther King (1963) wrote "Science investigates, religion interprets. Science gives man knowledge which is power; religion gives man wisdom which is control. Science deals mainly with facts; religion deals mainly with values. The two are not rivals." Although we should try to apply wisdom and reason to develop bioethics, bioethics involves these questions of value.

Even more dominant is the pursuit of economic growth, often seemingly for its own sake. Countries try to increase their economies by a certain percentage every year, regardless of the environmental and social consequences. There is only a limited correlation between economic growth in % terms and increased living standard, other measures such as personal wealth and ease of living are economically desired. The goals of societies and the measures that reflect the life goals of societies, need to be examined more. There must be an end to consumer demand and increased economies - or is this the only goal that people of the world have for themselves?

8.2. Global ethics starts at home

When we realize the enormity of many of the bioethical problems we may want to give up, yet we must realize that individual action is a necessary prerequisite for developing a better world. Individual shortcomings can destroy the harmony and peace of any relationship, but collectively they can have global consequences. The basic principle of ethics still is "love thy neighbour as thyself", and if this was followed there would be no need to write a book restating that bioethics is love of life.

According to Confucius in the Analects, written in the 6th century B.C., the experience of love begins in the home among one's closest blood relatives. The instruction to honour one's mother and father is included as one of the ten commandments. Mencius believed that human nature has an innate predisposition to favour one's family, which was several millennium earlier than the selfish gene idea of evolution which supports this view. As Lee Iacocca wrote in Talking Straight (1988), "No matter what you've done for yourself or for humanity, if you can't look back on having given love and attention to your own family, what have your really accomplished?" The family and community we call home, is at least a testing ground of love.

There are large and small problems in ethics. We can think of problems that involve the whole world, and problems which involve a single person. We can think of global problems, such as the depletion of the ozone layer which is increasing UV radiation affecting all living organisms. This problem can be solved by individual action to stop using ozone-depleting chemicals, if alternatives are available to consumers. The law should encourage us to think about our ethical duties, and attempts to promote justice to all, recognizing our failings and selfishness (selfishness is excessive autonomy). The international convention to stop the production of many ozone-depleting chemicals is one of the best examples yet of applying universal environmental ethics.

Another environmental problem is greenhouse warming, which results mainly from energy use. This problem however can only be solved by individual action, to reduce energy use. We could do this by turning off lights, turning down heaters and air conditioners, building more energy efficient buildings, shutting doors, and driving with a light foot. These are all simple actions which everyone must do if we are concerned about our planet, like being tidy with litter and recycling (Figure 21), yet not many do so. Energy consumption could be reduced 50-80% by lifestyle change with current technology if people wanted to. New technology may help, but lifestyle change can have much more immediate affect. The economic interests of the major electricity and oil companies, slow such substantial reductions in energy use by reducing the goals that people strive to attain.

The picture that is painted in this book is realistic optimism, and the practical conclusion of such universal ethics must be in the synthesis of all the traditions, ideals, and aspects of biological, social and spiritual heritage that we have. The "we" includes not only peoples of the world, but all of life, however, ethics relates to how we regulate human behaviour and so this book is written in those terms. Ethics does start at home and with each one of us, we cannot wait for someone else to tell us how to love, or what laws should govern our action. While we can learn from the examples of saints, and many who love more than we, we cannot leave solutions to others. The joint responsibility of all world citizens is to love others, and do the best we can.

We cannot leave it to governments to look after the planet, the actions of individual members of the human community are required. Some types of environmental improvement can be brought about already by individuals. Some useful guides have already been produced (Corson, 1990). Using alternative products is one option. In many countries improving the efficiency of lighting, in houses and street lighting, can result in very large reductions (50-75%) in energy consumption. Not only do the consumers save electricity charges, the lights may also be cheaper. There also should be a change in behaviour that uses excess resources, such as a reduction in the use of unnecessary lighting. Another example is how we can reduce the human health damage caused by the increased UV radiation. The quality of sunscreen lotions, the clothes that we wear, and changes in people's behaviour are needed, what we can call preventive medicine.

