Ethical Considerations 
supply, or the proportion of people who are undernourished, 
are almost meaningless; because when you actually come to do 
anything about it, however much you may achieve at the top 
level, you have ultimately got to come down to some village in 
Nigeria, which is on a track miles from the main road, which is 
bound by local cultural traditions, by agricultural techniques, 
by lack of seed potatoes. It looks as though ultimately whatever 
we may do at the top we come down to doing good by minute 
particulars, just as we have to change people’s minds, if we 
can change them at all, individually. 
We seem to be agreed that one essential is to educate people 
more in biological facts as a necessary preliminary to any action. 
Although we have heard so much about conflicting values, I 
have not felt that they are really the obstacle they seemed to be 
to start with; because I think we have seen that we do not deal 
with an abstract value and particular facts, but with a feedback 
mechanism in which both get changed. So, when we come to 
look back at views on population and birth control, we see a 
reflection of what is actually happening now. In time the force 
of facts alters the effect of values and action is finally taken. 
Then there is the question of the price of progress, and the 
point that Koprowski raised about the effects of antibiotics in 
ridding us of infection. It is certainly true that as a result of 
immunization against poliomyelitis, virus infections are now 
seen which were not at all common before, leaving the clinical 
picture very much the same as it was. I am sufficiently opti- 
mistic to think that many of these problems will in fact be 
overcome. Part of the price of progress obviously is that people 
who would have died earlier, live on to provide geriatric 
problems; though I am sure they would rather live on to get 
rheumatism or strokes in old age than die at thirty-five of 
pneumonia. 
There are also the iatrogenic diseases, where new drugs 
produce fresh diseases or monstrosities. Here there is a curious 
disturbance of the sense of proportion. When we had one or 
two cases of smallpox introduced into Britain there was some- 
thing like a panic, with people queueing up to be vaccinated. 
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