The diversity of bioethics

Abstract

One of the accomplishments of global bioethics is that respect for cultural diversity and pluralism is regarded as an ethical principle in itself. The Universal Declaration on Bioethics and Human Rights is the first international bioethics document advancing respect for cultural diversity as an ethical principle to be applied in the moral assessment of bioethical issues and problems. However, the status of this principle when balanced against other ethical principles is controversial. It is also unclear how respect for cultural diversity should be situated in the delicate balance between universalism and particularism. Two years ago, we therefore predicted that respect for cultural diversity would trigger further debate as a result of the ongoing globalization of bioethics (ten Have and Gordijn 2011). This issue supports our prediction. Chattopadhyay and De Vries (2013) argue that respect for cultural diversity is an ethical imperative. As such, this claim is not hugely controversial, but the disagreement is about the weight that this principle should receive in regard to other principles. In fact the authors take issue with a more general position that they call ‘‘the universalist approach to bioethics’’. They make a somewhat radical claim that applying universal principles can be harmful. In support of this claim the present three arguments. First, mainstream bioethics has a western bias; because of its specific origin it is focusing on particular issues and interests only. Second, confronted with other cultures, bioethics poorly addresses moral diversity. Third, bioethics is simply exported to other cultures without sensitivity to moral diversity. The conclusion is that this leads to ethical imperialism. Bioethics is ‘imposed’ on non-western cultures. It is according to Chattopadhyay and De Vries like a Cadillac in a village bazaar. Such a point of view apparently assumes that bioethics in 2013 is similar to the one of 1973 or 1983. Bioethics seems to be a stable product of American culture that can simply be exported like a smart phone. It does not take into account that principlism no longer is the uncontested theoretical framework, that other methodological approaches have developed, that a wide range of theories have been formulated, and heterogeneous practices have emerged. No worries about care ethics, narrative ethics, or interpretive bioethics; they are all modifications of the same basic pattern. Not only does this static view not recognize scientific advances; it also does not appreciate cultural change and transformation. Apparently, the nonwestern countries have remained the same despite globalization. In this view contributions of scholars from India, South Africa, Brazil or China have not significantly contributed to the development and expansion of global bioethics, or have under-articulated the specific character of their contributions, or perhaps they have even been too much involved in the intellectual realm that perpetuates the imposition of western bioethics. In our view, it is time to leave the static view of bioethics behind and to acknowledge that ethics itself is changing as a result of processes of globalization. The confrontation with different ethical traditions and cultures is challenging ethics to rethink and transform its content, character, methods and sources of validation (Dower 2013). Respect for cultural diversity therefore requests to go beyond the dichotomy of imposition or acceptance. Taking diversity seriously may result in the emergence of a new global ethics with a new vocabulary and content from many traditions. Or it may result in a two-level approach: a global ethics emphasizing the shared principles and values, and a localized ethics articulating the norms of different H. ten Have (&) B. Gordijn Pittsburgh, PA, USA e-mail: tenhaveh@duq.edu