Reproductive choice is another domain given to individuals to control. Birth control is essential, to reduce the numbers of humans. This is a medical and political issue, and even some scientific academies of the world do not agree. In 1993 an international gathering of scientific academies called for zero population growth, however, the academies from Africa disagreed, saying overpopulation is not a problem for Africa. Let us hope that in several generations time their children do not have to face the dire consequences of ignoring population growth. In addition to growth in population, other lifestyle factors are important. Fairness in the distribution of food and materials would decrease the needs of the poor, an economic and political issue. More efficient agriculture will also reduce the land that is required for agriculture, a scientific issue. Reducing consumption will aid this, an issue that the public as individuals must change.

A lasting earth is possible only if we all share proper concern and treat others as a family. Both social and technical approaches are required to solve the environmental crisis. We should reduce pollution by adaptive changes to our human society and system. Reducing consumption is something that the public as individuals can already change and must. Fairness in the distribution of food and materials would decrease the needs of the poor, an economic and political issue. We should work towards life philosophies emphasizing the shared earth that we live in.

Over the medium term the industrialized countries can switch to alternative energy sources, and more efficient energy use, combined with more significant lifestyle change. This would be aided by the early introduction of personal environmental quotas to ensure people are conscious of the environmental costs of different products and behaviour. The use of new technology will aid us in reaching a lasting earth. More efficient agriculture will reduce the land and energy that is required for agriculture, and the pollution arising from agriculture, a scientific issue. Changing the way human beings behave towards each other is a supernatural task, that can be aided by all of us changing our attitudes. We must ensure that sustainable living is encouraged, but recognize that it is only part of a broader solution. Sustainable living involves not just efficient agriculture, but also minimizing our energy use and pollution. It involves changing public policy. It involves changing the way people think. In developing countries the population growth rates must be decreased, and economic pressures that lead to the destruction of the environment must be eliminated.

In the medium-long term the whole world can be using a large proportion of renewable energy sources, such as biomass and solar energy, combined with efficient agriculture using new varieties of crops. In the long term (50-100 years), the world could be living in a stabilizing earth, with a stabilizing population. Improvements in lifestyle can be made through the increase in energy efficiency brought about by technology, and by the acceptance of more natural things that consume less energy, as the pleasures of life. Let us hope that urbanization does not mean that people lose the enjoyment of being able to be in the presence of undisturbed nature under a blue sky.

The broadest concept of the human family is the entire world, and the term human family has been used in United Nations declarations. It has ancient roots, whether it be in Christian concepts of the world or of Mo Tzu in China. Mo Tzu argued that practicing universal love was in one's long term interests not only because other human beings tend to respond in kind to benefits and harms received, but also because heaven wills those practicing the doctrine shall ultimately benefit.

As a biologist I see the development of the value of love of life quite consistent with a holistic view of life. Reductionists question why do people love others and love life? There have been various explanations of this. Richard Dawkins (1976) in The Selfish Gene suggested that human beings no longer are shaped by only selfish genes but ideas, he called memes. Peter Singer (1981) in The Expanding Circle looks at a similar question, how the range of human compassion grew beyond its primitive bounds of the family. He argues that the autonomy of reason from self-interest has lead to the idea of disinterested defense of one's conduct, and "in the thought of reasoning beings, it takes on a logic of its own which leads to its extension beyond the bounds of group". The recent concept of love of others in human beings has developed independently over the past millennia in religions of ancient urban civilizations, China, India, Greece, Mesopotamia, Egypt, Mexico and Peru, and they all aim to stop excessive self-love. It is also interesting that often efforts to introduce love are made to combat excessive legalism found in the culture.

8.3. Love as a decision-guider

While I conclude that love is universal, what are the other ideals of ethics that are universal? How do we balance conflicting ideals? How do we balance protecting one person's autonomy with the principle of justice, that is protecting all people's autonomy? Utilitarianism (the greatest good for the greatest number) is as the founders argued, rooted in love. But even if we make the goal as serving love or happiness, it is very difficult to assign values to different people's interests and preferences. Different people's interests will conflict, so that there are exceptions to the maintenance of privacy and confidentiality. Many medical and environmental technologies are challenging because they involve technology with which both benefits and risks are associated, and will always be associated. Sometimes love of technology replaces love of the object, and the love of the object may replace the goal of good, beauty or happiness, that Plato argued for. Human beings are challenged to make ethical decisions, they have to. The benefits are great, but there are many possible risks - the greatest of which is to do nothing.

