Morals and Medicine by Joseph Fletcher

Abstract

BOOK REVIEWS Morals and Medicine. By JosEPH FLETCHER. Princeton: Princeton University Press, 1954. Pp. ~43 with index. $4.50. The first reaction of a Catholic on encountering a book by a Protestant theologian on specific moral problems such as the patient's right to know the truth; contraception, artificial insemination, sterilization and euthanasia is pleased surprise. Perhaps the traditional Protestant vagueness on definite moral issues, deplored on the dust-jacket and in the preface by Dr. Karl :Menninger, is to give way to a more conclusive moral theology which, while probably differing on some points, will at least provide a basis for civic cooperation. Such happy expectation of a new ally is heightened by the high praise there accorded to Catholic moralists for their diligence. With such a gracious introduction, it is possible to thumb blissfully, if not too carefully, through the first two chapters. The first, on human rights, displays an interesting historical insight into the relations of religion and medicine, with an impressive background of reading in modern medical problems as well as Catholic moral theology. The author is quite concerned with the interference of old religious beliefs in medicine. He carefully distinguishes reflective or rational morality from theocratic or revealed morality and chooses the second as his frame of reference, while at the same time professing his belief in the revelation of the Old and New Testaments, and expressing the hope that his conclusions fall within the range and provision of Christian theology. His opposition is reserved, it seems, for a third type of morality which he calls customary, that is, the confusion of mores with morals. The problem encountered in the second chapter is that of the moral right of the patient to know the truth about his condition. This preliminary skirmish, like the introductory chapter, is, at first glance, uneventful. However, both chapters strike the tone which is maintained throughout the work. The reader is reminded by the smooth urbanity, worldly wit and amicable benignity with physicians that the discussions of these medico-moral problems were originally the Lowell lectures. There is a slightly discordant note in rather constant and petty peevishness with Catholic moralists, but then this might be expected in a field the author confessed had already been filled by those whom he could not approve in every respect. The real shock comes in the succeeding chapters. The pleased surprise this time is for the medical men rather than the moralists. It was perhaps best expressed by the science editor of the New York Times who wrote 89 90 BOOK REVIEWS in his review: "As a devout clergyman, Dr. Fletcher might be expected to champion theological conceptions of morality. He opposes them." The nature of that opposition the disappointed moralist may glean by turning back to the subtitles in the table of contents. Contraception is there described as our right to control parenthood. But that is only the third chapter. The fourth, fifth and sixth are successive illuminating explosions. Artificial insemination is the right to overcome childlessness. Sterilization is our right to foreclose parenthood; euthanasia, our right to· die. What proof is offered for these interesting conclusions, so novel in a moralist? Each chapter discusses the history of the practice, its current medical and legal status,' but the discussion of morality is in each case a negative argument directed against Catholic moralists and anyone who agrees with them, be he Protestant clergyman or physician. Are the conclusions of these four chapters, the bulk of the book, then merely assumptions ? Oddly but perhaps significantly, the principles which are supposed to guide the conclusions, while dispersed rhetorically as slogans throughout, are not found in anything like definite form until the seventh and last chapter which is on the ethics of personality. Dr. Fletcher there justifies his procedure by stating (p. 214): "Deliberately we have relied upon a cumulative support for our central thesis, choosing to bring out what it means in a clinical style .by examining concrete problems rather than by presenting a contrived and systematic construction of ethical doctrine." This process from conclusion to principle undoubtedly would enjoy a certain attractiveness for men accustomed to the inductive methods of scientific research. Yet, while apparently...