Reforming bioethics: a world of contrasts

In America, reflection on the limits of bioethics doesn’t seem to come naturally: it is typically induced by battle fatigue. After furiously debating stem cell research, cloning and end of life issues, some American bioethicists pause, reload and take their grievances to another level: the chasm between religious and secular conceptions of humanity and nature. The latter are frequently regarded as the ultimate, underlying basis of bioethical disagreement.

There are those who recognize that the culture of bioethics as a whole may be suffering to the extent that its practitioners are divided into feuding ‘religious’ and ‘secular’ camps. Recognizing that the culture war in bioethics may be a war of attrition, there are periodical calls for reform in terms of compromise, consensus, inclusion and tolerance. ‘Reforming bioethics’ in this context means finding ways in which religious and secular bioethicists can get along better.

It is sometimes refreshing to break free of the fishbowl of American bioethics to see how others reflect on the limits of the discipline as it is currently practiced. Take the recent article by Benatar and Singer, Global health ethics: the need for an expanded discourse on bioethics. Here the ‘religious versus secular’ debate hardly enters the picture. Reforming bioethics, according to Benatar and Singer, means bioethicists confronting the challenges to fundamental human values posed by inequalities between rich and poor, rapid population growth, emerging infectious diseases, wars and dislocation of communities, nuclear proliferation, ecological destruction, unfair international trade relations and more.

Extending the discourse in this way could promote the mindset that could improve health and deal with threats to health at a global level. That mindset requires that health, human rights, economic opportunities, good governance, peace and development are all intimately linked within a complex, interdependent world.

Many of the challenges mentioned are all-too-familiar to those living in developing countries, but it remains to be seen whether bioethicists in North America are willing, ready or able to promote a new ‘global mindset’ in bioethics.