Bioethics

In the 1990s, communitarian approaches to bioethics became increasingly common and explicit in the literature. This evolution was the result of the prominence of the communitarian philosophical critiques of liberalism that occurred in the 1980s, particularly works by Alasdair MacIntyre, Michael Sandel, Charles Taylor, and Michael Walzer.

Communitarianism is a neo-Aristotelian philosophy that focuses on the common good and is concerned with the relationship between the good person or good citizen and the good of the community or society. As would be expected, it has much in common with other neo-Aristotelian approaches, such as casuistry and virtue ethics. Communitarianism is both a critique of the dominant Western ideology of liberal individualism and an orientation to ethical problem solving.

Communitarians often argue that the notion of human nature and the concept of the self behind liberalism are insufficient to make possible a shared common understanding of values among members of society. Similarly, communitarians sometimes argue that liberal society is committed to neutrality toward all notions of the good life, and thereby cannot adequately address ethical issues. As a result, communitarians often stress an orientation toward ethical questions that relies on the establishment, or re-establishment, of a shared common understanding, a shared notion of the good life, or a shared notion of the self.

Only a few bioethicists have openly embraced the communitarian label in their writings (Emanuel; Brennan; Loewy; Nelson; Callahan, 1996; Kuczewski, 1997). However, much work in bioethics shares community-oriented assumptions—that healthcare is special and different from market commodities, for example (Daniels), and may be seen as a good that is part of the common good (even by those who do not embrace communitarianism in other spheres of distributive justice) (Jecker and Jonsen). Similarly, many writers take relationships as the starting point of their ethic, rather than the individual (Murray).

Furthermore, even if society tries to remain neutral toward visions of the good life, ethical issues arise within the context of healthcare and require that the public institutions that provide medical treatment and conduct biomedical research somehow address such ethical dilemmas. As a result, pragmatists such as Jonathan Moreno embrace communitarian strands of thought in an effort to resolve such questions through the production of consensus (e.g., the creation of shared common understandings) (Moreno).

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