 participants in this conference. Your work assures us also that you will help us look together toward the working out of those complexities. Gustavus Library Associates has a great honor in presenting you to guests gathered for this final event of Nobel Conference 19 at Gustavus Adolphus College. I present Gwinnett, June Goodfield speaking to you on the subject without oaths, laws or revolution. If I was ever tempted to behave as I have sometimes observed banquet speakers behave, namely to offer you first a well-prepared speech which is laid in front of you which I then get upon the podium and then read the remarks of my very kind friend Joan. I wish I knew what your other names were would undoubtedly have prevented that. There was another reason too why I couldn't deal with it that way partly my own Celtic blood and part of which I'm happy to share even perhaps some distance with Lou Thomas but also the fact that while I was talking to somebody who has been so kind to me on these gambas and we were saying I said what happens at this banquet and she said well you see it varies a lot but one thing is always sure we're really all flaked out you know what an interesting evening we're going to have with a flaked out lecturer facing a flaked out audience and this I felt called for a degree of drastic action and the only thing I could think of was to utter those immortal lines from that quite magnificent film all about Eve and I only wish I could utter them with the force and penetration of that marvelous American actor Betty Davis and the lines are, fasten your seat belts it's gonna be a bumpy evening. Now however flaked out and tired I am I do think we just have to pull ourselves together or I certainly do for this final particular occasion. Make it clear at which direction I come to you from which direction I come to you tonight as somebody who is neither now any longer a professional working scientist that part of my career lasted approximately 18 months and if I hadn't resigned I would have been fired because I was really awfully bad and I come neither also as a professional philosopher you may stab me with a syllogism and impale me on the horns of any philosophical dilemma and you can observe me wriggle with great delight rather as somebody who really comes I hope from the way those young people at the back of the room are coming people in the ordinary society and I guess it's really primarily to them I'm awfully sorry but it's primarily to them that my remarks are going to be directed this evening but I come as somebody who has certainly a great interest in history and certainly has a great interest in the whole problems of not only what it is to be human but what actually it is to have or acquire moral responsibilities and moral sensibilities because I am indeed going to paint a very broad canvas though I'm going to take the widest possible view of the brief that I was given to the point of being probably accused of downright irrelevance not to mention irreverence which you may have noticed in me from time to time nevertheless I do want to approach this in a fairly broad way and invite you to share with me as I share with you some of my musings about morality now the hope I'm going to have to now look over my spectacles which I think is really rather nice problem of human responsibility and human moralities and sensibilities I'd be quite interested in pursuing teasing out the question what does this notion embrace what does it apply what does it imply and how does it apply not only in the professions but in a wider society and indeed how does it evolve and what spoil a time one when I was musing I asked myself what is there to be explained about moral responsibility or moral sensitivities and had I been born in an earlier age I would have said absolutely nothing at all because man is a naturally moral animal just as things move naturally to their preordained course and that's the end of the matter we may not be divine like God but we're not just totally bestial like animals and when Kant spoke of two things that filled the mind with all he spoke of the starry heavens above and the moral law within but now I think we would tend to regard this not in these absolute absolutist terms but see its origins the origins of moral sensitivities rather within communities rather within social groupings and we will also see actually that it has evolved in time through times and in times and at times as we look back across historical societies we will see that from all occasion there were pools within societies with strong collective senses of moral responsibility in whose moral sensitivities were heightened for that moment and when I once was talking to this about a friend a medical friend at Michigan he shrieked at me and when he said when I said pools he said pools you mean droplets yet nevertheless droplets or pools but perhaps certainly not lakes I do have a sense that over periods of time in certain societies that there have been a gradual evolution of notions and acts which altogether curl less which to heighten one's own personal and individual and collective moral and ethical sensibilities and I find it extremely interesting to ask myself how did this come about and how did this evolve now the evolutionary analogy is perhaps a thoroughly bad one because so far as I'm aware and my colleagues here will correct me from biology animal societies don't regress but so far as morality is concerned and ethical sensibilities societies and humans most certainly do and professions do we have seen through history the peaks and we have seen indeed the troughs and some unkind person once described Texas as a state that moved from barbarism to decadence without an intervening state of civilization we certainly all know and can point to societies that have moved from barbarism to barbarism with an intervening stage of civilization and I find the regression just as puzzling as the build-up it is as if a moment is it is as if the moment the awareness goes or the pressures or the response falls away then it all falls away and if the price of liberty is eternal vigilance then I want to argue that the price of moral responsibility is eternal conscience compassion and caring and whatever it takes for moral responsibility to be there at all it is going to take it forever please for the moment hang on to this caring theme because I'm going to return to this and what it entails now clearly for societies to have a moral responsibility and I apologize for making it sound like the measles there have to be some kind of prerequisites I suspect there have to be a certain stability and I suspect that does perhaps have to be pressure from sheer physical pressure sorry the lack of pressures for sheer physical and psychological survival but I'm not too certain about that because one did see within the communities of the concentration camps in spite of the terrible degradation one did see most wonderful acts of moral and ethical sensibility arising there but one thing however is certain whatever the prerequisites are there do have to be certain things that make to hire loyalties for hire for hire loyalties than to oneself there has to be a notion of transcendental values and an awareness of the existence of these transcendental values and a desire to apply or live by them is also one very important attribute now what could all these features be and I want to make it clear that I'm not talking about those utilitarian