A view of bioethics from down under

Abstract

When I immigrated to Australia from the United States a few years ago, at first I found many similarities between the countries. But underneath the apparent similarities, notably a shared language, lay much deeper differences in history, politics, and culture that have considerable impacts on attitudes and approaches to issues in bioethics and medicine. For instance, debates continue regarding cloning and embryonic stem cell research, particularly given the long history of research in reproductive medicine and reproductive technologies in Australia. Although there are individuals and groups opposed to such research on grounds associated with pro-life or anti-abortion stances, the discussions more often hinge on what should be funded by the government and eventually what should be provided to all within the public system of healthcare. This theme is one common thread that unites many current controversies in bioethics, but perhaps not for the reasons that an outsider might at first expect. Indeed, allocation of limited resources is part of what is considered relevant, but money is rarely presented as the decisive issue in these debates. Instead, considerations such as what is medically necessary (based on a broad definition of what is medical), what contributes to a “good life” (as defined by what are increasingly heterogeneous community standards), and how to respect and enable fulfillment of autonomous decisions by individuals and families in this rapidly changing context are key to many of the disputes. This brief report is necessarily selective, but it is designed to give a flavor of the terms of the debates as they are currently developing.