Margaret Somerville, perhaps the most influential medical ethicist in Canada, has written a thought-provoking book touching on a wide variety of topics relevant to medical ethics. The chapter likely to be of the greatest interest to the readers of this review is also the shortest chapter, in which she discusses male circumcision. The author begins by describing how her initial lack of interest in male circumcision as an ethical issue changed as she gave fair-minded consideration to what she heard from opponents of the practice. Eventually, Dr. Somerville decided that, at least in the non-religious context, male circumcision lacks sufficient ethical justification, and she was not shy about writing articles expounding her views.
One thing led to another and in 1998, she found herself receiving the NOCIRC Human Rights Award for her work in furtherance of the intact male body. At the award ceremony held during the Fifth International Symposium on Sexual Mutilations in Oxford, England, she was surprised to find herself being booed by roughly a third of the audience. The participants were angered by her argument in her acceptance speech that an exemption to a prohibition of male circumcision should be considered on the grounds of profound religious belief and obligation (of the parents). She notes ironically and perhaps with a little astonishment that she had somehow managed to make nearly everyone mad at her over her position on male circumcision-opponents of the practice, advocates of the practice, Jews and Muslims who felt their religious practices were being questioned, opponents of female genital cutting who rejected the comparison with male circumcision, physicians and parents.
The book’s other chapters address such ethical issues as influencing human reproduction through artificial means including both fertility treatments and abortion, human cloning, xenotransplantation, euthanasia, withholding treatment on terminally ill persons with their consent, imposing treatment on seriously ill children, access of healthcare, and allocation of healthcare. Dr. Somerville addresses all these topics with an admirable poise and generosity of spirit, attempting to examine all reasonable positions on her topics, and seeking fair resolutions to the quandaries that result.
The Ethical Canary is an excellent, thought-provoking book that demonstrates how tricky many of these issues are. One of the difficulties seems to be that we have lost some of our ethical markers and guidelines that enjoyed fairly widespread acceptance as recently as 1-2 generations ago. Dr. Somerville herself struggles in this book to balance her own definite views (at least on some subjects) against her openness to opinions differing from her own. Usually she succeeds. If occasionally she seems to get momentarily lost in her self-created thicket of thorny ethical dilemmas, she is still as good a pathfinder as we might hope for. The most dedicated intactivists will still fail to feel fully satisfied by what might to them seem an overly nuanced position designed, if not to please everyone, at least not to alienate anyone too mightily. Nevertheless, The Ethical Canary deserves the same sympathetic, open-minded reading which the author manages to give, over and over, to the people whose positions she judiciously explains and analyzes.