Abstract
BackgroundEnd-of-life decision making constitutes a major challenge for bioethical deliberation and political governance in modern democracies: On the one hand, it touches upon fundamental convictions about life, death, and the human condition. On the other, it is deeply rooted in religious traditions and historical experiences and thus shows great socio-cultural diversity. The bioethical discussion of such cultural issues oscillates between liberal individualism and cultural stereotyping. Our paper confronts the bioethical expert discourse with public moral attitudes.MethodsThe paper is based on a qualitative study comprising 12 focus group discussions with religious and secular persons in the USA, Germany, and Israel (n = 82). Considering the respective socio-political and legal frameworks, the thematic analysis focuses on moral attitudes towards end-of-life decision making and explores the complex interplay between individual preferences, culture, and religion.ResultsOur findings draw attention to the variety and complexity of cultural and religious aspects of end-of-life decision making. Although there is local consensus that goes beyond radical individualism, positions are not neatly matched with national cultures or religious denominations. Instead, the relevance of the specific situatedness of religious beliefs and cultural communities becomes visible: Their status and role in individual situations, for example, as consensual or conflicting on the level of personal perspectives, family relationships, or broader social contexts, e.g., as a majority or minority culture within a political system.ConclusionsAs the group discussions indicate, there are no clear-cut positions anchored in “nationality,” “culture,” or “religion.” Instead, attitudes are personally decided on as part of a negotiated context representing the political, social and existential situatedness of the individual. Therefore, more complex theoretical and practical approaches to cultural diversity have to be developed.
Highlights
End-of-life decision making constitutes a major challenge for bioethical deliberation and political governance in modern democracies: On the one hand, it touches upon fundamental convictions about life, death, and the human condition
When Terri Schiavo died on March 31st 2005, she had been at the centre of a protracted legal struggle and a heated public debate for 8 years
The fierce, at times seemingly irreconcilable culture wars sparked by the Schiavo case exemplify why end-oflife (EOL) decision making constitutes a major challenge for bioethical deliberation and political governance in modern liberal democracies
Summary
End-of-life decision making constitutes a major challenge for bioethical deliberation and political governance in modern democracies: On the one hand, it touches upon fundamental convictions about life, death, and the human condition. On the other, it is deeply rooted in religious traditions and historical experiences and shows great socio-cultural diversity. The fierce, at times seemingly irreconcilable culture wars sparked by the Schiavo case exemplify why end-oflife (EOL) decision making constitutes a major challenge for bioethical deliberation and political governance in modern liberal democracies. The same holds true for political players who claim to speak on behalf of certain cultural or religious communities and to advocate their alleged positions [17]
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