Students
Introduction
I am a 44 year old Swedish anaesthesiologist, having completed the second edition of the MB-programme (Master of Bioethics). I studied medicine at the Karolinska Hospital in Stockholm, and I also have a degree in practical philosophy from Stockholm University. Today I work as a consultant anaesthesiologist in the small hospital of Moss in southeast Norway.
I was at first hesitant to apply to the MB-programme, because of its Catholic impress, even though the courses and the content of the programme seemed to be of very high interest to me. After some hesitation I applied anyway. Being a utilitarian socialist I would probably not be accepted. And if I was accepted I would probably not get a leave from my work to be able to participate. So, an application was fairly "safe" so to speak. This is a view that I have completely revised today. I could not have been more wrong! Today when I look back to what has been achieved I can say without hesitations that having realized this programme is one of the best things I have done lately for my professional as well as my personal development.
My motivation to apply to the MB-programme
As I said, I was a little bit afraid of applying to what was presented as a Catholic project. This can maybe best be understood if one considers my socio-cultural background. I come from a very value neutral, secular and socialist, consensus oriented society where religion is quasi non-existent in the contemporary society. I got my philosophical education in an academic institution of utilitarianism. My professors had the answers to most philosophical and existential questions in the "total happiness achieved" by various actions performed. However I always felt very uneasy with these myopic answers. As if happiness alone could be the ultimate answer in all situations for mankind. So an internal protest against this one-dimensional utilitarian view was maybe the main reason why I wanted to join this programme. I simply wanted to ethically escape the utilitarian tyrrany, or what I today know as "the logic of the sacrifice", simply to broaden my bioethical consciousness.
Also - and this is the second big motivating factor for me to join the MB-programme - is my work, which is roughly divided into approximately two different parts. Half of the time in the hospital I work in the Operating Rooms giving anesthesia to patients undergoing operations of various kinds, and the other half is in the Intensive Care Unit (ICU). It is the latter part of my work that is of particular bioethical interest because of the amount of technical and computerized machines for vital support of the critically ill patients, and the phenomenon of death that is always present as an alternative to successful treatment. In this professional context a broad bioethical approach is indeed important. Or as one of my MB-colleagues put it: "If you open the doors to the ICU, the ethical problems come pouring out of the doors...".
Intellectual "high-lights" during the MB-programme
Much of the bioethical vocabulary used in this programme was new to me. I realize that I today have extended my vocabulary in following the MB-programme. I will mention some examples of what I mean. These examples of key-words also reflects some of the content of this programme, and are as follows. Principium, princeps, praxis, poesis. Solidarity, motivation, process, application. Vulnerability, dignity, responsibility, transparency. Socio-cultural, multifactorial, context, change of perspectives. Futile therapy, stigmatization, best interest of the patient, hidden ethics. Instrumentalization of human beings, moral strangers, ethics on demand. Balancing, practical morality, ethos, deliberation.
I will also mention some recurrent topics of the programme that particularly caught my attention and interest. They are the following. Why preserve our biological nature? The Instrumentalization of Human beings. Levinas and his opinion that responsibility comes before freedom. People who are different and "imperfect" teach us about the meaning of equality and commitment. Genetical issues, like: the gene is such a strong contemporary cultural icon that people tend to re-identify themselves in terms of DNA, and the gene thus today replaces the former "soul" of the human body.
I was also happy to get some insight into how man, through religion, enters into that realm of meaning which stands beyond his own existence, his own time and space. One of the characteristics of almost all great spiritual traditions is that they move toward an experience of the self and the world beyond image, word, and text.
The absolute high-light was a fascinating daylong lecture by Professor Paul Moyaert from Leuven Catholic University. He spoke on the analysis of the double pole of attraction of desire or the "Teddy Bear Analogy". It was a truly enlightening philosophical experience to attend his lecture. Another prime intellectual high-light in my view, was to read C.S. Lewis "The Abolition of Man". This book was given to us as a gift from Father Bruno, another much appreciated lecturer from Fondazione Lanza. I would also like to mention Professor Paul Schotsmans of Leuven Catholic University and Professor Henk ten Have of Nijmegen Catholic University in this context. They were both - along with many others - two very inspiring key figures and lecturers of the second edition of this programme.
