The first challenge I faced when made Chair of the Bioethics Consultative Committee was the question of embryo freezing to facilitate the process of in vitro fertilization. It is no news that I was always in favour of doing what is possible for infertile couples and I refused, on the moral principle of patients’ rights, the argument that people ought to accept their lot if they are infertile. Of course, having children is not a right in the sense that if you cannot succeed then government has to do something about it. But medicine works in a different way and once we had in vitro fertilization through the freezing of ova, a more expensive technique but which was conciliatory at the time politically, the law seemed fine. However, there were now issues of sustainability, if one may call it so, with many couples coming forward. There was bound to be a debate on freezing some embryos and surrogacy.

Moderating the committee is no easy task when there are members of diametrically opposing views. On such a committee I argued that once this request was made through the ministry then we are bound to reflect and give answers. I insisted that members had a right to express their opinions and minority reports would go to the minister as well. Once they were individually chosen to serve, it shows that their views were valid and requested. My position was that arguments such as that are millions of embryos frozen were rather outdated and even countries like the UK, where embryos have no rights, standards and practices have improved over time. I suggested that fertilizing a minimum number of eggs and binding couples to use them (and if they were not then government would be able to take custody to give them for adoption), was a reasonable request. I was accused of course that I was seeking “damage control”. This was not of course the case. The fact was that we had to find ground in which the moral compass of the people is judged against the traditional moral compass which tend to be very strong and did not favour any sort of dialogue. In politics one has to find conciliatory responses and this is fair in this day and age of social change. Otherwise the strong moralities will collapse, as in fact one sees happening across the world.

This is not an easy pill to swallow, and it was neither for me, coming from a traditional conservative and Catholic family, and having been (in a way) “raised” in a Catholic movement. But this movement also thought me dialogue as a (Trinitarian) tool, and whenever I was in crises as a young doctor, I was pushed to continue. Nevertheless, there were those in the same movement who shunned me, which I understood. Malta was changing. The divorce referendum had showed this. If we dilly dally on an issue, we tend to lose everything. I was the first to shout out that it was scandalous that the “festa familja” was done on the eve of a referendum. Where was everybody when the Cana movement was in crisis? Annulments took almost a decade. Where was everybody when single mothers deliberately remained single “until they settle their children into a Church school” – this is a fact one learns from one general practice. While helping single mothers, indeed a good thing, we deliberately ignored young married couples. They did not qualify for flats or other social benefits, which we gave to single mothers. Certainly equity, in this case, worked in the opposite direction. Where were we when, as I have often argued, people did not qualify for benchmarks because they had some money in the bank, which they saved throughout their careers, and those who spent it at the bar and had nothing left were remunerated for their vices? Sounds unfair but government is bound to help the weaker. The point is that if we take long to answer, or worse, do nothing, we are bound to find ourselves in the opposite of what we want.

Now this result paradoxically sounds appealing to some – politically appealing – because they can use arguments such as abortion (which will happen unless we accept that women have a right to decide if their life is in danger, for example), to capitalise on traditional values. Since I am not a politician, I care about finding a moral ground which is conciliatory and which does not challenge traditional moral values, especially the conservative views, in a rough way. Conciliatory politics tolerates differences. As Benjamin Gregg puts it, “agreement on points of public policy despite differences in the participants’ specific ways of life, or particular religious faiths, ethnic identities, or socioeconomic status” is a sign of what he calls “thin politics” which tolerates these differences. At the end of the day that is what politics and politicians ought to be about. Many Maltese are tired of the marriage of political parties to Unions and Churches – using each other for their own egoistical benefit. Those who cherish faith cherish mostly the Golden Rule and fraternity through conciliation.

One has to place one’s faith in public deliberation. One has to follow, I would say, the principles of kenosis and perichoresis (the Trinitarian foundations) – one meaning making space for the other person and the other term meaning understanding in a fraternal sense of unity. The person who says that one is simply trying to have “damage control” is wrong. It is about finding a conciliatory moral ground on which all can live. This was done, notwithstanding decades of condemnation, for gay people. We have a lot to learn about tolerance from our children whose groups are now more open and who realise that they are as human as themselves and ought to have rights. When we were young, we were brought up to believe that those on the opposite side of the political arena were “bad” people. Many my age will remember this.

Bioethical issues tend to be more fundamental but when push comes to shove, being conciliatory rather than saying an outright “yes” or “no” meant that when it came to surrogacy and I was asked to give my opinion, it was accepted. The opinion was merely that you cannot solve one moral problem by introducing another (surrogacy), which has not been debated. In Sweden, for example, there was an outcry against surrogacy because it exploits women and the more vulnerable. They sought conciliation and toleration.

We need to foster politically communitarian relationships between diverse groups and a unifying model for a society which is more and more heterogenous. In the long run the conservatives have more to gain and so do the liberals, who may tend to “support” issues they in principle oppose in order to have own ideas supported as well. Having faith in the collective thought of society takes courage – it also takes a lot of education and public dialogue, which up till now is still, alas, left to the media which is not often neutral. Common ground can always be found. While fostering strong moral values, we need to address a more conciliatory political arena and not use bioethical arguments as political or ideological battle fields.

 

Pierre Mallia is Professor of Family Medicine and Patients’ Rights and teaches at the University of Malta. He Chairs the Bioethics Research Programme of the Faculty of Medicine and Surgery. He also chairs the Bioethics Consultative Committee.

This article is his personal opinion and does not represent the opinion of any committee or Board he serves on.

 

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