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Society's Choices: Social and Ethical Decision Making in Biomedicine
thought and experience can appropriately contribute to public debate and decision making in a democratic society, in which religion is neither to be favored nor curtailed.
The separation of church and state has worked to prevent the dominance of any sectarian theology or religious ideology within U.S. society. As both secularism and religious pluralism have grown with great rapidity during recent decades, some religious groups that had rarely been politically active in former times have developed coalitions that have become a political factor. Some of these groups have mastered the use of the mass media (radio and television, advertising, mass mailings, and political action committees). They have been enlisted by politicians and political parties to further general, national programs, and they have themselves enrolled politicians in their own causes. This public activity by some religious groups has, on the whole, contributed positively to the clarification of issues in the field of biomedicine (Bishop and Coutts, 1994). Religious zeal can, however, lead politically active groups to insist that their religiously derived norms must be accepted by the society at large. Out of such religious zeal, some individuals have resorted to violence against their opponents.
Naturally enough, virtually all religious groups have given major attention to fundamental moral questions raised in the fields of medical science and medical technology. Some of these issues divide the religious communities sharply; issues related to the inception and end of life are particularly divisive. This division is not unique to religious communities, nor is the division merely between the more conservative and the more liberal portions of the religious community, as the issue of abortion makes clear. Persons committed to a traditional or conservative theology may nevertheless be forceful advocates of a more liberal social, economic, and political agenda (see background paper by Swezey in this volume).
At the same time, much religious thought and activity has been directed toward more effective ways of presenting commonly held religious values, such as respect for the views of others, honesty in individual, group, and public life, and the overcoming of racial, ethnic, and sexual biases. Representatives of many religions, including Islam, Buddhism, Hinduism, Judaism, and Christianity often have joined in this effort. Note, for example, the effort by the World Parliament of Religions to articulate a set of common moral commitments and understandings.
Religious organizations are not the only groups that have actively debated and responded to major moral issues, including those brought on by developments in biomedical technology; many other groups are notable for their participation in such debates. Moreover, in addition to the response of diverse social groups, institutions (e.g., the scientific research community and biotechnology industry) also react to and change in accordance with developments in biomedicine. Both specific actors (e.g., mi-