The precise outcome of interventions in nature or medicine is not always certain. This uncertainty can be called a risk of failure or chance of success. This is common to diverse activities such as taking a new medicine, driving a car, generating energy, or production of materials. It has taken major ecological disasters to convince people in industry or agriculture of the risks. Introducing new organisms to the environment is also associated with risk. We may never be certain to have complete control over the effects of introducing new gene sequences, and with many cases much further experimentation is required before we will be able to ethically allow full scale use of them. We will never know exactly how one person will react to a drug or treatment, especially if it is novel. Ignorance of the consequences means caution in using new techniques, and this is an approach seen in the regulations governing the introduction of new organisms into the environment, the basis of quarantine regulations, or the need for ethical review boards for human experimentation and clinical trials, respectively.

The uncertainty is more important the greater the consequences of any disaster. If we introduce very novel chemicals, or unusual gene combinations into the environment they could have major consequences, which may be irreversible. The new genes may enter other organisms, or the new organisms themselves may replace existing organisms in the ecosystem. The ecological system is very complex, minor alterations in one organism have effects throughout the ecosystem. We can not yet predict these affects, so we must be careful, and move cautiously. We have had bad experiences in the past to make us realize our limitations. There is only one earth and we are dependent upon it, we must walk carefully. If a person has an extremely bad reaction, then life will be lost, breaking the principle of loving life.

There are other emotions that are strong, but fear is one of them. I want to recollect an experience which also made me write this book. India is a land of contrasts, and one where you can really see the power of fate. The small beggar girl comes with a face seeking money, help or love. But for fate, the same girl can be smiling in the hand of her father on the beach on a holiday. One beach can be clean golden sands without a person. The other beach may be a home for misplaced persons, with their faeces lying on the sand facing the waves. This is what fate asks of love.

We can only overcome fate with the power of God, that is what people saw when they said God is love. This answer has been given around the world at different times. There has to be a smile, a word, a glance, to interact. Without this, the world is so cold and heartless. The response that we cannot love one beggar girl because ten will come is based on our fear. Our fear that we cannot cope. The solution is the strength to love, a gift of grace that is beyond us to explain. Grace is a parallel to fate - one a positive pleasant sound to our ears, the other a shattering one. Next time I come back to share a second with that beggar girl, I will be better prepared to handle it, and seek the strength that is needed. Then I hope she will be added to those I dedicate this book to.

Love is infectious, but so is apathy. The answer to the question on Figure 8, "Can love be sucked dry?" is Yes, if we do not open our heart. As I returned from that experience my flame burnt a little hotter, and I hope it will not dim again. I wrote in my diary on that day, that I hope that I have a chance to share it, and I do. To help one in ten, a hundred or a billion needy persons in the world, we have to start somewhere or else our fire will die out completely. Love can be a decision guider, and it should overcome the fear that it will make us vulnerable or weak.

We need to critically assess whether the love of life can be a theory of bioethics, even though it seems so obvious. Beauchamp and Childress (1994) listed eight conditions for construction of an ethical theory, though not all theories can satisfy them. The conditions given were:

1. Clarity. A theory should be as clear as possible as a whole and in parts.

2. Coherence. An ethical theory should be internally coherent, with no contradictions and inconsistencies.

3. Completeness and comprehensiveness. If a moral theory includes all moral values it would be the most comprehensive, but at least it should cover as many moral dilemmas as possible.

4. Simplicity. The theory should have no more norms than is necessary.

5. Explanatory power. The theory should provide enough insight to help us understand moral life.

6. Justificatory power. The theory should give grounds for justified belief, not a reformulation of beliefs we already possess. It should have the power to criticize defective beliefs, no matter how widely accepted those beliefs may be.

7. Output power. The theory should produce judgments that were not in the original data base of particular and considered judgments on which the theory was built.

8. Practicability. A moral theory should not be so demanding that only a few persons could follow it.

Can love provide us with one answer for each dilemma? Should that even be the goal of bioethics? The answer to both may be yes or no. At an individual level we are faced with a need for a decision, even if the decision is to avoid to face the problem and run. The balancing of principles, self-love (autonomy), love of others (justice), loving life (do no harm) and loving good (beneficence) can provide us with a vehicle to express our values according to the desire to love. But when we ask two people to do this balancing, the decision may differ. It is healthy for bioethics that we do differ.

