Steve Cooke

measuring the boundaries of our nation by the sun

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Discovering bioethics

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
  • Non-maleficence
  • Beneficence
  • Justice

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.

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This afternoon I’ve been reading A.C. Grayling’s essay on Epistemology from the Blackwell Companion to Philosophy. Epistemology deals with defining knowledge, asking how we come to knowledge, and how we justify beliefs. It’s a fascinating area of philosophy, but one that fills many people (myself included) with dread because there’s simply no getting away from the fact that studying it is hard.

Seeing Grayling’s name at the top of the chapter was reassuring because I know that he’s used to communicating complex ideas to non-experts. His task is described as looking at how justification for belief is possible and exploring some responses to the challenge from sceptics (how do I know I’m not dreaming, why should I trust my senses etc.).

I should say now that my purpose with this blog is not so much to provide regurgitated summaries of all of the things I have read – so apologies if you’re expecting to learn anything useful here. Rather, if I’m honest, the blog’s main purpose is to force me to keep reading, and to do so carefully. No no long discussion of epistemology here (check out the Stanford Encyclopaedia of Philosophy for that) However, the more I write, the more tempted I’m becoming to post up some more general musing – such as research questions I’m grappling with, or arguments for my own beliefs. Watch this space.

What I can say it that I am a bit less terrified of epistemology thanks to Grayling (also, I’ve learned a lot about how to introduce a paragraph – Grayling is a master of this). Admittedly the reading was a slog, but I was helped out a little by having read half of Feinberg’s chapter Basic Deductive Logic in his brilliant little book Doing Philosophy last night. Epistemology still looks pretty daunting as a subject, but at least I feel a little less ignorant about it now. However, I’ve also spotted that at this point I’m just 77 pages into 965 of this book – this reading project looks like it may end up taking quite some time to complete.