features that make society just work and I don't mean when I talk about being morally responsible or morally aware I don't mean the awareness of the existence of laws nor do I mean the recognition of the laws of the need for laws in the first place nor the recognition of the need to obey the laws when we have them because all that is is just an awareness of the possibility of anarchy I mean something quite different I mean an attitude which is just one step ahead of the law or one step beyond the rules of society I mean an awareness of existing wrongs things which you find plain intolerable and an awareness of future needs and a desire to do something about them and I will ask you young people to make certain that you do from time to time decide what are the things you just do find plain intolerable in the existing human condition and decide whether you also find it possible to do something about them and later if anybody wants to ask me what I find intolerable I'll be most happy to tell them in this rapid scan of human history I have invited you to see a gradual progression in certain societies in certain times in certain places where we have seen these coalescing of whatever features there be so that for that moment in time our societies sensibilities were in heightened I think you would be able as easily as I to make out that list we no longer believe in we are prepared to concede as totally intolerable a notion of the divinity of kings and therefore we have moved to far more egalitarian views we have long conceded I think except in certain places of the world the iniquity of slavery which was predicated upon the existence of a divinely ordained ruling class which should have dominion over not only things but people too we do not we find intolerable the existence of child labor we are finding intolerable notions of race and we have abolished these and we have abolished these sometimes with horror at the recognition of how we once could so easily have tolerated them and we have abolished them with a wedge of thought and awareness which is always one step ahead of the law one step ahead of the existing condition so I would argue if one arm of moral sensibilities and awareness of injustice another arm is certainly wanting to do something about it and in the last analysis if we bring it down to our own individual lives it becomes an individual awareness of the likely consequences of one's own actions upon not only one self and other people but actually caring about the consequences of these actions and everything I say here about individuals can be applied at all times also to professions and also to societies now I'm not going to tell you a parable I'm going to tell you a true story I was working in Tehran for a remarkable organization which alas has been abolished by the Ayatollahomni which was the paramedical work among the nomadic tribes and the 95% of the rural population in Iran which have no access whatever to medical care I was one standing at the intersection of Fadoce Avenue and trying to cross the street and the traffic was coming at me like the Perala fish in an Amazonian Brazilian River the drivers of the cars ignored not only the pedestrians but the policemen and the red lights completely and my dear colleague who was with me observing me dithering on the brink said no no you don't understand you mustn't look at them and it was my turn to shriek and I said why mustn't I look at them and he said because then they will know you know they are there and they will come and get you now clearly the name of the game when crossing the street in Tehran traffic is moral responsibility and the aim of the game is to shift it because at the argument goes if you actually look at them they know that you've seen them and it is your responsibility to get out of the way but if you don't look they don't know whether you know they are there and you've neatly shifted the moral responsibility to them to be careful of you and they actually won't know you down in cold blood so for what it is worth that you cross the road with the supercellius disdain of a camel combined with the insouciance of Sophie Loren and it is incredibly difficult point of the story is not my education by the Iranians so much as my argument that the twin pullers of awareness and caring and caring to the point of practical action is what for me adds up to moral responsibility and it seems also to me that only when the two things come together which is the awareness and the practical action do we find change do we get change and what I now want to do in the next little section of this is to try to bring this into context first the medical and scientific professions and then of the wider issue that we particularly faced what fashion faced out faces outwards to the world the other very much inward to a degree that for some the scientific profession has been a refuge from the harshness of the world in medicine its morality in the moral attitudes where we think enshrined in the hypocritic oath developed we believe by an ethically sensitive group of people to protect their parents not to be cynical about it we know that that is strictly for the birds it has as Jack bars and been said once it has been in many respects a wonderful exercise in noble futility and I can say this with a certain degree of confidence but not wishing to be cynical because of course as many of you I know are aware the open history was administered before graduation before even being admitted to medical school admitted to sorry was administered to the students before being admitted to medical school and its provisions were designed to protect the secrets of the craft rather than the interests of the patient it defined a set of rules or of etiquette rather than ethics and it delineated very neatly the gills relationship to society through history it came down in 20 different versions from the pagan oath modified for the Christians through the Arabs through medieval times into Montpelier into Glasgow and then finally into the Nuremberg code and it was not until the 13th century AD in the Arabic version the provisions were laid down for the very first time the procedures must be solely for the benefit of the patient and I would like to know why and then did it happen I don't know throughout history there have been no sanctions and none were actually possible certainly no legal sanctions on those who transgressed the code or the etiquette except appeal both to a person's religious religious groupals or to their sense of honor it was not a set of codified laws but around the turn of the 18th century a time of which will Galen was speaking in the course of his address this afternoon several things happened and bear harbour particularly became the advocate for the patient and really influenced the turn which switched us from medical ethic from the medical etiquette round to medical ethics in which which became enshrined to an extent in the Montpelier versions and when for the first time the oath became to be administered when you left medical school rather than before you admitted now there are various clauses here one is always certain of a laugh and it reads like this I will never exact a fee higher than my work deserves and I will always give my services to the needy without fee again why then and why that clause why did it come in at that time but whatever the answer to that what we are seeing is the evolution of a profession's moral sensitivities