This Is Bioethics. Udo Schüklenk
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1.4 Be mindful that even if we agreed with the content of the Hippocratic Oath or a modern version of it, and even if they actually provided us with guidance for the problem under consideration, we would again have to take it on authority that we should go about the NGO’s problem in one particular way and not in another, unless there is an ethical justification provided why we should do what it admonishes us to do. Given that in our scenario almost certainly a lot of people would disagree with whatever it is that is being proposed, policy wise, it is important that we get our justification right. Here is where ethics’ second purpose comes in: In addition to providing us with action guidance, it must also provide us with a reasoned justification for the guidance given.
1.5 As we will discover, there exist a fair amount of competing ethical theories, some more influential than others, that succeed with varying degrees of success both on the action guidance as well as on the action justification fronts. How should we decide then, which one, or which set of them to adopt for our own purposes? Is it ok to use one set of theories for one type of problem and another set of theories for another type of problem? Couldn’t we choose virtue ethics for decision‐making at the hospital bedside, but decide to go with utilitarianism for matters of resource allocation decision‐making? But why should we do that, as opposed to just the opposite? Could there be a meta‐theory telling us which theoretical approach to deploy under what circumstances? Or must we determine which theory is the right one and try to abide by its guidance as best as we can, even if some of that guidance is turning out to be deeply counter‐intuitive? Well, these are questions about the nature of ethics; they ask whether there can be a true ethics, whether ethical statements must be of a particular kind, whether they can be objectively true or false, or whether they ultimately boil down to statements expressing our feelings. These and other questions are typically analyzed by meta‐ethicists. They don’t create ethical theories, rather they create theories about ethics. There are also legitimate questions about the extent to which ethical theories truly lend themselves to be ‘applied’ in some sense or another to problems such as the one mentioned at the beginning of this chapter. We will not engage in this sort of theorizing about ethics in this chapter, with the exception of a few paragraphs on ethical relativism. The reason for this is that the discussions driving meta‐ethics are quite technical in nature, and by and large there is no obviously correct solution to many of its controversies. Even in the absence of final answers to many of these questions, however, it is still quite possible to undertake ethical analyses. As we will see throughout this book, some arguments are more plausible than others; certain types of argument, such as for instance slippery‐slope based arguments, are almost always flawed, and so on and so forth. However, you can easily read up on meta‐ethical theories elsewhere. (McMillan 2018) A wonderful source of superb on‐line Open Access content, written usually by the some of the best philosophers around, is the Stanford Encyclopedia of Philosophy. Check, for instance its entry on Theory and Bioethics10 (or Singer 1991, Part VI: The Nature of Ethics).
1.6 Bioethics is specifically concerned with normative issues in the biomedical and life sciences. Bioethicists hail these days from many different disciplines, including theology, law, medicine, sociology and many others. Think of typical problems bioethicists analyze in their research: Should we permit editing of the human genome? Is it acceptable to use sentient animals in clinical research? Is abortion wrong? Should we decriminalize assisted dying in some form or shape?
1.7 Theologians will be able to tell us what a respective religion would make of the problem at hand. Legal experts could tell us what the law currently says with regard to any of these issues; they might even bravely venture into an analysis suggesting that the law ought to be changed, if they find it to be a violation of their country’s constitutional values. Health care professionals should be able to enlighten us with regard to what their professional values have to contribute to these difficult questions. Sociologists do what sociologists do best, they will ask other people, say taxi drivers, philosophy students, or a representative sample of a given group of people, what their take is on these questions. None of these discipline‐specific responses is capable of enlightening us in a moral or ethical sense. The problems flagged earlier can all be read as asking fundamental ethical questions, namely: Is it ethical to alter