The Reasonable Content of Conscience in Public Bioethics
Jason Eberl, Saint Louis University Albert Gnaegi Center for Health Care Ethics, St. Louis, MO; and Abram Brummett, Oakland University William Beaumont School of Medicine, Rochester, MI
Bioethicists aim to provide moral guidance in policy, research, and clinical contexts using public reason, which is appropriate in a pluralistic society because it eschews argumentation grounded in religious as well as non-religious (e.g., Marxism, utilitarianism) comprehensive doctrines. This public reason-based bioethics was largely successful in the 1970s and 1980s, but subsequent decades have seen increasing criticism of this methodology, resulting in what John Evans refers to as the “crisis of the bioethics profession,” namely, the wavering public confidence in public reason to secure common moral ground sufficient to resolve bioethical controversies. If public reason fails as a viable methodology for bioethics, then the whole discipline would need to be reconsidered. Leonard Fleck has recently surveyed and responded to a litany of criticisms against public reason, such as the argument from Tristram Engelhardt and Mark Cherry that public reason cannot rationally secure moral content in a secular society and thereby reduces to moral relativism where content is provided by the majority or reigning political power. In part one of this presentation, we further develop the concept of public reason by distinguishing internal (having to do with logical structure) from external (having to do with widely shared content) criteria. We then describe Engelhardt’s critique in greater detail and show why it is unreasonable. In part two, we show how public reason can resolve at least one of the perennial controversies of bioethics by developing a public reason-based “reasonability view” of conscientious objection. We review some recent forms of conscientious objection and explain why they would be prohibited by a reasonability view.