CONCLUSION

A major aim of the dissertation entitled A Study of Some Contemporary

Bioethical Issues from Philosophical Perspective is to address core
controversies prevailing in three biomedical practices namely: stem cell
research, cloning and surrogate motherhood; and to take an attempt to
resolve these controversies with the help of moral theories. This puts the
onus on developing a credible interpretation of concerned subject matters.
Hence, this discussion is divided into four chapters: historical background
of bioethics, dominant ethical approaches in bioethics, contemporary
bioethical issues, moral evaluation of contemporary bioethical issues with
the help of six dominant ethical approaches.

The first chapter ―Historical background of bioethics‖ provides a brief

literature regarding the development of bioethics. Any philosophical
discussion requires true and detailed observation from the beginning.
Bioethics as a new field of discourse receives it‘s designation in the last
decades of twentieth century i.e. after 1970. However, before that time, the
concerned themes were used to be discussed in the field of medical ethics.
Thus bioethics owes much to medical ethics. Now, the practice of medicine
has been associated with certain moral values for many centuries in all the
renowned cultures like, Hindu, Islamic and Christian cultures. Thus it seems
reasonable to speak of an ancient heritage of medical ethics. After exploring
these historical aspects and presenting the definitions of bioethics; this
chapter concludes that the term ‗bioethics‘ refers to both a concept and a
practice. Conceptually, bioethics engulfs each and every moral features
related to life. However as a separate discipline it is limited within a narrow
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scope that is to remain focused on the moral impact of advanced
biotechnology on living beings such as humans, animals and plants. Since it
has been decided in this dissertation to address and to resolve moral debates
of some bioethical issues with the help of dominant ethical theories in
bioethics, we made a new chapter based on ethical theories after providing
the historical background and two fold definitions of bioethics.

The second chapter, ―Dominant ethical theories in bioethics‖ provides six

ethical approaches dominant in the field of bioethics. These approaches can
be divided into two categories on the basis of their applicability. The first
five approaches namely, utilitarian approach, deontological approach, virtue
ethics approach, care ethics approach and principle based approach are
categorized as theoretical approach and the sixth one that is case based
approach is categorized as pragmatic approach. Among the theoretical
approaches utilitarian approach is a single principle based approach that
evaluates an action as morally good or bad on the basis of consequence.
Thus it is known as a consequentialist theory. Deontological approach
emphasizes on duty independent of consequence. Virtue ethics puts stress
on the moral character of the agent. Care based approach values noble
emotional aspects of human beings, like, sympathy, empathy, compassion,
sensitivity etc. which for care ethicists, help to understand the moral
situation. Principle based approach emphasizes on moral principles in
ethical reasoning and in providing adequate justification of a moral
problem. It has been shown that utilitarianism is also a kind of principle
based approach, but in this dissertation it has been discussed separately as a
consequentialist theory based on single principle. Consequentialistic
attribute of utilitarianism sets it aside from other principle based
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approaches. Basically principle based approach with all its various forms
receives the ultimate shape in the four principle based approach of
Beauchamp and Childress and becomes popular as ‗principlism‘ in the
bioethical discussion. Principlism is a pluralistic approach to bioethics that
articulates four principles from different monistic ethical theories. For
example, principle of respect for autonomy is taken from Kant‘s
deontological theory, principle of beneficence along with nonmaleficence
taken from utilitarianism and principle of justice is taken from virtue ethics.
Thus principlism conjoins key principles from different narrative ethical
approaches and tries to provide an adequate theory based framework to
evaluate moral problems. The sixth approach which is categorized as the
only pragmatic approach in bioethics is popularly known as casuistry.
Unlike theoretical approaches this approach emphasizes on practical moral
problem and then compares it with same sorts of other moral problems and
finally resolves the case following the same successful method performed
in other resembling cases. Case analysis plays the most important role in
casuistry. In the field of biomedical ethics Jonsen, Siegler and Winslade
have introduced a straight forward casuistic framework namely four topic
method to analyse clinical cases and resolve the moral problem. This four
topic method involves, medical indication, patient‘s preference, quality of
life and contextual features. Each topic is based on ethical principles. The
first topic medical intervention is based on the principle of beneficence and
nonmaleficence. The second topic patient‘s preference is based on the
principle of respect for autonomy. The third topic quality of life is based on
the principle of beneficence and nonmaleficence again and the fourth topic
contextual features is based on the principle of loyalty and fairness i.e.
justice. Here a deep analogy is found between the four principle based
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approach of Beauchamp and Childress and the four topic method of Jonsen,
Siegler and Winslade. Both of these approaches are founded on same
principles like respect for autonomy, beneficence and nonmaleficence and
justice.

