INTRODUCTION

This chapter addresses the development of bioethics in continental Western Europe, by which I mean the area including Portugal, Spain, France, Belgium, Switzerland, Germany, Austria, and Italy. Great Britain, Holland, and other Scandinavian countries as well as Greece, Cyprus, Turkey and all the other countries which until 1989 were in the Eastern block are not included: they have a different “culture.” (The development of bioethics in Britain is addressed in Chapter 39 and in Eastern Europe in Chapter 41.)

At the beginning of the 1970s, in continental Europe, ethical issues in medicine were limited to a few topics attracting the concern of a restricted number of specialists who discussed them quietly. In approximately two decades this situation changed radically, and bioethical issues are now debated in public and even influence political elections.

To understand how such a change occurred, it is useful to distinguish two aspects: bioethics as a cultural movement, that is, as an emergence of some new ideas and spreading of new attitudes; and bioethics in an institutional setting, that is, as organizational resources that support the debate in the field, especially research centers and university curricula. These two aspects of bioethics are related but distinct: institutions are supposed to produce ideas and influence the wider culture, but seldom does even a well-organized research center have a significant impact on culture. On the contrary, new ideas can get off the ground and influence society at large, quite independently of institutional support.