GESTIÓN EN SALUD PÚBLICA: BioEdge: Is bioethics fading away?

lunes, 4 de noviembre de 2019

BioEdge: Is bioethics fading away?

BioEdge: Is bioethics fading away?

Bioedge

Is bioethics fading away?

by Michael Cook | 3 Nov 2019 |

The etymological roots of the word “bioethics” suggest that its subject is the principles governing the morality of dealing with life, especially human life. For a word coined to describe a new discipline in about 1970, it has had a good run. But according to a commentary in Nature by a sociologist at the University of Cambridge, it may have done its dash.

Sarah Franklin’s contribution to essays marking the 150^th anniversary of Nature charts the rise and decline of the field of bioethics. It meanders through Darwinism and eugenics, and it concludes with the ominous (for bioethicists) conclusion that bioethics has become irrelevant. “The pursuit of a more ethical science has come to be associated with building trust by creating transparent processes, inclusive participation and openness to uncertainty, as opposed to distinguishing between ‘is’ and ‘ought’.”

In other words, bioethics is being displaced by sociology.

It turns out that this is a particularly English response to bioethical dilemmas which began with Dame Mary Warnock’s expert management of the controversy over embryo experimentation in the 1980s. A philosopher who viewed the metaphysical and ethical issues at stake with a clear and steady eye, she nonetheless made a hash of it with her 14-day rule -- it was philosophically inconsistent, said the philosophers. But she understood, as others perhaps did not, that the goal was to secure public support, then legal approval, and then government funding. The niceties – and the goal post shifting – could come later.

The law itself, Warnock argued, would act as both a guarantor and a symbol of public morality; it would in its combination of permissive scope and legislative precision express “the moral idea of society”. This was a new template for ethical reasoning.

Warnock opened up a pathway for controversial biological research which the English have followed successfully ever since. The science lobby wins over legislators with studies of public opinion, focus groups and never-ending stream of position papers from the Nuffield Council on Bioethics:

In short, expert knowledge and reliable data are essential but never enough to enable enduring, humane governance to emerge. So there is now more emphasis on continuous communication and outreach, and on long-term strategies to ensure collective participation and feedback at all stages of scientific inquiry. The result is less reliance on specialized ethical expertise and more attention to diversity of representation.

Well, she would say that, wouldn’t she, is the response of Udo Schuklenk, who edits the journals Bioethics and Developing World Bioethics. He responds indignantly to her “lovely mix of half-truths and nonsense”:

What is mostly off-base about Franklin's take on bioethics is that she sees apparently no room for ethical analysis and expertise on matter biopolicy when we could have the freewheeling societal dialogue instead that she prefers. Clearly there is no contradiction in having both. The former should hopefully fruitfully inform the latter.

Craig Klugman, writing on a blog of the American Journal of Bioethics, complains that Franklin fails to understand how bioethics works in society:

This article shows a common misunderstanding: Bioethics has never been the arbiter of what can be done. Bioethicists have never had the power to say what research can and cannot take place. Her claim that we have fallen out of favor and out of power is based on a mistaken idea that we ever held such lofty positions in the first place. We never have. Sure, we consult, serve on boards, and offer frameworks for understanding, but that is a far cry from being Clotho, Lachesis, and Moirai (The Greek Fates).

Bioethics writer Wesley J. Smith, writing in the National Review, believes that Franklin’s account of the brief history of bioethics confirms his darkest fears about the future of a humane and principled approach to human research. “Franklin says bioethicists have ceased being thought leaders but merely so many PR professionals in the service of Big Biotech.” He believes that we are caught between the crass pragmatism of the biotechnology sector and bioethics “experts” [his emphasis] who deny the sanctity and intrinsic dignity of human life.”

Michael Cook is editor of BioEdge

With IVF firmly established legally and socially, the status of children has become a bit murky. Initially IVF was a remedy for medical infertility for married couples. Then it became a solution for "social infertility" for solo mothers and gay couples. A recent decision by an English Court extends the logic of IVF a bit further. A judge has ruled that a brain-damaged and severely handicapped woman should be allowed to have child to give meaning and purpose to her life. (See article below.)

Where are the rights of the child in this development? To have no father, to be raised by grandparents who may die early, leaving a youngster in charge of a handicapped mother... It seems to violate a fundamental tenet of liberal democracy -- that people exist for their own sake, not as means to an end.