Bioetiquette

BIOETIQUETTE JUDITH MARTIN* and GÜNTHER S. STENTf To the scientific community, etiquette may seem a totally outdated topic, hardly suitable any longer for serious discussion, except as a bizarre historical or anthropological fringe phenomenon. The cant from the 60s can still be heard: etiquette is just a bunch of silly rules invented by snobs to put down social inferiors. Serious people have no use for etiquette in everyday life. Didn't we finally rid ourselves of all that artificiality, all those phony social pretensions, all that hypocrisy? We can be our real ourselves at last, doing our own thing. No. We cannot help troubling ourselves with etiquette: it still remains, as it has been ever since the dawn of civilization, the essential lubricant of civilized life, which depends precisely on not being our real selves. The Decline in Civility Professionals commonly complain these days that in their formerly highly respected callings, civility and standards ofconduct have dreadfully deteriorated . Politicians, lawyers, and athletes are bemoaning the disappearance of what they call "statesmanship," "legal dignity," and "sportsmanship" in their workaday worlds, while biomedical scientists are lamenting the decay of "proper scientific behavior," "fairness," or "generally accepted practices." They also grumble about the prevalence of rudeness, to which they refer as "less-than-collegial behavior," or "sharp procedures," or "deviation from normal practices." This decline in the standards of professional conduct is due—at least in part—to the ascendancy of the liberal ideal of personal freedom, under which civilized conduct is left to personal improvisation, guided by common sense and good will. Unfortunately, however, common sense and good will are not sufficient guides to civility, especially not in the workaday world, where the complexity and contradictions inherent in societal and individ- *Judith Martin is the author of the Miss Manners syndicated column. "("Department of Molecular and Cell Biology, University of California, Berkeley, CA.© 1998 Judith Martin and Günther S. Stent. AU rights reserved. Perspectives in Biology and Medicine, 41, 2 Winter 1998 267 ual goals forestall deducing civilized conduct from first principles. Success being the goal of most professionals, civility, when left to personal choice, is usually dismissed as a laudable but counterproductive tomfoolery. Hence the standards of civility have to be imposed de haut en bas, with calls by wellmeaning elder statesmen for general cooperation and collegiality being no substitutes for promulgating specific rules. Civility is not merely nicer than rudeness: it is essential to the smooth operation of any profession. In the absence of rules of conduct that allow both sides to have their say, disallow personal invective, and require a veneer of respect even among bitter adversaries, substantive conflicts cannot be resolved. In fact, the weightier the conflict, the stricter must be the rules of the conduct. Thus civility is not mere icing on the cake of harmonious life: it's its leavening. There used to be few curbs on biomedical research. With the rise of scientific medicine in the 19th century, its practitioners came to be regarded as people of the highest integrity, toiling selflessly for the benefit of humanity. But when society, frightened by seemingly ominous consequences of the discoveries of 20th-century biomedical science, challenged their ethical practices, biomedical scientists responded by setting their own limits, before laymen could call on the law to do it for them. The rules that biomedical scientists adopted for experimentation on humans and animals, as well as for such practical applications of their research as genetic engineering , genetic counseling, organ transplantation, or in-vitro fertilization, became known as "bioethics." In recent years, public concern came to transcend the domain addressed by bioethics. Society has begun to question also the extent to which the conduct ofbiomedical scientists meets their obligations to their own profession , their colleagues, and the public at large as sponsor of their research. There always were some swindlers, usually neophyte or marginal scientists, whose misdeeds were promptly uncovered and their careers ended. Lately, however, allegations of misconduct by a few well-known senior investigators have fostered a public perception of scientists as charlatans, if not actually crooks. The National Academy Report Alarmed by this ominous development, especially by the threat of the U.S. Congress passing...