Discussion of the third chapter ―Contemporary bioethical issues‖ is based on

three biomedical issues namely stem cell research, cloning and surrogate
motherhood. Hence the third chapter is divided into three sections. The first
section deals with moral issues of stem cell research, second section deals
with moral issues of cloning and third section deals with moral issues of
surrogate motherhood. After discussing the advantages and disadvantages
of stem cell research we have entered into the moral debate regarding the
value of life of the pre- embryo which is to be destroyed at the time of
harvesting stem cells. It is said that pre-embryos are potential person and
thus killing a pre-embryo is as offensive as killing a person. After exploring
the moral debate regarding this matter we have concluded that pre-embryos
cannot be referred to as persons and thus they are not eligible to enjoy the
same moral status that of persons. In the next section of this chapter we have
discussed the ethics of cloning. Cloning research can be divided into two
parts─ animal cloning and human cloning. Each type of cloning is of two
kinds namely, therapeutic cloning and reproductive cloning. In this
dissertation we have limited our discussion on moral issues of human
cloning. We have seen that objections against therapeutic cloning are same
as objections against stem cell research because therapeutic cloning is a kind
of stem cell treatment to heal sufferings. The highly controversial aspect of
human cloning is rooted in human reproductive cloning. In this chapter we
have explored the arguments given for and against human reproductive
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cloning. In the third section of this chapter we have discussed the moral
pros and cons of surrogate motherhood. After exploring the moral debates
of these three issues we have understood the central point of moral debates
of these issues. In the stem cell research and therapeutic cloning the central
point of controversy is personhood of pre-embryo, in human reproductive
cloning this point is the quality of life of the cloned human being and in
surrogacy this central point of objection lies within selling human dignity
and degrading mother-child bond. After reaching these core points of
objections we have decided to evaluate these problems with the help of six
ethical approaches at hand.

The fourth chapter entitled ―Moral evaluation of contemporary bioethical

issues‖ begins with an aim to resolve moral controversies of above
mentioned bioethical issues with the help of six dominant ethical standpoints
discussed in second chapter. This chapter is divided into three sections. The
first section highlights the moral justification of stem cell research and
succeeding two sections emphasize on the moral permissibility of human
reproductive cloning and surrogate motherhood. After exploring these topics
with the help of six ethical standpoints we have concluded that stem cell
research is morally permissible. However to bypass the whole controversy
we can encourage the ongoing research on inducing pluripotent stem cell. In
this research researchers are trying to convert multipotent stem cells that is
adult stem cells into pluripotent stem cells. Once they achieve success over
this research, the process of harvesting pluripotent stem cells from the pre-
embryo would not be required then. From the discussion of second section
we have concluded that human reproductive cloning fails to receive moral
acceptance from the six ethical standpoints. However case based approach,
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which is based on the data received from animal cloning, may seem to
permit this practice but that with an alert of risk. Evaluation of surrogate
motherhood shows that though utilitarianism allows this practice, other
ethical approaches prohibit the practice of commercial surrogacy. There are
two reasons causing such prohibition against commercial surrogacy. The
first is, this process humiliates the bond between a gestational mother and
her child and second, monitory transaction in commercial surrogacy paved
the way of exploiting poor women. However it would be difficult to
motivate a woman for lending her womb without any incentive. Thus it
seems surrogacy may surface as a popular trait in saving family lineage and
also saving mankind in future. The legal system should take care through
inducing appropriate amendments in saving potential womb lenders from
exploitation. Surrogate mothers are often treated as commercial entities. It
all depends on perspective as to how we view this action. A surrogate
mother may be viewed as savor of gene from another perspective, which
brings her much honour and respect and thus being means to an end she
becomes an end in herself.

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