Today’s post is my first since passing my viva – so now that I’m a doctor (feel free to congratulate me in the comments section) my posts are bound to be more authoritative. For my reading today I’ve picked a chapter on ‘Bioethics, Genethics and Medical Ethics’ by Bennett, Erin, Harris, and Holm. John Harris works at the University of Manchester and I’ve enjoyed hearing him speak on ethical issues in the past – which is why I’ve picked this topic.
Bioethics, if you didn’t already know, looks at ethical issues in the life sciences. It’s always interested me that Manchester’s bioethecists tend to operate out of the law department rather than philosophy, and perhaps this is illustrate of how the subject draws in thinkers from many different fields. In spite of this, as the authors of the chapter explain, bioethics is a branch of applied ethics having its roots in moral philosophy. The fact that the methods and vocabulary of bioethics comes from moral philosophy, whilst its practitioners come from a wide variety of backgrounds, probably explains why I enjoy talking to bioethecists and find myself so interested in it. The importance of linking theory to practice makes it even more fascinating.
Because bioethics is simply the application of moral philosophy to practical issues in a particular discipline I wasn’t expecting to learn anything from the chapter. I’m happy to have been proved wrong by the discussion of The Four Principles approach (4PA), an approach particular to the field. The four principles 4PA takes its name from are:
- Respect for autonomy
Between them the four are supposed to be able to mediate between conflicting moral theories such as deontological (rule based) and consequentialist theories, and further to reconcile those theories with common-sense morality. By the 4PA method, ethical dilemmas can be resolved by determining if a problem falls within the scope of one of the principles. If more than one principle is at stake then the content of each aspect and its relationship to the principles must be specified and a balancing act performed to reach a conclusion.
I can’t say that this is an approach that looks terribly attractive to me. For one thing, it risks reducing moral solutions to what can be most easily agreed rather than what is right, and for another all of the principles, particularly ‘respect for autonomy’ and ‘justice’ are highly contested. Nor am I at all sure how a proponent of the 4PA method might go about ranking or weighting considerations relating to the four principles. The apparent simplicity of the method makes it look attractive whilst masking some pretty big theoretical issues. It may seem desirable to try to ‘attempt to combine the ‘best’ insights from deontology, consequentialism and virtue ethics in some form of coherent framework’ but I confess enormous scepticism.
I’ve encountered a degree of suspicion about bioethics in the past, particularly from specialist philosophers. This suspicion comes from the view that bioethecists are experts in non-philosophical fields who are dabbling part-time in moral philosophy. I happen to think that view is generally (although not always) misplaced – I’ve met some really excellent moral philosophers working in bioethics (The University of Manchester is a particularly good place to find them). However, approaches like the 4PA outlined above probably don’t help – they look like a rather shallow short-cut to solving a moral problem.
Fortunately there’s much more to bioethics than that one method, and its subject matter is utterly fascinating. Think about issues like euthanasia, abortion, organ donation, elective surgery, drug rationing, medical testing, animal experimentation, and all of the interesting questions provoked by advances in genetics. I can think of few more vibrant areas to take moral philosophy, and apply it to stuff that matters, than the field of bioethics. Reading this chapter has made me a little more envious of those working in it.