the emphasis less on craft more upon the patients and society and a strong obligation now to consider the ultimate consequences of a physician's conduct and all of this is occurring at a time when several other things are happening to one is the profession is becoming professionalized one is that it is actually also one of those moments when that droplets are coalescing when actually within society there is for some reason that I cannot yet understand a general increase in ethical and moral sensitivities that would culminate in many things that I mentioned earlier that we went on to abolish like slavery child labor the extension of the universal franchise and the American Revolution all these political rights and attitudes became enshrined in the writings of many people including can't and I see can't hear as somebody who encapsulates many things beside what can't was thinking many things within society that were going on though I don't suppose he was aware of doing that nor it is absolutely obvious did many people at that time read him but as we'll mention this afternoon as I had always wanted to mention for me one of the great moments occur at a point at which eventually someone did say that the way we have to regard people is not to consider them as means to an end but as ending themselves because we all in fact belong to the great kingdom events and this once more as will himself pointed out this afternoon is one beginning of society's awareness of the individual worth of human beings it's also the mark of course of the rise of professional obligation and motivation that now begin to enter in strongly rather than behaving caring now becomes of both the source of moral obligation and the source of wider action that extends this obligation not only to the patient but to society too and so in the 19th century we see as the hallmark of professionals maturity is their guarantee not so much of each other's technical competence or the fact that they'll share the secrets of the art and teach each other these secrets but a guarantee of each other's behavior and morality towards the public they act as protectors of the public interest as a professional the law might hold you to the highest degree of care as a professional the profession will hold you to the highest degree of ethical behavior in the 19th century and so that free protections get built in towards the patient towards the professional members of society to sorry towards the members of the profession and to society too and the standards that have to be maintained were both technical standards and they were moral standards this was new in the guild and this was new in society too and the medical profession at that time saw themselves as one of the wedges have changed within society but we also do see that how the institute in the same way that how the institutionalization of the profession also gave rise to these higher perhaps more transcendental transcendental values we also see and have perceived as the 19th century moved into the 20th century how they the existence of the profession also began to institutionalize opportunities for professional self-interest we saw the beginnings not only within the medical profession but in other professions too of that professional and disciplinary fragmentation that ultimately was going to lead to a degree of remoteness from society and a degree of bankruptcy and let me just quickly for the moment turn to the scientific profession which evolved in a quite different relationship with society one which was more detached there were no professional services to the public and the members were committed basically to one common goal which was understanding and to a methodology for arriving at that goal there was initially no accountability to society but in the late 20th century the conference of several things happened more political and populist awareness in society an increase of our own command in our own command both intellectual and technical of the world and the processes of the world the merging of scientific knowledge with people's new perception of just what this knowledge is knowledge seen as power whether nuclear whether that applied to psychos surgery we saw the beginning of a total comprehensive understanding of life processes and I want to argue at times and places an inability to separate out as neatly as we had managed to do before the pure knowledge from the applied knowledge and especially this I argue in areas like human genetic engineering and this force the profession to answer even perhaps justify to the public at large this was something they never expected that have to do just what they do how they do it what are the likely consequences and whether they should do it at all it is in fact it was a state of affairs which provoked amongst other things this conference and questions of wider moral responsibility now begin to impinge so heavily upon the profession that people have argued to this extent that there should be a Hippocratic oath which in fact would hold them to certain standards now by now you probably aware that not only do I find the Hippocratic oath vague I also have found it unenforceable laws I am rather suspicious about to they don't guarantee people's behavior they only insist that this is a situation that must be taken seriously and one radical answer that is often mooted to all the problems with which we feel we are afflicted is the answer which argues that since it is in the nature of all systems and all professions to be totally self-serving then the best thing to do is to have one great big glorious revolution and sweep away everything well I say I find the oath impractical I find the law here rather dangerous and revolution is utterly beyond my competence even if it weren't even if it weren't moral sensitivities have never come by oaths or by laws or by revolutions let me now try and tease out the dilemma a little further there's a widespread assumption which has a great deal of force that science is the most appropriate technique for understanding reality reality it's an epistemological statement with a degree of totalitarian overtones but I'm prepared happily to go along with it but put in those terms people have said okay you see questions of morality can't arise in the operation of science I didn't say in the method they can't arise in the operation of science questions of morality can really only operate in the application and though I have met that partly by saying that I think the distinction between basic research and an applied research it doesn't easily apply what I would rather argue is this that rather than being a particular class of person who is finding out things by an absolutely guaranteed and an impeccably purified method a scientist is as much shaped by and is a shaper of social and human reality as anyone else and they probably have had to get to the point as the older professions have had to in which they would have to consider what do they do if they are in a situation where human values a society wants to determine them clash with traditional professional mores and attitudes and then what are you going to do and it's confusing for a scientist to have to be faced with this because at some stage and at some level there's no way but in order to achieve your understanding as a scientist you have to be as objective even as a moral as you possibly can to do your method now there's no problem so long as the object of your interest