Empirical ethics: a growing area of bioethics

Abstract

Clinical Ethics is still a relatively young journal, but it has achieved a lot in the last four years by consolidating health-care ethics as a truly interdisciplinary field. The decision to have a section of the journal specifically focusing on empirical ethics was noted, in the first issue of the journal, to possibly ‘come as a surprise to some readers . . . but reflects the importance the Editorial team give to this area’. This decision has proved to be a fruitful one, with the section flourishing and publishing many innovative and influential papers by some of the leading people in the field. After four years as the editor of this section, Professor Clare Williams has passed the baton to me and it is with great excitement and anticipation that I have taken it on. Clare has done a wonderful job with the Empirical Ethics section, providing a forum for robust empirical work in ethics and showing how productive this kind of work can be. I come to this area from a different background to Clare. My first degree was in philosophy and I became interested in empirical methods in bioethics initially from a theoretical perspective – what does this kind of research contribute to ethical deliberation in terms of informing what we should do? This theoretical interest led to me deciding to actually do some empirical research myself. This decision was driven by many complex and inter-related factors, among them a desire to experience first hand what ‘doing’ this type of research would be like; to see in practice what this kind of research might contribute to ethical deliberation; and to find out about how ethical issues were approached and managed in the everyday practice of an area I had an existing interest in – infertility treatment. I conducted a qualitative project on infertility clinicians and thoroughly enjoyed the process of carrying out in-depth interviews and getting a more nuanced understanding of the area. Since then I have carried out other projects in a similar vein and now see the empirical component in my work as very valuable. Empirical ethics is still a relatively recent phenomenon in modern bioethics and has its opponents as well as proponents. The growth in engagement with empirical research has, arguably, been the biggest change in recent bioethics. Sugarman et al. conducted a study that pointed to the rise of empirical research in bioethics during the 1980s. Borry et al. continued this work and charted the rise of empirical research, conducting a quantitative analysis of peer-reviewed journals in the field of bioethics in the period 1990–2003 to analyse the evolution and nature of published empirical research in bioethics. They found that the proportion of empirical research rose in these journals from 5.4% in 1990 to 15.4% in 2003 and concluded that, ‘it is likely that the importance of empirical methods in medical ethics and bioethics can only be expected to increase’. The reasons for this ‘empirical turn’ are disputed; Borry et al. have argued that it can be attributed to three factors. First, the rise of evidence-based medicine and the extension of this to bioethics, where ethical arguments should either be tested by empirical evidence or ethical decisions should be grounded in the best scientific evidence. Second, the development of clinical ethics as a distinct field, which has a greater focus on the specificities of actual practice than mainstream bioethics. Finally, the increasing dissatisfaction with the discipline of bioethics as exemplified by the social science critique. Draper and Ives have argued that it is this critique that has been one of the main motivating factors behind the increase in empirical research conducted by bioethicists. It is beyond the remit of this editorial to consider in depth why bioethics as an academic discipline is changing and this is possibly more a topic for a sociology of ethics. However, there is no doubt that more empirical studies are now conducted in bioethics and there is an increasing focus on the role of empirical research in moral deliberation (see for example the article by Kon in American Journal of Bioethics and the large number of associated commentaries and the special edition of Bioethics in 2009). This ‘empirical turn’ has provoked extensive debate around such questions as: