- Yaman …rs MD, D.Phil.,
Unit of Medical Ethics, Ankara Medical Faculty, Sihhiya, 06100 Ankara, TURKEY
Godot, as the hero of one of the avant-garde playwrights of our time, may have been interpreted differently by different people. A colleague of mine, originally a psychiatrist, has said that he represents God (2). In my interpretation of the play, the two men wait for a symbolic figure who will supposedly come and apparently solve the main problems in their lives - poverty, loneliness, existential reflections and worries, quest for meaning... At all events, I think that Godot symbolizes an unrealizable expectation (whatever its background may be), possible, in my view, with an ethical implication. This may perhaps be called Godot'ian Ethics, or the ethics of Vain expectation.
Judging by what people in general expect from bioethics, or from the ethics of the professions, Bechett's hero might also be regarded, for instance, as a biomedical ethicist, if not a moralist in the field of biomedicine. What will concern me in the present context is whether we could question the professional and social function of the bioethicist as the role of a Godot in this field. However, I do not mean by this the role of a "person" whose arrival would be welcome by those social circles waiting eagerly for the solution of our bioethical problems, whether they be biomedical, social, environmental, or any other. I am rather concerned here with the question of how certain bioethicists are inclined to see themselves as regards their professional function and social role. I hope to be able to have clarified, in the end, my concern on what I would call the Godot-syndrome and/or Godot-drama of those bioethicists whose self-identification with their field or activity seems to me as unduly unrealistic.
The expression "Waiting for Godot" is part of the title of an editorial in a Newsletter of the Pennsylvania Bioethics Center (3). "...Looking for an Ethics of Nursing" in this country, the author stresses that in recent decades "nurses relied on biomedical ethics textbooks, which put the emphasis on clinical decision-making for physicians and policy issues in medicine, rather than on the ethical dilemmas faced by practicing nurses. But one of the most exciting things going on in bioethics these days is the development of new ethics of nursing." Nursing having become increasingly professionalized, nurses seek "a key aspect of any profession: a philosophy." But "each theorist claims to speak for all of nursing and for every nurse", there being "little talk of a multifaceted or "possible part" of nursing ethics. "And having discussed the three known philosophical approaches in nursing, that is, "principalism" (nurses as ethicists), "advocacy" (nurses as steadfast patient defenders), and "caring" (nurses as empathic caregivers), the author finds a fourth potion more sober. This is called a postmodernist approach, which follows Michel Foucault's work and includes a web of political, historical, socio-economic, and institutional constraints, thus expanding nursing ethics beyond the deceptively simple arena of the patient-nurse encounter. This larger, contextual search for a nursing ethics is the aim of the Centre at Penn's School of Nursing. The article comes to an end with the following short sentence: "But we too are still waiting for Godot."(3)
The reader might expect me to give a short descriptive account of nursing ethics in Turkey. I must say that among the most frequent visitors to our Unit and the participants in our activities are young registered nurses, mostly from the nearby Hecettepe University School of Higher (Registered) Nursing. We have also very good contacts with nursing teachers and research workers in general, and I have been the advisor of a registered nurse who has received a doctoral degree in Deontology and Medical History. I think, however, that the ethics of nursing and the related topics such as the professional identification and the self-image of nurses in this country, together with their social role and function, could be much better described and analyzed by someone within the profession. And in case my efforts in this direction are going to be fruitful, the reader might be able to read such a contribution to EJAIB in the near future.
In more general terms, we may ask ourselves whether the "philosophical" situation is more or less similar to, if not identical with, that of other areas of professional ethics when "bioethicists" critically evaluate their own activities. As far as I can judge, and for all the impression it may give as an "established" field compared with nursing ethics, medical ethics for instance is far from being an end-product, so to say, and this neither methodologically nor socially. Apparently, many people involved in bioethics and its education are also waiting for Godot who would come and change the "state of their art" in a positive direction (which is, by the way, not a fortunate expression). Given the in-principle open-endedness in the methodology of ethics as well as in moral issues, what sort of a Godot-ethicist could satisfactorily meet the expectations of bioethics\cists? And, in actual fact, is this realizable at all? Or is this expectation vain, as human history shows us with so many people waiting, among others, for a philosopher-Godot (4)?
In a working group on a comparative study of medical and nursing ethics during an international bioethics conference, one of the discussants, an American nurse, was trying to see the issue from a more or less feminist point of view. While medicine is, as she was rightly pointing out, predominantly a male profession with its established paternalistic attitude in the clinic; nursing, its main preoccupation being patient care, has basically been a female activity. When I reminded her of the meaningfully high number of women physicians in certain countries, Turkey being one of them, she replied: "Our female colleagues in medicine say that once they reach a certain level of experience and professional status, they begin to realize that they have already assumed an essentially male attitude to their patients".
Particularly from a feminist standpoint and academically speaking, it could indeed be better that we should visualize a female Godot in the field of bioethics. In any case, however, we must also take into account that bioethics is a multidisciplinary activity, trying to recognize and conceptually analyze moral issues in different fields, and formulating solutions to them. And bioethicists need not, indeed should not, assume either the role of a "meta-moralist", let alone moralist, nor the function of an applier who is expected to be responsible for the implementation of the solutions formulated/proposed, such as a politician or bureaucrat. If they also want to become activists in relation and in addition, to their usual work so much the better. In that case, however, I do not think that gender would be an overall determining factor in the solution of academic and/or professional issues in bioethics.
1. Ors, Y. "Can Psychodrama be a Tool in Ethics Education?", EJAIB (1886) 16-17.
2. Gojsekm F. A, (Private communiation), September 1996.
3. Glenn, M. G. "Waiting for Godot: Looking for an Ethics of Nursing". University of Pennsylvania Centre for Bioethics Newsletter, 1:(4) 5-6, (jWinter) 1996.
4. Ors, Y. ("Godot, Glasnost, and Philosophy") Felsefe Tartismalari (Philosophical Discussionons), Book 9 (1990) 102-112 (in Turkish).