or investigation is a static rock an atom or a planet and I don't want any of us here to try to confuse the issue by investing matter or the investigations of matter with moral tendencies matter has its own autonomy but that's that the problem begins for science when the object of their interest has two kinds of autonomy the autonomy by big that exists by being part of material world and the autonomy that exists by virtue of being human and the clash arises here and not only for scientists too and we cannot get around that clash by saying either on the one hand well in basic science there is no morality or on the other hand by saying kindly build morality in your science to your scientific method this is sentimental waffle its romanticism and it cannot be done for I tell you there are always going to be facts that are facts whether they kill you whether they enable you to laugh whether they enable you to cry or rejoice or despair and that is the glory of being human which is also the tragedy of being human that there are facts which cannot be mitigated but they can be gone on from and this is where I suppose I want to move next now equally of course with these three autonomies that of material that of method and that of human beings we must also add that science itself is a human activity in that it is promulgated by human beings and we have seen throughout history that when pools of morality do emerge they array they arise out of humans as operatives and what they are doing and it's certain things there is no evading the fact that possession perceptions of matter perceptions of value have to be faced and have to be reckoned with and have to be wrestled with and for those of you who want to go into science I say as the Peter Meddler said in his advice to a young scientist face these and wrestled with these before you go into the lab because by then it is too late if you are aware that most of your research is inevitably going to have to be underwritten by the Department of Defense if you are aware that there are a number of things you may have to do in order to get your grants then try if you can to see where you are going to stand on this before you begin because by the time you are in there is something inevitable I don't mean inevitable that was absolutely wrong there is something which is inherent in the way science has to be done that commits you to a particular way so what do we need I think we need a community of people who are dedicated to doing science as rigorously as possible but who are also dedicated to being as human as possible and who will help one another in bearing at the consequent tensions and I met such a group of people once and I think it is wonderful that in a conference where we are worried about the whole processes of biomedicine that this group of people that I met were actually concerned in what I consider to be the greatest medical triumph of the 20th century and I'm speaking of the eradication of smallpox and especially as I came to know it in Bangladesh where a remarkable group of human people from many nationalities did the science as rigorously as possible and did what they had to do as humanly as possible and help each other to share the tensions of doing that which were absolutely enormous and as a sideline you will be interested to know that the three nations that together almost single-handedly together were the prime people who did more than any to make the eradication of smallpox possible were the Russians the Americans and the Swedes so you young people out there rather than admitting yes you know such questions are important but as we can't answer them how can we bear them so don't even think about them I say that what we do need is a restoration both of communal concern but more importantly of communal support of rebuilding communal resources for living with these questions and there's no abrogation here there's no possibility of saying I'm too busy it's my job to heal the sick make discovery code of make discoveries codify new laws develop new weapons build new auto automobiles this can't be pushed onto one another this is acting as the Tehran taxi drivers do and is evading pushing away the moral responsibility I attended a meeting at Basel quite recently where a group of young and very concerned affluent Swiss were attacking the drug companies for not having eradicated leprosy and said if you will only give all the drugs free leprosy will go away I can tell them that that by no means is enough but the important point of the story is that they bashed up these people for a good seven hours and I sat in the seven hours and then finally someone said to him well all right you know okay will you please tell us what to do tell us what to do and the answer came oh no that's not our job we only are here to criticize that's of course it is not good enough and the questions are not going to away and nor is it enough to say I'm disturbed I'm bothered I need a dose of ethics we all have to ask these value questions we all have to see where they arise and we all have to try to establish where our values are coming from and why because they alone provide the human challenge and the human sustenance now why does the prospect of having to do this disturb us it's easy to understand why sometimes it does disturb scientists because as a professional group they've not always had to do this they had had been fearful of just that it would disturb the methodology and they also do hate having to deal with uncertain questions untidy answers and especially problems that seem either permanent or insoluble for us in society we also have felt rather unhappy with having to deal with these questions and I wonder whether but this again I'm purely speculating whether the difference here is that whereas in past times we were so certain of the existence of the future that we could happily tolerate the existence of uncertainties in the present for us we are so uncertain of the existence of the future that we grab at any kind of certainty that we can hang on to because we just need to and that's all we've got yet you know disturbance is creative most great discoveries in science have started with apparently impossible problems disturbance has been creative in society disturbance has probably been as Kenneth Clark showed probably the most creative force in civilization it's been creative all the way and therefore to be moral I argue and to be human is to welcome the disturbance and to be prepared and ready to as wrestle as hard as you can with whatever resources you have for as long as need be with the dilemmas you find and follow your feelings in your troubles and excitements and your pain about being human because as well again has said some questions have to be adenizing questions now our conference question was in a way stated by Steiner George Steiner in the Brunovsky lecture when he spoke of science just laying a whole series of moral ambushes in wait for man and of course that was really restating an old and perpetual problem the myth of the fall the myth of Prometheus and how it is that getting new powers always seems to lead us if not to disaster at least to terrible problems but this is the constant human dilemma and being reminded of this again today on this occasion with this particular topic we are being forced to think not only about what it is to be human but what sort of society we are creating and what a sort of humans we want to be now socrates had