A Response to Clements Environmental Bioethics: A Call for Controlled Human Fertility in a Healthy Ecosystem

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A RESPONSE TO CLEMENTS ENVIRONMENTAL BIOETHICS: A CALL FOR CONTROLLED HUMAN FERTILITY IN A HEALTHY ECOSYSTEM VAN RENSSELAER POTTER* Clements [1] has noted the nearly simultaneous appearance of my paper on "Bioethics and the Human Prospect" [2] and a new book by E. O. Wilson in which he discusses "The Conservation Ethic" [3]. She identifies two problem areas that need clarification in both contributions. Granting that a healthy ecosystem is essential for the survival of the human species, she asks, first, whether moral exhortations using words like responsibility, stewardship, obligations, or duty have anything to contribute either conceptually or practically to an environmental bioethic that would contribute to the survival of the human species. Second, she questions my suggestion that there is a noticeable dichotomy or polarity between medical bioethics and environmental bioethics, as indicated in my figure, which she reproduces [I]. Basically the issue is whether medical ethics has been or can be reconciled with environmental bioethics and become in fact medical ¿»¿oethics. I propose to discuss the second problem area first. In my earlier essay I discussed five kinds of survival that can be imagined: mere, miserable, idealistic, irresponsible, and acceptable. It is worth noting that both Clements and Wilson do not question my basic premise that survival of the human species in some acceptable form, that is, not mere or miserable , is desirable and that it is not something that can be taken for granted. It is something that we will have to work at, and that effort is what environmental bioethics is all about. I emphasized that "medical bioethics needs to operate in the perspective of environmental bioethics. Editor's Note.—Dr. Potter's response to Dr. Clements's " 'Therefore Choose Life': Reconciling Medical and Environmental Bioethics" (this issue) is an invited comment. *McArdle Laboratory for Cancer Research, University of Wisconsin Medical School, Madison, Wisconsin 53706.© 1985 by The University of Chicago. AU rights reserved. 003 1-5982/85/2803-0438$0 1 .00 426 I Van Rensselaer Potter ¦ Controlled Human Fertility The former deals with individuals now; the latter deals with the survival of society, which is necessary for a decent life for individuals in the future." Clements believes that medical bioethics can be reconciled with environmental bioethics if we "choose life," as indicated in her title [1], while she makes clear that "life" is to be understood in the context of biological systems theory. She agrees with me that if medical ethics continues to "make artificial and disconnected the human experiences of birth and death" and if it continues to ignore our ecological subsystems, it will "lead at best to miserable survival." She concludes by noting that "medical ¿wethics should be an important cluster of biological values at the level of individual survival and adaptation, linked to other levels by a systems view of the world" using a hierarchical model to emphasize the point. Continuing my response to Clements's second problem area, I agree that medical bioethics should be linked to other levels in a systems view of the world, but I am still convinced that present self-proclaimed advocates of medical ethics have neglected the issues of environmental bioethics: there remains a remarkable dichotomy or polarity between the views of those who deal with medical ethics and those who deal with environmental issues. To emphasize this dichotomy I have prepared a flow diagram that indicates how the basic concept of bioethics—"ethical values cannot be separated from biological facts" [4, p. vii]—has evolved into two divergent lines of thought (fig. 1). It is not here claimed that medical ethicists have no long-term views or that environmental bioethicists have no short-term views, but it does appear that at nearly all levels the balance of the medical ethics flow of ideas and consequences is heavily weighted in the direction that leads to an expanding world population . They have neglected the overall biological systems of the world and are not really operating as ¿»¿oethicists. Little has been said or written by medical ethicists about the need to limit population growth by bringing into balance the processes of death control and birth control and to adjust cultures toward the restoration and maintenance of...

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