Reversing the Protections

Abstract

The distinction between the public and the private in this symposium is, I will assume, continuous with both the communitarian-autonomy and responsibilities-rights distinctions in other symposia. I will also assume that issues about what should remain private are linked to issues of privacy and autonomy and that issues about what should remain public are linked to issues about the common good and community control. The moral and political theories most closely aligned with these distinctions are individualism and communitarianism. By a liberal individualist, I mean a person who holds that a specified social space should be carved out within which the individual is protected in the pursuit of personal projects. A communitarian, by contrast, holds that public policies should be derived primarily from communal values, the common good, social goals, traditional practices, and the cooperative virtues. Any well-ordered society will leave room to maneuver between these two poles of protecting public interests and protecting private interests. Various political systems may be slanted more heavily in one direction than the other, but to exclude the one or the other, or to rigidly close off the possibility of shifts from an emphasis on the one or the other would not be an acceptable political system. It is not surprising that we periodically find ourselves redrawing the boundaries between the public and the private. Unless we are committed to a radical communitarian or libertarian philosophy, we will expect a balance between the two to be struck in different ways as cases and circumstances turn our eyes to new consequences of policies and new social needs. This thesis should be sufficiently noncontroversial that it needs no defense. More pertinent are the specific ways in which society is at present seesawing in the attempt to preserve an appropriate balance between the public interest and the private. Here I can only give some examples and suggest some ways we can increase protections for either the public or the private. I choose two issues in bioethics that should illustrate this seesawing tendency and its desirability: euthanasia decisions and the collection of organs and tissues as social resources. Controversies about euthanasia have been driven by a strong sense that decisions to end a human life are inherently public matters because of the consequences for society that would flow from poor or uncontrolled decisionmaking. The focus and priority has been on the public interest, rather than on autonomy interests. By contrast, controversies about the collection of organs and tissues have been driven by a strong sense that decisions to harvest organs are matters for private decisionmaking. …