a state sorry had a word for the state in which we are in it is the word is a poria it is a state of being of not knowing one's way not knowing one where to place one's feet and it is the essence of human and moral advance that people are sustained through a poria and do not get frightened by it and do not simply fall back upon old precedents which have limited force in new historical situations because we are in a totally new historical and scientific situation and we can no more revive Victorian professionalism or Marxism or even the Ten Commandments alone to help us none of them alone will do them though they may all be drawn upon and this is particularly difficult for people who've interpreted scientific life in a narrow sort of way and it's painful for those of us who didn't expect scientists science to get us to the point where we were going to have to be forced to think about these things but why should we think we're exempt it happened before in human history at the time of Copernicus it happened at the time of Darwin and if we believe as I do what Nobel laureate David Baltimore said it is happiness happiness to us now with these problems and there is no way to avoid wrestling with this requirement of being human unless we want to say oh no no you know human just being human is just actually being very very dull and we must be very careful to keep it this way not so we won't get excited even though that is bad for our blood pressure but so we won't suffer so just let keep it all calm stay just where we are and not even get worried about these problems now that's our attitude okay we keep our nice comfortable existence and we're also of course going to risk heaven and we're going to risk hell and we're going to miss heaven because it is within human aspiration the result of human aspiration the result of human ecstasy and the result of human suffering that we make any kind of progress at all now finally I want just to swing back to those pools those droplets of human moral responsibility and those events which cause people and circumstance to curl us together we might I don't know but we might now find ourselves in just one position that this is just a possible point where things might begin to curl less because circumstances are forcing us to think about them and if this is indeed so then we are mightily privileged to be alive and to be participants in this particular problem we might be at one of those points where some where as before there have been some issues which in the past have sometimes been economic sometimes political sometimes scientific we might be in a position where we are just absolutely being forced to reassess ourselves and our values now right now the major pressure for this comes from within science both in our capacity to manipulate life which is more than equaled by our capacity to annihilate it and this poses tensions and cultural contradictions of the most stupendous proportions but also the pressure comes from within ourselves and from what we have allowed our society to become and if I've had one message which I've tried to run clear and cool through this whole conference is that whenever we begin to talk about these things we must never make the fundamental mistake of trying to extrapolate the work the activity the consequences of any one single group of society out of the totality if we are there if we are where we are it is because we have chosen to be there not because scientists alone have taken us there in this situation and you can say oh my god she's uttered so many generalizations is to be utterly and totally useless you know where do we go from here well I think one way in which we go from here at least this is my way in which I go from there is to become to face outwards a little bit and to refuse to accept the fragmentation of our political and intellectual life that spirals continuously upon us upon itself we are forced I think to have to shake ourselves out of this and regard not only the other people next door and those down the block but those across the state line and those over the ocean because otherwise such inset stuciousness such introvertedness leads not only to a bankruptcy of ideas and a chilling of the spirit but if we regard Martin Luther at all it leads to his definition of sin core in Seratus in say the heart turned upon itself for Martin Luther that was the definition of the sin and so too for the individual and for the profession and for the political institutions they have to face outwards and you have to face outwards to where you find the problems are and we find the problems are will be quite different probably each one for you have to find and reach out to those things in the human condition which you find intolerable and you have to be prepared I think to do something about it whether it is leprosy over the world whether it is all the problems that we have touched on in the course of the conference ranging from nuclear warfare to the soup lines which I understand exist from time to time now in American cities to do this is to have the courage to be human as posing one's values and acting upon them is to have the courage to be human and this involves a great act of moral imagination but this of course is what it's all about for as Jacob Bronofsky says it is not the business of science to inherit the earth it is the business of science to inherit the moral imagination for without it there will be no earth no men no women and no science and so this is an invitation to be human in a rather different kind of way I think from many of the ways that we have been talking about today it's an invitation to have a vision it's an invitation to have hopes it's an invitation to have emotions and it's an invitation to have a feeling for humanity and it is an invitation in spite of everything to believe that there is going to be a future and make certain that there is going to be a future and your children and your children's children are there to inherit it it is I keep returning to you will it is the freedom to be human is to embrace the freedom to do this the challenge to do this and to do this starting from a very peaceful place like this and if we don't want to do it well we won't do it and we've got to accept the collective consequences which is that we may all one way or the other perish if we do decide to do this if we do decide to incorporate into our professional lives wherever they take us these elements of in heightened moral awareness combined with a deep desire to do something practically about it I have to say straight away there's absolutely no guarantee of success whatever there is a guarantee of a great deal of personal cost a great deal of personal disturbance and suffering and yet one parallel to this is in human creativity whether it is scientific or whether it is artistic human creativity and another parallel with this is in loving and so as befits a Welsh minister's daughter I too am going to quote from the Bible but I am going to quote from the New Testament and I will not tell you the trouble I've had to get the actual version of Saint James in front of me today because I think it is so beautiful and it goes I'm sure you know the epistle of Paul the Corinthians 13 though I speak with the tongue of men and angels and have not charity I become a sounding brass or a tinkling symbol and though I have the gift of prophecy and understand all mysteries and all knowledge and though I have all faith so