Personal reflections on content of the MB-programme
Because of several reasons it is not easy to deal with ethical issues in our contemporary western culture. It is a common view that anything goes as long as no one gets hurt. Technical progress confronts us with new challenging situations like genetic manipulation. In the same time multicultural societies develop. And the utilitarian attempt to secure happiness is not very likely to succeed. If we try to produce happiness at will, it will inevitably elude us. The result is often that life in our contemporary western culture becomes more and more pervaded by a suffering from meaninglessness. Postmodern men and women today have lost the keys to understanding and interpreting life. They live and work in a world without significance. This important contemporary phenomenon has never before been clarified better to me than throughout the MB-programme.
Life is complicated, and the whole ethical enterprise is a very complex one. In the end of the day ethical issues is about what we do in life. And we have to make choices. And this is another point of the MB-programme. The reality of the human condition is much broader than only personal preferences and utilitarian calculations, seeing human beings as counters in a mathematical game. Utilitarianism depends very much on what figures we put into our calculations. Furthermore it leads to a reduction and objectification of the human reality. In utilitarianism the result is what matters. But in speaking, taking a position, or defending an argument, I always do this in respect to others. If not, my argumentation makes no sense. Most ethical issues involve matters of judgement which arise out of initially ambiguous or marginal situations where no universal principle can settle the matter once and for all. And this is precisely what the MB-programme is about. Bioethics is about resolving practical cases in a particular socio-cultural context. The dynamic of this moral experience manifests itself in practice primarily when people are confronted with a conflict of values for which there is no clear solution. And here the ethical awareness and perception was greatly enhanced by the practical approach of the programme and the great variety of cultural difference among the different participants. I would like to call the MB-programme "applied ethical learning". As we discussed during the courses, the applied ethicist will have to be a sort of "handy-man" who can make arrows out of every type of wood, i.e. a person who can collect arguments wherever they are to be found. This is one important thing - among many others - that the MB-programme has taught me.
What has been realized during the MB-programme
Coming from a secular, consensus-based, pragmatic socialist country, with a very "utilitarian" approach in general to solve (ethical) problems, this programme was an ethical turningpoint of my heart. Personally, the MB-programme has been an ethical "metanoia" which has made me see ethics with new eyes and understand it with a new mind. The MB-programme has radically changed my way of interpreting life and thereby also ethical issues. I was previously not used to discuss values, especially not "intrinsic" values. I find it very rewarding to realize that there is, and can be argued in favour of a (any) transcendental belief-system.
Today I notice that my colleagues - knowing about my MB deed - often approach me to ask my opinion on what they perceive as ethical problems at work. Sometimes I also notice a trace of awe in their faces in regard to my accomplishments, and my way of clarifying the ethical dilemmas we are faced with. This is a nice feeling of course, and it makes me confident of the ethical usefulness of having taken part in the MB-programme.
I think all of the participants of the second edition of the MB-programme today are well prepared to become "ethical leaders" on a small scale, each and everyone of us, in his or her local setting. And ethical leadership is more than acting in a context. It is the capability to change this context, to break through limited and closed horizons of interpretation. Ethical leadership is to be an ethical "handy-man" who can open up new perspectives for meaning. I think as such - ethical "handy-men" - the participants of the second edition of the MB-programme, with a practical approach to ethical problem-solving are well equipped to solve ethical dilemmas in real life situations on a local professional level. Its also my prediction that some of my MB-colleagues may even achieve much more in the field of bioethics.
I want to thank the steering committee of the participating universities for an excellent programme!
Per Svensson, MD, MA.
Second Edition of The MB-programme.
