Progress in the biological sciences and medicine is rapid, and it seems likely that the pace of advances in treatments and technology is set to increase over the next few years. For those involved in scientific research and at the frontline of care and treatment of people suffering debilitating diseases, the availability of new therapies is often seen as the criterion which trumps any need for further ethical evaluation or interference. The advances which filter down to the hospital wards present patients who have well-developed moral sensibilities with a moral maze to navigate. As Catholics, being able to navigate with confidence requires a good deal of help and information. Of course, what filters down to the faithful depends a great deal on those who commit themselves to working in the service of the Church understanding this complex, ever-changing landscape.

Anthony Fisher, a Dominican, has the ideal CV to make an important contribution to the development of Catholic thought in bioethics. He has a strong background in law, theology and ethics, obtaining his doctorate in Oxford under the direction of John Finnis. He has been a bishop for almost ten years, and is an ordinary member of the Pontifical Academy for Life. Thus far, much of what Fisher has produced has come in the form of lectures and talks, and they have often been published in collections of papers from conferences, journal articles, and so on. This book, then, seems to be his first as the sole author.

The first thing to note about this book is that it is not an attempt to provide an introductory textbook, or even a systematic treatment of bioethical issues from the beginning of human life to its end. Rather, it is a collection of essays, a gathering together and reworking of material presented and published elsewhere. This is certainly not a bad thing: first, because the reworking, the introduction assures us, is often substantial; and secondly, because it makes more accessible material that would be otherwise hard to obtain. Given that the book is a collection of essays, the attempt to divide the chapters into four parts, ‘How are we to do Bioethics?’, ‘Beginning of Life’, ‘Later Life’ and ‘Protecting Life’ is unnecessary, and may give a potential reader who glances at the contents page online a sense that this book will be more systematic than it actually is. Only the first chapter of the first section is very directly concerned with methodology, the other two deal with specific issues relating to conscience and cooperation in wrongdoing. Whilst both these chapters do raise methodological issues, the classification under the given heading is a little forced. However, this is a minor criticism. The eleven chapters deal with a broad range of topics, and I wish to highlight some of the notable chapters.

In his first chapter, which is on the context in which bioethical study operates, he sketches out the status quo in society, reflecting on the moral landscape we live in. He sees the major bioethical problems as having their roots in a society where sexuality is ‘chosen more or less at whim’ (p. 13). He also notes that a consumer mentality has entered thinking about the human body, sex, and relationships, with the result that the ‘language of the markets’ has a hold (p. 14). He then outlines the Church's response to such a culture: starting with such teaching as Gaudium et Spes and Humanae Vitae, along with a renewal of the use of Scripture in moral theology. He also makes mention of the New Natural Law Theory writers – Finnis, Grisez et al., a group of theologians for whom he has clear (and obvious) sympathy. There is a strong attack on the theologians who were instrumental in the development of new schools of moral theology post-Humanae Vitae; in particular the proportionalists, whose effect on Catholic moral theology was ‘devastating’ and ‘left the Church ill prepared to meet the challenges of secular liberalism and post modernity’ (p. 23).

The chapter on conscience states a theory as to why our understanding of conscience has gone wrong. He sets out a short history of the development of our understanding of conscience, starting with both Old and New Testament sources, before briefly mining the tradition, taking heed of Augustine, Bonaventure, Aquinas, and Newman. He then goes on to show how a proper understanding of conscience cannot be one which allows for subjectivism and relativism. In this, he clearly sees John Paul II's Veritatis Splendor as a timely and authoritative response to post-Humanae Vitae attempts by some theologians to deny the possibility of a ‘moral magisterium’ (pp. 55–60).

The chapter entitled ‘Beginnings: when do people begin?’ is a good showpiece for Fisher's versatility. It starts as an examination of Norman Ford's ‘When Did I Begin? Conception of the Human Individual in History, Philosophy and Science’, and particularly the assertion in that book that there is no human individual present until two or three weeks after fertilization (p. 102), the theory of ‘delayed hominization’, which has widespread support. Fisher points out the influential effect of this idea in the realm of embryo production and experimentation, despite Ford's own reservations about such practices. Fisher then goes on to treat the issue of the beginning of life in the light of Ford's biological survey, and his metaphysics. He sets about his task by making appeal to recent literature on the biology of the event of fertilization. The possibility of monozygotic twinning up to the point of the formation of the primitive streak is often used as an argument in favour of some form of delayed hominization, including by Ford, which is, in Fisher's opinion, by far the most plausible reason for a theory of delayed hominization. However, Fisher challenges the biology that Ford cites in support of his claim, showing that research on the matter of twinning is far too incomplete to build a strong biological case for the existence of something which is not an individual up to the point of the development of the primitive streak. And in challenging the metaphysics, Fisher demystifies the basic ‘one becomes two’ event of monozygotic twinning, by claiming that there is nothing problematic about this idea for the metaphysical status of the original individual. He uses the case of asexual reproduction as an example of how this happens naturally, and yet no-one makes the case that there is not one individual, and following the event, another discrete individual (p. 120).

The chapter on suicide and euthanasia is an attempt to survey the biblical texts on the subject. Fisher is keenly aware of the methodological complications in such a survey, and in particular, the risk of veering towards either a fundamentalist or ‘Bible as ordinary literature’ approach. He is also aware of the problems of reading modern day issues into the text. He uses contemporary scholarship on suicide in the Bible and antiquity as a guide, and as interlocutor, especially the text by Droge and Tabor, called ‘A Noble Death: Suicide among Christians and Jews in Antiquity’ (pp. 248 onwards). In his treatment of the topic, Fisher develops his own position based first of all on examining Old Testament texts. His conclusion is that all the texts he analyses show no sense that suicide is considered a noble death, but rather fall into the ‘death of the bad guy genre’ (p. 265). He then goes on to highlight a theology which is against suicide from the New Testament, a striking part of which is an analysis of the Passion of Christ. In this he argues that resigning oneself to an inevitable death does not entail an intention to suicide – ultimately, the death of Jesus was the result of the sinful actions of those who killed him.

This book is a very fine effort from a bishop theologian who has been highly thought of for some time. It shows Fisher to be highly intelligent and a versatile thinker, who is able to write well on a range of important topics within bioethics. He makes good use of philosophical, moral theological, Scriptural and biological approaches, and always integrates these well to make his case. At one level, the position he takes is exactly what one would expect (dare I say, hope for) from a bishop, who is a self-confessed member of the ‘John Paul II generation’ (both in terms of his age and theological inclination). But he does so much more than restate the Church's position: he shows that it can be a defended, developed and preached teaching which protects human life and is a signpost towards human flourishing. Fisher tackles head-on those schools of thought which he feels have too easily put aside the Church's position in favour of one which would be more in line with standard secular thinking; and he does this quite directly and unapologetically. The basic charge, which is a thread throughout the whole book, is that moral theologians have let the faithful down since the Council, because they have failed to equip them with the tools to navigate the bioethical questions which impact the lives of a great many people, and will affect even more people in the future. Fisher's book is a challenge to such theologians, and an example to Catholic bioethicists of how good bioethical thinking, which is rigorous, informed and imaginative, can be put at the service of the Church.