Moral Policy and Public Policy

  • Maurice A. M. de Wachter
Part of the Nijenrode Studies in Business book series (NSIB, volume 3)


Recent discussions (ca. 1972-1976) on biomedical research into the human fetus, especially in the United States, illustrate the process of decision-making. Every decision presupposes a scale of values which establish priorities.1 For some, this proves that all decisions are rooted in ethics. However, the difference between the eventual outcome of strictly moral policy decisions on the one hand, and public policy decisions on the other raises the important ethical issue of possibly divergent scales of values being applied in setting priorities. The ethicist, then, would like to know to what extent the ethical component still plays a part in determining public-policy priorities.


Public Policy Unborn Child Ethical Component Hastings Center Report Moral Policy 
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  1. 1.
    LeRoy Walters, Fetal Research and the Ethical Issues, in The Hastings Center Report 5 (1975), No. 3, p. 16.CrossRefGoogle Scholar
  2. 2.
    E. Freidson, Profession of Medicine, New York, 1971, p. 120.Google Scholar
  3. 3.
    E. Goode, Marijuana and the Politics of Reality, in Journal of Health and Social Behavior 10 (1969), 83–94.CrossRefGoogle Scholar
  4. 4.
    E. Goode, ibid., p. 88 explains how concepts of ‘true’ and ‘false’ are being distorted by social and cultural lenses. He then goes on to say that this does not mean that ‘no research has ever been conducted which approaches scientific objectivity… It is to say, however, that not all participants in the marijuana controversy have been trained as scientists, nor do they reason as scientists’ (my italics). This used to be a strong argument against lay participation in policy-setting and determination of priorities, e.g. in the jury model.Google Scholar
  5. 5.
    H. K. Beecher, Research and the Individual: Human Studies, Boston, 1970, p. 142 ff.Google Scholar
  6. 6.
    H. K. Beecher, ibid., p. 143. The fact that some selection committees operate with the norm of ‘church-belonging’ as a sign of greater social involvement and, therefore, greater worth to the community has been greatly criticized. See: P. Freund, Experimentation with Human Subjects, London, 1972.Google Scholar
  7. 7.
    Nobody fails to see that Beecher’s description reveals a clear preeminence of medical criteria. Compare with Goode’s opinion that only expert scientists should participate in policy-setting. Compare also with E. Freidson, op. cit., p. 5 who sees this as the main characteristic of medicine today: prestige and expert authority make physicians within official policy-making positions lords and rulers, with no rivals or competition.Google Scholar
  8. 8.
    LeRoy Walters, op. cit., 16. The author also offers a good example of such policy deployment of a moral principle. ‘Non-therapeutic fetal research should be done only to the extent that such research is permitted on children or on fetuses which will be carried to term’ (p. 15).Google Scholar
  9. 9.
    At the outset of this discussion I wish to follow rather closely the line of an expose by R. A. McCormick, Fetal Research, Morality, and Public Policy, in Hastings Center Report 5 (1975), No. 3, 26–31.CrossRefGoogle Scholar
  10. 10.
    Ibid., 16.Google Scholar
  11. 11.
    Ibid., 16.Google Scholar
  12. 12.
    McCormick sees this too: ‘I emphasize here that I am discussing for the present a moral position (not immediately what public policy ought to be) and one that reflects my own views.’ (op. cit, 28). Nevertheless, P. Ramsey holds quite different views as he believes that ‘a searching inquiry into the morality of fetal research must be the foundation of fetal politics, if it is to be good politics’ (Ethics of Fetal Research, New Haven, 1975, p. 72). The difference between these two positions is not just a matter of more or less, but is rather substantial.Google Scholar
  13. 13.
    The approach taken by P. Ramsey would hardly need such a distinction, since moral policy is the root of public policy. Ramsey has no need for two principles. As was said in the previous footnote, Ramsey would consistently deny the question we keep asking about the extent to which moral policy should be present in public policy.Google Scholar
  14. 14.
    A more detailed description is given by P. Ramsey in The Ethics of Fetal Research, New Haven, 1975, pp. 1–20. Equally important and giving a broader historical context is R. M. Veatch, Human Experimentation Committees, in Hastings Center Report 5 (1975), No. 5, 31-40.Google Scholar
  15. 15.
    Quotation from P. Ramsey, op. cit., pp. 72-73.Google Scholar
  16. 16.
    Such an allowance is in fact made by one of the regulations issued on July 29, 1975 by the Secretary of Health, Education, and Welfare.Google Scholar
  17. 17.
    See, e.g., R. A. McCormick, Fetal Research, Morality, and Public Policy, in Hastings Center Report 5 (1975), No. 3, 28:‘… since there is such profound division on the moral propriety of abortion, the moral notion of cooperation in an abortion system will not function at the level of policy.’Google Scholar
  18. 18.
    P. Ramsey, op. cit., p. 60.Google Scholar
  19. 19.
    W. D. Delahunt, ‘Biomedical Research: A View from the State Legislature,’ in Hastings Center Report 6 (1976), 25–26.CrossRefGoogle Scholar
  20. 20.
    Ibid., p. 25 (italics mine).Google Scholar
  21. 21.
    R. M. Veatch, ‘Human Experimentation Committees: Professional or Representative?’ in Hastings Center Report 5 (1975), No. 5, 31–40.CrossRefGoogle Scholar
  22. 22.
    Ibid., p. 31.Google Scholar
  23. 23.
    W. D. Delahunt, op. cit., p. 25.Google Scholar
  24. 24.
    The eleven members of the committee are ‘distinguished in the fields of medicine, law, ethics, theology, the biological, physical, behavioral and social sciences, philosophy, the humanities, health administration, government, and public affairs.’ See R. M. Veatch, op. cit., p. 34.Google Scholar
  25. 25.
    H. Jonas presents similar insights regarding one of the principles at stake in experimentation: ‘On principle, it is felt, human beings ought not to be dealt with in that way (the ‘guinea pig’ protest)… Putting the matter thus we have already made an important assumption rooted in our ‘Western’ cultural tradition. The prohibitive rule is, to that way of thinking, the primary and axiomatic one; the permissive counter-rule, as qualifying the first, is secondary and stands in need of justification. We must justify the infringement of a primary inviolability, which needs no justification itself; and the justification of its infringement must be by values and needs of a dignity commensurate with these to be sacrificed’ (in P. A. Freund, op. cit., 3; italics mine).Google Scholar
  26. 26.
    As an illustration of the applicability of the diagram, we can consider the following, by P. A. Freund in his Experimentation with Human Subjects. He discusses the Seattle case about selection of candidates for hemodialysis. The principle upon which the decision had to be made was ‘worth to the community’ (e.g. church attendance). Freund then made the following objection: ‘My own submission was that in a matter of choosing for life and death, not involving specific wrongdoing, no one should assume the responsibility of judging comparative worthiness to live on the basis of unfocused criteria of virtue and social usefulness, and that either priority in time, or a lottery, or a mechanical selection on the basis of age should be followed.’ Note that in this statement the principle of worth is discarded and a rule of thumb for concrete action is presented (a lottery, etc.). This rule itself is justified by what I would call another principle, viz. ‘The more nearly total is the estimate to be made of an individual, and the more nearly the consequence determines life and death, the more unfit the judgement becomes for human reckoning’ (Ibid, p. XVII).Google Scholar

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© H. E. Stenfert Kroese B.V. 1978

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  • Maurice A. M. de Wachter

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