Non-adjectival bioethics

Abstract

Summary It has become customary to think about bioethics as populated by “adjectival bioethics” such as utilitarian bioethics, deontological bioethics, Christian bioethics, feminist bioethics, and more. The unfortunate outcome of such a designation is a perception of bioethics as incapable of offering definitive conclusions of practical or social importance, and so as useless for a modern pluralistic society . Accordingly, it is not a viable alternative to traditional ways of dealing with ethical issues associated with medicine or relations between human beings and non-human nature. Moral pluralism of the society is mirrored by the multiplicity of views of bioethicists and plurality of adjectival bioethics. The paper argues for an understanding of bioethics that is better suited to a pluralistic democratic society. On this view, bioethics is a complex of ideas, commitments, and practices, which enables the exchange of opinions of both experts of various specialities and lay citizens about ethical problems associated with medicine and relations between human beings and non-human nature. Such “non-adjectival bioethics” relies on a paradigm of intellectual engagement in the form of public debate, which is characteristic of a democratic society. The argument proceeds in two steps. The first step (which focuses on various forms of reflection on ethical issues in medicine but its conclusions apply to all fields of bioethics) starts with two distinctions. One distinction is between the medical-professional perspective and normative-theoretical together with a doctrinal perspective on ethical issues regarding medicine. The other distinction is between bioethics as academic research and education and bioethics as a practice of public debate. On the ground of these distinctions, the non-adjectival view of bioethics is offered. It is a two-layer discourse, which covers both academic research and instruction, and a social practice of public debate that involves professional, normative-theoretical, and doctrinal components. The goal of the debate is to clarify publicly recognised ethical problems and, if possible, offer their publicly shared solutions. Such a non-adjectival bioethics is normative; it functions on various forums and engages academics, the professions, and laypersons. The second part of the paper discusses normative presuppositions of non-adjectival bioethics. It is conceived of in the spirit of deliberative view of public decision-making. Non-adjectival bioethics is animated by two normative sources. One source is democratic values and ideals, such as individual liberty, equality, mutual recognition, and respect, which form the broadest normative framework for a public debate of a democratic society on publicly identified ethical issues. The other normative source of non-adjectival bioethics is doctrines, which are endorsed by citizens populating the society. These doctrines are valuable pools of reasons and arguments that can be examined in the bioethical debate. Non-adjectival bioethics is therefore a discourse and discipline, which is defined and bounded by the democratic values and ideals. Unlike adjectival bioethics, which aspire to universally bind conclusions by building their normative claims on metaphysical doctrines or to being a freestanding theory or framework, non-adjectival bioethics looks for clarifications and solutions of ethical problems recognised by pluralistic democratic societies, which are founded on such moral values and ideals as individual liberty, equality, and mutual recognition, and respect.