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When supererogation is supererogatory. A case of medical ethics

In this paper I analyze critically real cases of actions, often deemed “supererogatory” in the context of bioethics and medical ethics, in order to assess whether it is appropriate to classify them in this way. More specifically, I try to discuss the moral legitimacy of a consequence of In Vitro Fertilization (IVF), i.e., the freezing of the so-called supernumerary embryos, and their “adoption”, focusing on the possibility of it being a supererogatory action…

INTRODUCTION. SUPEREROGATION AND MORAL EVALUATION

The question of supererogation is often evoked in bioethics (in particular in the context of medical ethics1) in relation to all those cases in which it is difficult to make an accurate moral judgment in agreement with the given moral paradigm. I am talking about uncertain situations of clear uncertainty, which give the moral agent the possibility to “pay or give more than what is rightly due, and thus to develop actions that are not strictly required”2, i.e., to act in view of a good that does not closely coincide with one’s duty. It is even clear that, when talking about supererogatory acts, I am referring to actions pursuing an end that is considered good, and that can never be determined by the sole purpose of damaging to the moral actors. However, the relevant question, in the context of supererogatory acts, is whether the good involved in the action has sufficient normative force to “motivate” the agent to act in view of its fulfillment, or, to be more precise, whether there are some elements of the action itself that mitigate such mandatory dimension, being themselves good. The moral evaluation becomes thus complex, since the possibility to hierarchize these goods involved in this particular action is difficult, i.e., as the use of the past experiences seems to be hardly practicable, making the final decision particularly hard. Another issue to take into account within this process is the notion of sacrifice3: there cannot be supererogatory actions that do not involve, at the same time, the sacrifice of other “goods”4, that is, something which is considered valuable in itself.

Indeed, it is precisely when the practical reason – and thus the perception of the “duties” – ceases to provide its stringent criteria to direct “what must be done”, that the theme of moral supererogation comes into play, more specifically, a dimension that is not necessarily “mandatory” or “due”5. The moral agent may then decide  to act in a certain way, but, strictu sensu, he/she is not required to act in that way; the context of non compulsory actions leave a “moral” range (or perhaps it would be more appropriate to call it an “extra-moral” range) to the subject’s freedom. In this regard, the moral agent usually decides to sacrifice his/her own good for the sake of allowing other subjects to enjoy other goods.

To use a contemporary language more appropriate to the context of meta-ethics, we are dealing with actions that are neither mandatory nor prohibited, and hence fall within the rank of those actions that are formally permitted but not compulsory6. As pointed out by Chisholm,

“the status of supererogation can be summarized in this way. If I seek advice, concerning an act which would be supererogatory, and ask: ‘Shall I do this?’, I may well be told: ‘You ought to, but you don’t have to’ – it is advisable, but not obligatory. It is ever appropriate to say, similarly, ‘You ought not to, but you may?’”7.

Once the issue of supererogatory actions has summarily clarified, it seems interesting to analyze critically real cases of actions, often deemed “supererogatory” in the context of bioethics and medical ethics, in order to assess whether it is in fact appropriate to classify them in this way. The starting hypothesis is that this denomination is often “abused” to describe actions that do not have a clear moral connotation (are they good or bad?), since it is offered as a “shortcut” to resolve moral issues without clearly defining the issues at stake. This is precisely what it is happening with two distinct situations that find a common ground in the controversial topic of the “gift”8 (repeatedly evoked not only in the field of bioethics), namely: One of the “undesired” – though not unexpected, for the sake of truth – consequences of the practice of In Vitro Fertilization (IVF), i.e., the issue of “supernumerary non-implanted embryos” (or surplus embryos), and one of its possible solutions, the so-called “embryo adoption for the birth” 9, or “prenatal adoption”10.

The so-called “Good Samaritan” donation of organs (in particular of kidneys), sometimes called “nondirected live-kidney donation”11.

In the next few sections, following a brief reconstruction of the facts and situation, I will attempt to outline the ethical issues involved in the first example given below, in order to determine whether we can correctly talk about “supererogatory actions”, in reference to the issue of embryo adoption.

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Pontificia Universidad Católica de Chile 2020

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