At the level of a social system and policy we also seek appropriate and consistent answers for bioethical questions. In many cases love does provide a clear answer, unfortunately the answer and power of love may be unacceptable for the selfish state that we find ourselves in. But I do not think it is too demanding to be unpractical, at least as an ideal. When we reflect upon our conscience we know the answers are clear, all deserve a good chance, all deserve a chance to be able to love themselves and love others, like the beggar girl in my story before. We should always not only respect life but love it, in the Platonic spirit of eros, seeking the best for our common heritage now and in the future.

The principle-based approach to bioethics based on love is both a reconstructive theory that is interested in application of moral principles (Birnbacher, 1994) as well as a foundational theory that seeks to justify the use of principles in the foundation of love. Theories of bioethics like Beauchamp and Childress (1994) are basically reconstructive, and leave the question of the fundamental foundations. They have an attraction because the same principles can work for people who look at actions, consequences or motives, and provide power for decisions that need to be taken in a world and culture that is split by apparently conflicting ethical theories, but they leave the fundamental questions inconclusive. I propose that love is the basis and foundation of human ethics and is central to the way people make decisions. It is the universal basis to ethics and human behaviour, and should no longer be neglected in formal bioethical theory, nor in ethical cases.

Do we need formal laws and standards? The idea of a slippery slope suggests if we perform some action, we will perform another. This expression envisages a slope where once footing is lost it cannot be regained, and suggests that controls which are adequate for initial exploration may fail under increased pressure. While we may not do any direct harm with an application in question, it could result in progressive lowering of standards towards the ill-defined line beyond which it would be doing harm.

The inability to draw a line is no measure of the nonimportance of an issue - rather some of the biggest fundamental questions in bioethics and life are of this nature. It applies to more than just the near impossibility to satisfy desire, but applies to decisions in general so that each new decision may go a little further along the road towards what was considered unethical. There is a danger that if love is unchecked actions performed in the name of love will proceed along a slippery slope. In our life we may try to draw lines, and maintain them as moral standards. As we get older we may cross more lines, and often this makes the crossing of the line the second time more easier. Few of us can learn from our mistakes, which is why the presence of some clear guides can aid us. However, rather than imposing laws that are correct 99% of the time and neglecting the 1% of times when the law is not ethically best, we should give law the flexibility that love demands. For in exceptions a law may not be consistent with a moral law of the universe, and thus it becomes unjust (King, 1961).

In order to have a sustainable future, we need to promote bioethical maturity (Macer, 1994). We could call the bioethical maturity of a society the ability to balance the benefits and risks of applications of biological or medical technology. It is also reflected in the extent to which the public views are incorporated into policy-making while respecting the duties of society to ensure individual's informed choice. Awareness of concerns and risks should be maintained, and debated, for it may lessen the possibility of misuse of these technologies. Other important ideals of bioethics such as autonomy and justice need to be protected and included in the benefit/risk balancing which is important for the ethical application of biotechnology in medicine. Concern about technology should be valued as discretion that is basic to increasing the bioethical maturity of a society, rather than being feared as a barrier to the implementation of new technology.

There have been many issues that have led to moral protest at different times, whether it be nuclear power or weapons, irradiated or genetically modified foods, involvement in wars, use of animals in research, occupation by unjust governments, forestry, to name a few (Jasper, 1997). A society which has bioethical maturity would be expected to have moral protests, and even support them as diversity. We would also expect activism against questions of conscience, though when this protest violates respect for life we would say it is not mature. The motives for protest are not always based on love of others, they may be excessive self-love in terms of protecting a group which we belong too, whether it be a disease-linked association, like muscular dystrophy association, or an activity based association, like the gun lovers groups that consider owning a gun is a human right.

An important measure of the progress of society and cultural maturity is the degree of the development of better ethical discretion in the personal and societal use of technology. The criteria of technological progress as a measure of social progress is inadequate because technology may be misused, or may be unavailable. We should not be soft-minded, but rational. Adolf Hitler in Mein Kampf wrote "By means of shrewd lies, unremittingly repeated, it is possible to make people believe that heaven is hell - and hell, heaven... The greater the lie, the more readily it will be believed". A more mature individual will be able to have discretion beyond what they are told, and beyond the efforts for manipulation of the mind by the selfish desires of others. Bioscience ethics demands responsible use of technology and responsible answers to important questions in life, such as reproduction (Pollard and Gilbert, 1997).

