The Emerging Tradition of Secular Bioethics
Jason Eberl, PhD, Albert Gnaegi Center for Health Care Ethics, Saint Louis University, St. Louis, MO; Abram Brummett, PhD, HED-C, Oakland University William Beaumont School of Medicine, Rochester, MI; and Matthew Shea, PhD, Franciscan University of Steubenville, Steubenville, OH
The idea of bioethicists offering moral guidance in an ethically pluralistic society understandably elicits an incredulous brow where the questions of medicine involve such philosophically charged issues as birth, child-rearing, sexuality, death, and the meaning of suffering. The saying, “We are not the ethics police” has become proverbial for many bioethicists, indicating their reluctance to embrace a morally authoritative role. While principlism has come to dominate secular bioethics, Matthew Vest has recently pressed the principlist method to explain whether the principles are a content free framework used to generate whatever action guiding content one likes, or a content-full framework that affirms ways to properly interpret and apply the principles to bioethical questions. In this panel, we argue for an emerging tradition of secular bioethics in the U.S. that affirms bioethics as a content-full framework that supports bioethicists giving justified moral guidance.
The first presentation opens by noting that the moral guidance offered by secular bioethicists should be grounded in bioethical consensus but acknowledges that many have denied the existence of bioethical consensus. In response, a distinction is drawn between “Bioethical Consensus”—understood as agreement on what to do regarding highly contentious topics in bioethics (e.g., abortion, euthanasia) and on deep philosophical foundations to support these positions—from “bioethical consensus”—understood as agreement on many other moral issues in bioethics and on middle-level philosophical content to support these positions. Bioethical consensus is further distinguished from what is generally accepted by society or established in law. Then, building on the work of Jonathan Moreno, many examples of bioethical consensus in clinical, research, and public health contexts are provided.
The second presentation draws upon the work of Alasdair MacIntyre, who famously opened his After Virtue with a “disquieting suggestion” that contemporary moral language is in a state of disorder akin to an imaginary world where a catastrophic event resulted in the destruction of scientific institutions whereby fragments of knowledge were then assembled arbitrarily into competing “systems” that were evaluated for their “merits” without realizing they had lost the original theoretical contexts that made science comprehensible. In response, MacIntyre, having eschewed all Enlightenment attempts to secure a view of objective moral reason abstracted from tradition and history, offers a choice between Nietzsche (meaning that answers will be provided by power) or Aristotle (meaning that answers can be provided by a return to premodern moral traditions). The emerging tradition of secular bioethics has chosen the Aristotelian option, but not in MacIntyre’s exact sense. Instead, it has embraced an openness to innovative moral methods and moral bricolage by drawing freely from the various sources available in a pluralistic society to generate a novel moral synthesis. To return to Vest’s challenge, we argue that the process of specifying, weighing, and balancing the principles to generate points of bioethical consensus requires some moral choices to be made that are neither systematic (i.e., driven by some higher order ranking of the principles), nor arbitrary, but based on the epistemological tradition of public reason-based deliberation as opposed to demonstration.
The third presentation lays out the philosophical framework we are proposing for the emerging tradition of secular bioethics. This framework is not neutral and content-thin, but philosophically substantive and content-full. Like principlism, it is a mid-level approach that incorporates elements of multiple moral traditions and can be endorsed by proponents of competing general or “high” ethical theories (e.g., consequentialism, Kantian deontology, virtue ethics, natural law). Unlike principlism, it includes more robust commitments in normative ethics and metaphysics. In normative ethics, our framework adds a theory of the good, a more prominent role for virtue, and additional moral principles to supplement the usual four principles. In metaphysics, it includes views of human nature, personhood, identity, mereology, property, benefit, and harm. These additional philosophical commitments give our mid-level bioethical pluralism theoretical and practical advantages as a foundation for secular bioethics.
The first presentation opens by noting that the moral guidance offered by secular bioethicists should be grounded in bioethical consensus but acknowledges that many have denied the existence of bioethical consensus. In response, a distinction is drawn between “Bioethical Consensus”—understood as agreement on what to do regarding highly contentious topics in bioethics (e.g., abortion, euthanasia) and on deep philosophical foundations to support these positions—from “bioethical consensus”—understood as agreement on many other moral issues in bioethics and on middle-level philosophical content to support these positions. Bioethical consensus is further distinguished from what is generally accepted by society or established in law. Then, building on the work of Jonathan Moreno, many examples of bioethical consensus in clinical, research, and public health contexts are provided.
The second presentation draws upon the work of Alasdair MacIntyre, who famously opened his After Virtue with a “disquieting suggestion” that contemporary moral language is in a state of disorder akin to an imaginary world where a catastrophic event resulted in the destruction of scientific institutions whereby fragments of knowledge were then assembled arbitrarily into competing “systems” that were evaluated for their “merits” without realizing they had lost the original theoretical contexts that made science comprehensible. In response, MacIntyre, having eschewed all Enlightenment attempts to secure a view of objective moral reason abstracted from tradition and history, offers a choice between Nietzsche (meaning that answers will be provided by power) or Aristotle (meaning that answers can be provided by a return to premodern moral traditions). The emerging tradition of secular bioethics has chosen the Aristotelian option, but not in MacIntyre’s exact sense. Instead, it has embraced an openness to innovative moral methods and moral bricolage by drawing freely from the various sources available in a pluralistic society to generate a novel moral synthesis. To return to Vest’s challenge, we argue that the process of specifying, weighing, and balancing the principles to generate points of bioethical consensus requires some moral choices to be made that are neither systematic (i.e., driven by some higher order ranking of the principles), nor arbitrary, but based on the epistemological tradition of public reason-based deliberation as opposed to demonstration.
The third presentation lays out the philosophical framework we are proposing for the emerging tradition of secular bioethics. This framework is not neutral and content-thin, but philosophically substantive and content-full. Like principlism, it is a mid-level approach that incorporates elements of multiple moral traditions and can be endorsed by proponents of competing general or “high” ethical theories (e.g., consequentialism, Kantian deontology, virtue ethics, natural law). Unlike principlism, it includes more robust commitments in normative ethics and metaphysics. In normative ethics, our framework adds a theory of the good, a more prominent role for virtue, and additional moral principles to supplement the usual four principles. In metaphysics, it includes views of human nature, personhood, identity, mereology, property, benefit, and harm. These additional philosophical commitments give our mid-level bioethical pluralism theoretical and practical advantages as a foundation for secular bioethics.