Bioethics past, present and future: a personal and narrative perspective from the European continent
Living in the centre of Europe (in Leuven and Brussels, Belgium) and having had the privilege of participating in the evolving practice of European bioethics (e.g. as Treasurer, Secretary General and President of the European Association of Centres of Medical Ethics (EACME), and also as a participant in many European research projects), I take the opportunity here to share some of my personal reflections on the theoretical mainstreams of bioethics, as it is practised in the majority of European centres. Conventional wisdom has it that bioethics began in the USA, and the temptation is therefore to address European-American differences. I have regularly made this mistake, for example in my opening speech at the bi-annual conference of the International Association of Bioethics in London, in 2000. Yet, I admit that this is a simplification: some bioethicists in the USA (such as Pellegrino, Reich, Thomasma, and Walter, amongst others) had and still have strong links with European philosophers and theologians. Some of them, like Reich and Walter, were even trained in Europe. On the European continent, Francesc Abel of Barcelona, one of the pioneers of bioethics in Europe, obtained his bioethical training from André Hellegers at the Georgetown University Kennedy Center in Washington. The early beginnings of bioethics in Europe are closely linked to what happened in the USA, especially in the Kennedy Center and in New York’s Hastings Center. However, in 1975, ten years prior to the birth of EACME, the British Society for the Study of Medical Ethics started the Journal of Medical Ethics , ‘a forum for the reasoned discussion of moral issues arising from the provision of medical care’ (Boyd, 2013: 661). The editor and publishers of this journal were, for a long period, defenders of ‘principlism’ (which I explore below), an ethical methodology which was imported from the USA to Europe. Similarly, in the Institute for Bioethics in Maastricht, principlism was regularly used as a framework for tackling bioethical problems in a pluralist society.