Bioethics in Italy Since 1997 10 Maurizio Mori

Bioethics in Italy since 1997 10 Maurizio Mori I. Introduction The watershed year for Italian bioethics was 1997. The birth of Dolly the sheep in Scotland at the end of February 1997 caused such cultural turmoil that bioethics was given a new social status. Before Dolly’s birth, bioethics was already a growing discipline that increasingly attracted attention from educated people, but it was still a field restricted to a few specialists.1 Dolly’s birth radically changed the level and magnitude of the inter- est in these topics: bioethics became a matter of public debate and a source of political concern. The media has been so deeply involved in this issue, for such a length of time, that the word “bioethics” itself has become popular and has gained a place in common usage. The “Dolly affair” likely would have been sufficient to start this new “bioethics blooming”, because cloning has a deep symbolic meaning in Western culture and incites strong feelings. However, in Italy several factors contributed to such a new atmosphere and, in one sense, prepared it. On Saturday, February 1, 1997, just before the annual “Pro-life Day” celebrated by the Roman Catholic Church, four well-known Italian intellectuals supported a new bill, presented by the Italian Pro-Life Movement and signed by over a million citizens, that would modify article one of the civil code. According to the present law, a human being acquires “legal capacity” – i.e., full acquisition of a person’s rights – at birth: according to the proposal, “legal capacity” would be acquired immedi- ately “at conception”.2 Since two of these intellectuals were Professor Francesco D’Agostino, the president of the National Committee for Bioethics, and Professor Giuliano Amato, the Minister of Treasury, their public Pro-Life declaration started a great deal of polemical discussion. On February 10, the Constitutional Court decided against the proposal of a referendum on abortion promoted by the Radical party and signed by about another million citizens. Opposed to the Pro-Life bill, this proposed referendum was aimed at increasing the availability of abortion, so that (among other things) abortion would have been permissi- ble even in private clinics (not only in public hospitals as it is now) and for young women under the age of 16 without their parents’ consent. According to the Court, this referendum could not take place because it was informed by a perspective that considers motherhood to be only a woman’s “private affair”. The Court held that this view was in contrast with the Constitution, in which motherhood is a “social matter” deserving public consideration. While the current law allows abortion to support motherhood, the 164 THE ANNALS OF BIOETHICS referendum’s proposal moved in the opposite direction. It is not difficult to imagine that this decision raised significant new controversies.3 A few days later, the team of Professor Carlo Flamigni (in Bologna) announced the birth of Elena, the first baby born by means of a brand new technique. The progenitor cell of the oocyte had been frozen and kept for some time. It was defrosted and matured in vitro, and finally fertilized in vitro. This new procedure allows women to store their gametes, which earlier could not be frozen without permanent damage. Elena was a healthy baby, but such an “extraordinary birth” attracted much attention: Cardinal Biffi, bishop of Bologna, declared that it was “un evento bestiale” (“a bestial event”). Debate over reproductive issues and limits to be established on science started again, receiving front-page news stories for days. As one can see, the whole month of February 1997 was full of bioethical controversy. At the end of February, Italian newspapers broke the usual informational embargo to report about Dolly’s birth, which was a real blow. Besides a few rare voices inviting a more cautious attitude and claiming that further reflection was needed, the reaction to Dolly’s birth was of absolute and irrevocable condemnation.4 Some scholars appeared to be furious and really worried for the advancement of science, saying that Pandora’s box had been opened and that from now on humanity was in real danger. Harsh criticism and heavy words continued for days, so that afterwards one could no longer ignore bioethical issues or even the word “bioetica” itself. Only a decade ago, scholars politely scoffed at the idea of being involved in bioethical reflection, claiming that it dealt with issues that could easily be managed through traditional disciplines; now, bioethics receives public recognition, social sanction, and academic standing. II. The Field of Bioethics in Italy In an amazingly short time, controversies on Dolly’s birth changed the status of bioethics in Italy, bringing it from the margin to the center of cultural debate. Such a sudden and unexpected “explosion” of the field had various side effects, one of which is that a number of people became “bioethics experts” in a day. Apart from this, scholarly bioethics bene- fited from the situation, because publishers became more interested in