The morality of meddling. (Management).(article includes author correction: "The Fuzzy Line Between Work and Home", Fall 2002 issue, was authored by Leah Curtin)

There is an old story told about a devout elderly woman who swayed and rocked in her pew, murmuring 'Amen. Amen. Praise God!' as the minister preached against all the more common sins ... Until he started in on the evils of snuff-dipping. At that, the pious old girl sat bolt upright and said, "Now he done stopped preachin' and took to meddlin'! " In similar manner today, while ethics has enjoyed a renaissance, the discussion of moral behavior seems to have lagged behind.

Ethics is an intellectual analysis undertaken to determine what is right in a given situation. Morality is the degree of congruence between a persons perceptions of what is right and his or her actual behavior. In short, it is the messy personal problems that determine what we do about what we think is right. It more or less takes over where ethics leaves off. So while we have ethics centers, ethics committees and ethics education, the subject of personal morality is taboo. For example, there is a United Nations resolution for an international ban on cloning a human being, which most likely will pass... But there is almost no discussion about the widespread use of fertility drugs as a lifestyle option - a way to time the conception and birth of a child rather than a way to treat infertility. As a result of this practice, there is an increase in selective abortions (because fertile women given fertility drugs become pregnant with veritable litters), and in multiple births, and most particularly in prematurity. Upwards of 50% of NICU beds (all of which are paid for by state Medicaid programs) are filled with infants born prematurely to women, many of whom are quite fertile, who have been given fertility drugs.

No one thinks it is good to use drugs on people who don't need them - nor do I know of anyone who thinks that increasing the number of babies born prematurely is a good thing to do. However, no one is debating this increasingly common practice, no one at all. Why? The cloning-a-human-being debate presents many ethical questions -- the kind that arise when people do not know what is right, and they hope - through careful analysis - to discover it. The use of fertility drugs as a lifestyle option, however, is about personal moral responsibility, that is, what we actually do about what we think is right. And while we are willing to debate what is right, we are unwilling to debate what ought to be done about what is right. That's called 'meddling.' This column, however, is not about fertility drugs, or even cloning. It is about the growing need for addressing moral development -- in this case, among health professionals. Why? Because technology is placing ever more powerful tools in the hands of more people. And also because we are not merely instruments of the wishes of others. Because each of us is a moral agent in his/her own right.

Because health professionals make decisions daily that affect the lives of their vulnerable patients, they customarily have been held to higher ethical standards than 'butchers, bakers and candlestick makers'. Moreover, as technology increased options to include procedures and sequelae that deeply ...