that I could remove mountains and have not charity I am nothing go to kids with rigor and compassion thank you thank you doctor Goodfield for that most stimulating and challenging presentation if I were to select one word that best describes you from what I have known about you in the short time that we've had to visit together and from your address it would have to be caring thank you for caring and coming here to give us that very challenging statement the Gustavus library associates is an organization whose purpose is to support and further of the library of the college and tonight it's our privilege to be sponsoring this 19th annual Nobel Banquet in the interest of time I'm going to refer you to the back page of your Banquet program which will provide you with considerably more information about the GLA than I want to take time to give it here but I would like to mention or tell you that membership in our organization is open to anyone and everyone who has an interest in the library the program to achieve and maintain excellence in every department of the library is one that will go on forever so we need your membership we need your support we encourage and welcome you as members now on behalf of the GLA it's my great pleasure to present an honorary membership to our illustrious speaker this evening doctor Goodfield welcome to the GLA the honor is ours it is very ungracious to beg to differ but I do the honor's mind thank you very much indeed I even heard ladies and gentlemen we come to the final event of Nobel 19 conversations at Nobel which has been a feature of the Banquet at the close of the conferences for a number of years I invite the people who have been on the program to come forward and I will introduce each of them as they come Christian Anfanson from Johns Hopkins University in Baltimore Karen Labax Pacific School of Religion in Berkeley, California and Pippa Robstein from the University of California San Diego Dr. Will Galen from the Hastings Center in Hastings-on-Hudson, New York our conversations have been quite wide open but I would like to invite responses or comments to June Goodfield's presentation tonight worthy of of comment I'm sure and if you aren't ready I am there's somebody who wish to speak because the chairman isn't supposed to say anything except you know moderate but this is an unusual challenge well I guess we might as well break tradition one of the interesting observations as far as I'm concerned is that in 1966 when I started to teach the ethics and medicine seminar at Gustavus there was very little literature available the Hastings Center started in 1969 the Kennedy Center in Georgetown about the same time maybe a little later and I've noticed and I'm sure my panel members who have worked in medical ethics much have noticed the explosion of interest and of literature in this field an observation that I heard made today was that the ethical questions and even the theological questions that were once thought to be irrelevant and unimportant had been brought back into the public domain by the biologists I'm wondering if that isn't relevant to the talk tonight and if any of you have any similar or opposite observations about recent developments connecting science and ethics it to me it's an outstanding thing I'm just overwhelmed by the developments of the last 15 years in this regard is it the biologists that have done this to us fortunately done this to us well since I was the one that made that statement maybe I'll jump in at this point I was very pleased with June's presentation tonight because I thought it brought us around and perhaps some people would have liked throughout the conference more clinical approaches to these problems and I heard some people saying aren't you gonna talk about the end of life or aren't you gonna talk about the beginning of life I'm rather happy that we didn't get a specific and that we related it to more general problems the reason is essentially this I've never brought the idea that there's something called bioethics I'm not at all sure what it is I don't like the term I'm stuck with it I don't like the term ethicists either as far as that's concerned I think what it has is that there are traditional problems that are inherent in the human condition which is why I was pleased that June brought us back to the broader issues and that periods of time we face it for the most part we don't face it we tend to get philosophical when we're frightened as far as I can see when things go well we forget about philosophy we just enjoy life so philosophy is something we do in hard times I think what has happened is that biology has made has frightened us has given us choices particularly current biology that we had never anticipated and I think something else happened in the process it raised the questions as I said the old questions these are not bioethical questions these are the same questions that were raised 2,000 years ago 1,500 years ago 125 years ago they happen to be cast now in the examples of medicine so we talk about justice we talk about autonomy we talk about the common good we talk about the individual's rights we talk as we were talking about family integrity and whether the family has a place in the moral sphere those are all the same questions part of the problem in the early days of quote bioethics end quote was that there was a confusion in that most of these issues were conceived of as medical decision-making we were talking at the dinner table about building scrivener the decision about whether you should go on a kidney machine or not is not a medical decision except that you don't put some with bunions on a kidney machine they have to be in kidney failure having made that who should go and whether you should save one year of life for 10 people or 10 years of life for one person or anything of that those are all complicated moral decisions so I liked the June's presentation for us whole if those of you who are somewhat disappointed that we didn't attack specific issues that you have been involved with such as whether it really sits well morally to put an upfront $100,000 charge for a liver transplant whether that sits well and what is the alternative who is going to pay for it the University of Minnesota is an affluent institution but I don't know how many of those freebies of they could hand out without going bankrupt these are the kinds of questions about placing money on I've always existed and I think if you come out of this conference when with an awareness that these are traditional questions to be resolved by traditional approaches or new approaches to values and philosophy but that there are no experts I mean someone who is trained theologian or philosopher like Karen may be expert in the methods of argument but she would be the first I think to tell you that she is not an expert in the solutions and that all of you here are testament to the fact that the lives that you lead or do not lead the deaths that you experience or will not experience and the kind of environment that your children and their children will be brought into will be determined by decisions you make through your legislators or you prefer not to make and therefore or not complain about June June good are you here to you June good field was wishes to respond to you I just wish to add to what will have said I mean not only are these very old questions and have been from two thousand years hundred years and fifty years they are