People are very gullible, believing in the power of advertisements and propaganda. We can fear the over-use of genetic screening tests as they enter supermarkets and mail order catalogues. In the UK, cystic fibrosis screening can be ordered by mail order with a telephone call a week later to receive the results and counseling. HIV testing is also available in many countries. Yet while these tests have created much bioethical concern, pregnancy tests can also convey news to persons which can change their life, and have major psychological consequences. There is no sharp line between tests, except the question whether the person is empowered by the information obtained to some good. The pregnancy test can lead one to change lifestyle, stop smoking and drinking, for example, and seek medical help. Diseases for which there is no prevention or cure, or risk to others may only cause worry to the person being tested even if self-love suggests an autonomy of knowing about ourselves. Love of life suggests we should not allow people to harm themselves, so we should not offer tests without counseling. Diagnostic tests when conducted carefully with prior thought are consistent with the informed choice of mature individuals, but especially when they involve prenatal testing counseling is needed so people can make decisions they can happily live with.

Part of the maturity is justice, to give everyone a fair chance. Methods to increase the ethical discretion and maturity of individuals and social systems should be developed. While I may agree with Pope John Paul II when he said "Only a socially just country has the right to exist", bioethical maturity also allows tolerance of the views of others to some degree, and working to make all countries just. Another measure of a bioethically mature society is one in which mobility between different groups is possible. Social classes are found in all societies, but mobility between these groups would be expected in a society which is ethically mature. This mobility increasingly depends upon education, in which case access should be made possible for all. We would also expect people in different classes to mix together in a more mature society, breaking down social barriers. We would also expect groups to tolerate each other, and to have less conflicts, as a result of the mobility of individuals within the society between the different groups.

These questions need international and cross-cultural answers for the world we live in. The questions need the perspectives of all, and some groups are represented in this book. I certainly do not imply by the absence of a viewpoint or the inclusion of one, that this is the only solution. Rather some papers illustrating approaches from different persons and traditions are included, and other diverse views are found in some other recent publications of Eubios Ethics Institute. The word "Eu-bios" means good-life, and such a life must be sustainable. We are still at the synthesis stage for determining what bioethical maturity is, and how it may be measured, but the comments from peoples in different countries from the International Bioethics Survey is another necessary part of the total picture needed to formulate any international measure of bioethical maturity, and to develop approaches to improve maturity.

How do we judge a morally correct decision? The use of love can be used to support legalism, situationism or antinomianism. Is love the only reliable principle or are the derivative principles also reliable? I may agree that love is the only absolute principle of ethics, but from that we can derive some primie facie principles and rules that can help us apply love. We do not need to examine every new situation completely afresh, rather we can use love as a moderator for conflicts between opposing principles of love.

How do we judge what is the greatest good for the greatest number, the action which will produce the most love? As Plato wrote in the Symposium, love is the desire for good. The values that will be regarded as good need to be defined. Looking among cultures the value that seems premier is life itself, and its preservation, therefore the conclusion that bioethics is love of life. The objects of that love can be persons, or theories, but above all life, living organisms. While a mature person is rational, they are also with a tender heart. As King (1963) said, "The hard-hearted person never truly loves. He engages in a crass utilitarianism which values other people mainly according to their usefulness to him. He never experiences the beauty of friendship, because he is too cold to feel affection for another and is too self-centred to share another's joy and sorrow. He is an isolated island. No outpouring of love links him with the mainland of humanity". Perhaps a mature person has a hard head but a soft heart, but they must work together.

I would generally agree with the comment of Jesus to those whose accused a women caught in adultery, "The person who is without sin can cast the first stone". We should not judge others, as we are all guilty of omissions of doing good, and for doing harm, and not reaching the ideals of love. In a study of The Moral Sense, James Q. Wilson (1995) wrote about sympathy, "It is easily aroused but quickly forgotten; when remembered but not acted upon, its failure to produce action is easily rationalized. We are softened by the sight of one hungry child, but hardened by the sight of thousands".