offering bioethical works, and many important books were translated into Italian. (See, for example, Harris, 1997; Jonas, 1997; Singer, 1997, 2000, 2001; Engelhardt, 1999; Beauchamp & Childress, 1999; Callahan, 2000; Ford, 1997; Kuhse, 2000; Dworkin, Frey, & Bok, 2001.) Moreover, some Italian secular scholars produced significant contributions on various issues: C.A. Defanti (1999) wrote a unique contribution that is possibly the first history of the concept of death from the Renaissance to contemporary times, examining also many issues related to this topic. Death is the topic of B. Morcavallo’s interesting book (1999), which focused on how the concept of whole brain death is related to the concept of person, and has far-reaching effects on the traditional sanctity of life doctrine. P. Borsellino (1999) boldly defended a view of autonomy that holds that the patient-physician relationship has already changed significantly and that it will continue to change, especially from a legal viewpoint. A. Santosuosso (2001) wrote a thoughtful history of the relationship between medicine and law, and M. Barni (1999) provided a connection between traditional medical deontology and bioethics. Fucci G. Ferrando (1999b, 2002) wrote possibly the most complete and informed BIOETHICS IN ITALY SINCE 1997 165 legal analysis of assisted reproduction according to Italian law; feminists and psychoanalysts also presented their views on the matter.5 D. Neri (2001) presented the issues of stem cells and cloning, and G.F. Azzone (1997, 2000, 2003) explored some bioethical issues assuming a wider evolutionary perspective and a liberal standpoint. S. Fucci (1998) contributed to nursing ethics, a field that has received additional attention since the importance of nurses within health care is increasing, even though – unfortunately and for unknown reasons – nursing ethics is not blooming as one would have expected (see also Cattorini & Sala, 1998; Spinsanti, 2001; and a special 1998 issue of Bioetica. Rivista Interdisciplinare, IV[3]). Proceedings of interdisciplinary and pluralistic conferences on death and birth as well as on autonomy provided a variety of positions on such issues (Cattorini, D’Orazio, & Pocar, 1999; Istituto Veneto di Scienze, Lettere ed Arti, 1999, 2001). Two important books deserve special mention: the first is the collection of papers on bioethics written by Uberto Scarpelli (1998), who was a pioneer of the new discipline in Italy and who died an untimely death in 1993. The other is a book by E. Lecaldano (1999) that is certainly one of the best articulated and mature contributions provided from a secular perspective followed by a “Dictionary of Bioethics” (Lecaldano, 2002). G. Berlinguer (2000) wrote a comprehensive book presenting his views on “everyday bioethics”, which is focused not on crucial and exceptional cases but on “everyday practice”; and L. Battaglia (1999) argued for a different perspective relying on the paradigm of “complexity” as a basis for bioethics. Finally, debate has been increasing about the role of non-human animals, which in the last several years has grown. Besides translations of P. Singer’s (1997, 2000, 2001) and T. Regan’s (1976, 1987, 1989, 1990) books, Italian scholars have published their own contributions to this growing debate (Battaglia, 1997; Pocar, 1998; Cavalieri, 1999; Marchesini, 1999, 2001). Catholics have been even more active and, since 1997, a veritable flood of books has been published. Here I can mention only a few of the many important contributions. Msg. E. Sgreccia (1999) expanded his textbook, which provides the basis of a general view called “ontologically grounded personalism”. Cardinal D. Tettamanzi (2000) did the same with another general book (see also Sgreccia, Spagnolo, & Di Pietro, 1999; Spagnolo, 1997; Spagnolo & Gambino, 2002). A. Pessina (1999) considers foundational aspects of such a view, pointing out the paradoxes of “techno-sciences” and focusing his analysis on a few basic normative issues as exemplary of former problems. L. Ciccone (2000) and M. Aramini (2001) provided a general overview of a Catholic position. F. D’Agostino (1998) presented a Catholic perspective starting from the viewpoint of the philosophy of law, holding that the European legal tradition can provide clues for solving bioethical issues (see also Dalla Torre, 1997; Tarantino, 1998). A. Bompiani (1997) and others focused their attention on the growing European legislation concerning bioethics, which (according to them) is informed with “personalistic criteria” and is respectful of an interpretation of “human rights” (see also Bompiani, Lorete Beghè, & Marini, 2001).6 G. Angelini (1998), P. Cattorini (1997), G. Piana (2002), F. Viola (1997, 2000) and C. Zuccaro (2000, 2002) (in various ways) defend a Catholic view, relying on a phenom- enologically oriented approach, which leads to a sort of “relational personalism”: most of this approach’s practical conclusions are equivalent to those reached by “ontologically grounded personalism”, but on some issues there are significant differences.

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