Introduction The Importance of Anthropology to Bioethics

Anthropology offers much to the world of bioethics, including theoretical approaches, methods, and practical guidance to health care professionals. Theoretically, anthropological research challenges cultural and social norms about identity, personhood, distinctions between self and other, definitions of life and death, and what it is that makes us human. Our comparative approach enables us to reveal just how moral assumptions and norms are not universal while demonstrating at the same time the cultural basis of moral reasoning. The social sciences also contribute to a view of ethical issues as societal problems, in this way illuminating the cultural processes that constitute ethical concerns (Haimes, 2002). Methodologically, anthropology has helped to "humanize" (Kleinman, 1995a, 1995b) bioethics by using ethnographic methods that enable a thick description of cases which illuminate people's grounded experiences of responding to ethical dilemmas and the values that enter into their moral reasoning (Hoffmaster, 1990, 1992; Marshall & Koenig, 2001). A contextualist approach to bioethics therefore prioritizes the "is" (people's actions and the values informing those actions) over the "ought" (what people believe they ideally should do), while recognizing that moral ideals vary cross-culturally. Anthropological approaches help develop "a more empirically grounded theory of morality" (Hoffmaster, 1992) and herald new or previously unrevealed moral considerations that help refine normative analysis (Haimes, 2002; Hoffmaster, 1990). Such first-hand experiences facilitate informed health policy-making.

In the following discussion I will explore ways in which anthropologists and sociologists have worked toward "humanizing" bioethics (Kleinman, 1995a, 1995b). First, I will briefly review the development of the field of bioethics and present some relevant concepts. I will then review anthropological research that examines bioethics as a cultural domain of inquiry and cultural process. A number of theoretical issues and topical areas will be discussed in light of cross-cultural research in the field. Second, I will cover various applied efforts of anthropologists working in bioethics. Lastly, I will explore some promising avenues for further research in bioethics. While anthropological contributions to the field of bioethics are central to our discussion, it is paramount to include some related work by those outside the discipline since: (1) anthropologists are increasingly engaged in interdisciplinary collaborations, and (2) non-anthropologists, for example sociologists and philosophers, are adopting anthropological methods and theoretical approaches to better understand bioethical issues from a cultural perspective. These trends are not surprising given that bioethics is a multidisciplinary field without its own discipline. This discussion picks up where several review articles have left off to provide a more current review of contemporary debates and issues in the anthropological inquiry into bioethics (Kleinman, 1995a; Marshall, 1992; Marshall & Koenig, 1996; Muller, 1994).

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