However, in society there will be times when people should be judged for crimes. Love of life would argue against capital punishment, being inconsistent with a respect for life. Responsibility of a person for their actions might be lessened when they were ignorant of the consequences of their action, as we already do for crimes by children and mentally sick at the time of the crime. Compulsion has also been used to excuse behaviour in times such as war, or mind control.

Rather than separating emotion and reason, they are inter-dependent. Tillich argued that justice is taken into love if the acknowledgment of the other person is not detached but involved. Our choices and intentions towards others should be governed by their aims and aspirations as well as our own (Campbell, 1984b). Love of others then provides a basis for respect of them, and a relationship with others. There are various cultural standards imposed for relationships as discussed in this book. Words, like thank you may be a symbol of love in their presence, or in their absence. In China and Tanzania for example, people may not say thank you or sorry if they are close. The idea of thank you is a European import into their cultures, and can be said to be unnecessary if people trust each other. Both those cultures though have the practice of gift-giving, which is another way to express the idea of thankfulness.

When one tries to think of the meaning of love we can imagine many of the features of relationships, such as trust, security and hope. The love that we receive from others keeps us alive and motivates us to new heights. Love can free us from the pressure that time imposes, as epitomized in the story Momo (Ende, 1973). Not only is love the message of ancient religions, but it is also incorporated into New Age religious movements, that blend a message of love into new hopes for the happiness of humankind (e.g. Okawa, 1990). It is interesting that personal happiness continues to be included in the message of love, as was the message of Buddha, Christ, Mo Tzu and Plato, many years ago. Mahatma Gandhi (1927) wrote that "I have nothing new to teach the world. Truth and non-violence are as old as the hills".

Freedom in moral thinking that is the result of applying the principle of love is not without a price. The freedom given us to love and chose who to love, can often lead to despair. As John Lennon wrote in Mind Games (1973), "Love is a flower , you've got to let it grow". However, we often stop the growth of love, by omission, or guilt or conflicts.

Education at all levels in society is called for by global bodies such as UNESCO and IUBS. Education of bioethics should lead to identification of values and better decisions which result in actions. A decision without an action is unfulfilled. Education should lead to empowerment of our ability to love life, but if it is incomplete or misled if can sometimes lead to hopelessness, a situation worse than before it was started. Do we want to understand how we make decisions and why or just follow the social norms? Social norms offer security and reassurance, for our failures, but the common morality may not be good enough for our future path.

Is a person who fails to love morally deficient? The story of the Good Samaritan is found in the New Testament of the Bible, and describes how a stranger helped the victim of a robbery and beating. Both motives and actions were based on caring or love, as there was no religious law forcing the Samaritan to help the injured man. The person who fails to love is certainly not reaching an ideal, but how much effort to reach our neighbour is necessary? As much as we can is not a frightening answer, it will enrich us. There will be a time when the stranger wants to be left to end their life, that peace comes from an expression of love that is often harder than trying to do something to keep them alive, a time to let love conquer the instinct of love of life.

Does the presence of an ideal put someone off striving harder to help others? Do people just give up totally and become bad? Generally we do not, though hope should be given when we are disappointed by our own failings to reach the ideal. Love points us to face others, we are not isolated individuals but one family of life. At least we can conclude that we should all try a little harder to reach the common ideal, and the world would be a better place.

Let us try.

Figure 21: Love of nature and litter, both start at home

- Two images from Japan, U.K., of the dumping of litter. The bottom image from Japan, shows vending machines, a common addition to nature in Japan.

Do the right thing or pay a fine, 100 dollars in New Zealand or 1000 pounds in Wales

Rubbish recycling, London, U.K.

- Different coloured containers code for different items of rubbish, in efforts to enable more efficient recycling of rubbish.

Figure 22: Bioethics with a view for the future and others

Whose view of life do we consider?

Tsukuba International Bioethics Roundtables

- Cross-cultural dialogue is important in comparing local responses and finding global answers to the dilemmas of bioethics.

Sphinx, Egypt

- Will the principles of bioethics last as long as the ancient monuments of stone? The principle of love has.

Remembrance of the past should help us grow in the future

Figure 23: Love is the stream for global bioethics

"My garden", a painting by Eileen Rose Macer, asks the question where does our path lead? What is beyond the hills?

For the mother duck and the ducklings, the cycle of life and death will be fought with a love of life. The ducks are not unlike the passengers on the boat in India, seeking the future while enjoying the love of life.

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