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Bioethics Forum Essay

Vive la Bioéthique? France’s Bioethics Initiative

Little noticed in the United States but a big deal in France, President Emmanuel Macron announced in January that he is creating a bioethics commission to review the country’s policies on a wide range of subjects, including human reproduction, euthanasia, neuroscience, and artificial intelligence. It’s a unique initiative driven by a problem that has bedeviled France for decades, the integration of various religious and ethnic groups into its special brand of secularism, called laïcité.

Since the late 1950s the doctrine of laïcité has been intended to bring peace and a sense of unity to a country that has been riven by religious conflict over the centuries. More recently, the perceived failures of secularism, especially with regard to an often-marginalized Muslim community, has been associated with France’s problems with terrorism.  But the application of laïcité has itself been blamed for exacerbating cultural frictions by, for example, banning face coverings among women.

The remit of Macron’s commission will be broad, but the friction points will appear in connection with the beginning and end of life. Assisted reproduction is not covered for gay and lesbian couples by the French health care system. Macron has said he supports reforms in that area short of surrogate motherhood. The president addressed the Roman Catholic and other senior clergy in the beginning of 2018 urging their participation in the commission and the public discussion of the issues.

Like many other countries France has a standing bioethics agency, the Comité Consultatif National d’Ethique, or CCNE. The CCNE will administer the commission process. Its director has expressed concerns about the speed of scientific change. Yet the pressures on France to sustain its historic leadership role in science are intense. Although the country has many distinguished scientists and institutions it risks falling further behind the U.S., China, the United Kingdom, Germany, and Japan. In terms of citable documents from 1996 to 2016 France is in last place after these other countries.

Evidently Macron sees bioethics as a venue for addressing the challenges of moral consensus as well as for preparing France to participate in the future of innovative science. American presidents have had similar goals for their bioethics commissions, though they have been flavored by the philosophical orientations of the administrations. Commissions under presidents Clinton and Obama tended to address specific topics and proposed generally moderate solutions, while President George W. Bush’s council saw itself more as modeling public discourse on a “richer bioethics.”

In my book Deciding Together (1995), I argued that bioethics had become a lingua franca in the search for moral consensus in an era when traditional authorities had lost much of their credibility. That assessment seems even more pertinent today. But in the early 2000’s, rather than fostering consensus bioethics became a cultural battleground on issues like embryonic stem cell research. Whether Macron’s bioethics initiative can help achieve a lingua Gallia remains to be seen.

Jonathan D. Moreno is the David and Lyn Silfen University Professor of Ethics at the University of Pennsylvania and a Hastings Center Fellow.

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