going to be very old questions a thousand years from now those questions are never going to go away and don't anybody delude themselves that they're ever going to go away because each generation will have to face them and sort them out and wrestle with them and deal with them and also I think each generation has got to face the fact that there's only one way of being absolutely certain of absolutely anything that's when you're dead I'm pleased to have you join the group of optimists since you have just been a thousand years I just want to make what I think might be a simplifying statement and that is that that morals and ethics were invented by human beings we wouldn't care too much about dogs being exposed to some strange medical manipulation and I think that all the talk all the frills and all the gym rack we see around us from me and from my fellow speakers has been put forth because we happen to be human beings the introduction of DNA recombinant techniques with bacteria was only threatening when there was a possibility that some of these bugs might go crazy and infect us it's it's it's it you can go on forever along this line so I think I hate to say this but I find myself sitting here in a slight state of amusement about the intensity of the discussion about something that really applies only to our species of course we are a pretty fancy species but nevertheless I think perhaps it's overdone and I think we should be more concerned with the practicalities of avoiding trouble avoiding threats to the human animal rather than going into great discussions about the the moralities and relationships to exodus or any other chapter you like etc etc at this kind of meeting that's a very negative statement but that happens to be the way I feel because it's not about a hot air it's not negative it's just safe it's playing it safe let me just go and record it's a hot air art that also seems to me in some ways to undermine or to be directly contrary to what june was talking about tonight because you're really talking about consequences as the only thing that we need to worry about and what I heard june doing was offering a sort of addendum to will's speech earlier and it's no wonder to me that she kept referring back to will will called upon us to ask what is distinctive or unique or wonderful about the human animal and he offered his own solution which had to do with potential and being unfinished and being able to participate in our own finishing or completing process I hear june offering us perhaps an alternative to that and the alternative might lie in your word caring that what may be distinctive to us is not just that we can finish ourselves or participate in our completion it's not just that we can worry about consequences but that we have the capacity to care for each other and I thought that that you're holding together a rigor which I would urge not only in science but elsewhere in our lives as well and of care and compassion is a particularly nice conjunction there and it does seem to me to offer us perhaps a different agenda for the human animal than the one that will was giving us earlier so I will call it an addendum he might see it as an opposition but I'm going to hope that they can be held together I take good loving and caring for granted oh never never do that in fact june the only the only question that I would love you a lovely life you must have no you can do that you can say that well that's the only question that I would want to put to you june is you have urged us to be loving and and to be caring but you have though you indicated that there might be institutions that would either help create that or perhaps destroy that you really have not given us a sense for how we create caring human beings and I'm not personally convinced that it comes about through the urging of people to do it if I knew I would tell you an occasional parable might happen are certain circumstances you know I can say that for some people I mean you know let me come back to smallpox and eradicating smallpox in bangland I know that for some people the the point of going out there and doing it in that country of 75 million people was an experience which actually generated in many of them who went out there as you know you good old hardball reductionist scientists now I'm going to go right up there and I am going to just clear out smallpox and I'm going to walk rough shot over everybody as I do it and they found they couldn't walk rough shot over everybody and they did as they did it it was impossible to eradicate it if they had that sometimes it may be through experiences like that that you become caring there are a whole variety of ways I can't answer that question even d.a. Henderson became caring oh god he did I mean yes he did I you know I'll tell you sometime yes he did yes he did I have a question I have a question what uncurves us so I like that definition of sin also curved in them so what is it that uncurves us so that we do turn outward that to me is a significant question I think that's a biased question I assume that we are born that part of our nature I'm with Chris on this I think that it's natural to be caring and loving I can't conceive of a creature like our own which is not we are not individuals we are not like amoeba we are an obligate social animal we know if we know anything from our development we know that we cannot survive and if we do survive that would survive there's very little relationship to the humanity that we expect from people without a network of supporting individuals we are born grotesquely helpless the only creature of our sort born like that and we remain helpless for such a prolonged period of time that it would make a guppy shocked the guppy knows the first thing it has to do is get the hell away from its mother who's going to eat it as a post-prandial delight now how in the world is such a creature survive how could it adaptationally have survived at all for 15 12 years of being totally impotent and helpless if they weren't built into the organism some caring and loving features to enhance or secure that survival the problem is that we have developed cultural institutions to numb and destroy that natural compassion so the question is not the reason you don't have any answers you're asking the wrong question she asked well she's used to asking the wrong questions the question is what have we done to our culture that has taken a naturally caring empathic and loving individual and squeezed it out of all the semblance of what he was intended to be and what institutions if we created the do that sorry to be so passionate about it but i'm introducing a little more of the passion you objected to chris but only in defense of your position well i don't know that i think that biology looked at in terms of all of its aspects is a particularly caring science science i think it is a gentle science to life as compared say with physics which deals with usually huge quantities enormous distance enormous energy biology tends to deal with minuscule in terms of energy and mass and so on it can only survive with the subject of biology can only survive within a fairly narrow range of temperatures and impacts of energy and so on it's a very gentle phenomenon but caring certainly caring comes later than that it comes in what i would have to call the human sciences and medicine is human i don't know whether it's science certainly lute Thomas suggested that it wasn't and