The New Year is a good time to reflect on
where one has been and where one is going. What have I accomplished or failed
to accomplish? What can I do better? It is hard to know whether Julian
Savulescu wrote his recent essay in the Journal
of Medical Ethics (‘Bioethics: why philosophy is essential for progress’)
in a bit of a fin d’annee funk. But
it certainly sounds like it: his conclusion is that bioethics and medical
ethics as fields have largely failed, and he seriously doubts that he as a bioethicist has made much of a positive impact over the past two decades. What is the
malaise, and what is the antidote?
According to Savulescu, bioethics and
medical ethics have failed because the philosophical engine that powers ethics has
been allowed to wither. In fact, much of his article is devoted to deftly exposing
what he considers crappy ethical reasoning. While one may not be a fan of
Savulescu’s brand of consequentialism, and/or why he thinks certain
positions are untenable, you cannot fault him for failing to present clear
ethical arguments in support of his views. This is part of his point: bioethics
is being overrun by intellectual laziness in the form of unreflective adherence
to ethical-sounding catch phrases (‘humans have dignity’), slavish appeal to
existing codes and regulations, or failures to distinguish empirical claims
from normative ones. The paragraph that really struck me was the following:
left a promising career in medicine to do bioethics because I had done
philosophy in 1982 and attended Peter Singer’s lectures in practical ethics.
The field was new and exciting and there were original proposals and arguments.
Singer, Glover, Parfit, Lockwood and others were breaking new ground, giving
new analyses and arguments. Now medical ethics is more like a religion, with
positions based on faith not argument, and imperiously imposed in a simple
minded way, often by committees or groups of people with no training in ethics,
or even an understanding of the nature of ethics.
The remedy for this, according to Savulescu,
is to go back to basics. Bioethics is a branch of ethics. Ethics is a philosophical discipline, and philosophy (certainly in its Western,
Socratic form) is all about critically examining claims and offering the best
arguments one can.
To the extent that Savulescu’s diagnosis is
right, bioethics may be in globally
rough shape. To make my own start-of-the-New-Year confession, I have been
involved with initiatives to strengthen bioethics in sub-Saharan African
countries for a decade now. One of the greatest challenges faced by those
initiatives is to stimulate critical philosophical thinking. Trainees often
expect the ‘right answers’ or ‘correct values’, which are then to be applied
mechanically to particular problems.
This may be due to educational systems that elevate professors high
above students, and encourage learning by rote while downplaying critical
engagement with what is being taught. In addition, I have found that much of
the interest in ‘bioethics’ in developing countries too often boils down to the (institutional)
interest in establishing and sitting on research ethics committees. Whatever
the causes of the trend may be, the net result may be the globalization of a diluted bioethics
that ‘is more like a religion.’ Those of us involved in such initiatives need
to seriously reflect on this phenomenon, to what extent we contribute to it,
and what can be done to minimize or counteract it.
Labels: crappy reasoning, global bioethics, religion, research ethics committees