i think myself to the good part of it is not and is concerned with things like caring but i think to see this in terms of biology somewhat distorts biology biology is certainly not like physics and chemistry but it's also not like the social sciences it has its own sphere and it ranges fairly widely in terms of levels of organization from macromolecules up to almost the kind of phenomena we talk about in humans is caring but it stops somewhat short of that so i think maybe when we when you are pointing out Bob that that this thing has happened in the name of bioethics i'd be inclined to feel and i think maybe i'm expressing agreement with will that what we're really talking about is not bioethics we're still talking about medical ethics predominantly i don't think we're we're talking about bioethics and there's certainly a very important problems in an ethical sense they are involved with caring in the sense that medicine is presumed to be a caring profession but not i think with the underlying science thank you um the evening is is going along and i i think i'll draw this to a conclusion if i may first invite each of you if you wish or some of you to focus on some feature or some theme of the conference that you felt was important wow christ has punched me so i don't think i care yeah she did laugh i mean you know whether i have been floating a helium balloon to which i have like we need the poo attached myself and suddenly gone upwards you know worries me and it worries me chris um and it does worry me when but it's totally humiliating you know very saladly when you say you know these are hot air questions and the real questions are the questions that you know you have in the laboratory perhaps or the or the solid ones that that you deal with and i think rather than saying these are the hot air you know i hope that what one says that rather than saying these these are hot air questions chris get me down let me okay you know there was a that's very i used a very unfortunate choice of words what i meant to say was that uh all of the metaphysical discussion we've had at various sorts is related pretty much to man and i somehow are in spite of being one um i always felt that we're not that much different from penguins or whatever else you're not but women are just just because glad happens to be a woman to be good but what i'm saying is that that i think the main point i wanted to make was not about your talk which was an elegant lecture but was the whole point that that all of these things become important only when they impinge on the human animal yeah well there's no argument you know i feel threatened yeah i don't think we're seriously threatened yet we will be but it seemed to me that some of my colleagues on the platform were were concerned with the kinds of discussions that will become really only critical when we have something to shoot them at and i'm not sure we've reached that point yet if you were talking about nuclear bombs would be something else but if it's all written down and available it'll all become very useful eventually but i'm not sure we're that far along uh karen and i want to answer the question that i put to june as well as i am able which is how do we create caring human beings and i agree in part with you will but not totally i do think that humans are meant to have the capacity for care and that we are probably born with it i also perhaps because of my lutheran background i'm a great believer in the fall with a capital f and i do not think that human nature as it exists on this world tends to live up to all of those wonderful capacities your mention of the institutions that can destroy our capacity for care is to me only one example of the fallenness of our world what do we do in the face of that other than to try to make our institutions better which i hardly support i would say that the stories that we tell our children and ourselves are very crucial for the kinds of people that we become and june you have done something wonderful for me by mentioning winnie the pooh because the stories of winnie the pooh are among my favorite stories in the world and if you do not raise your children on the stories of winnie the pooh then you are doing something wrong i can only assume that many of the young people that i have met at this conference must have been raised on the stories of winnie the pooh because i want to conclude my time with you by saying thank you to all of you but particularly to the young people here tonight for the gift of graciousness and care and thoughtfulness and intelligence and caring and warmth that you have given to me and in return i give you a gift may you have a parable a day to keep the monster away further comments well i like to continue along the caring's line i'm not at all sure that it's a theme of the conference but i must say that what i take away is a very deep impression of having had the opportunity to interact not only with members of the panel but with a community which it seems to me is among the most favorable that i've ever experienced to explore the kind of issues that we have been discussing and i also agree with karen that i carry away an impression of young people who are deeply dedicated from whom we can expect to hear in the future and i think we'll make contributions to the solutions of these fairly profound issues that we face thank you well i don't know whether the young people are all that hot i met a lot of nice middle-aged folk i knew in a few in my category of the elderly gee i feel the fund was taken away i was going to end with a parable for you bob and appreciation for all you gave us when you said i want this panel to give us one last word of wisdom i was reminded of the old days when life was poor and on sunday you had the ham roast for sunday dinner and by monday they were carving up the little pieces and making hash out of it and by tuesday they were boiling it up into a soup and by wednesday they were taking that poor miserable dried out bone and slapping a lot of peas around it and making something called a porridge and for you at this stage to ask us to make a word of wisdom at this hour i was going to say you're reaching one meal too far well i don't want to come back with a comment that we are all stuffed but i did it i have something to say in conclusion along the lines of gratitude from the moment we got on the phone or by letter contacted these people i experienced graciousness and kindness no abrupt kinds of of reactions to our invitation at all then monday night when we gathered at the house there seemed right away to be an ambience of friendliness and community i don't know how it happened but i know that you all contributed to it and as the chairman filled with worries i didn't seem worried but you know i'm only human to see the way this group of people interacted with one another honestly candidly as it is possible and to share with us so graciously did you see how the young people clustered around them after the sessions now when when young people in high school cluster around older people something wonderful is going on the fact that you made yourselves available not just afterwards but by your manner you did not threaten them away from you but you attracted them to you thank you for that thank you let's give them my opening remarks i said that part of what makes a Nobel conference is an interested audience and so therefore i also thank you all goodnight let me i'll get yours