Bioethics Pluralism and Public Discourse

The tradition of the Encyclopedia makes an instructive contribution to the future of bioethics in the academy because it includes the full spectrum of voices addressing the questions of bioethics, consistent with diversity in the public square of liberal democracies. The academic field of bioethics, in order to remain both relevant and creative, is wise to include thoughtful representatives from this full spectrum.

As Alasdair Maclntyre has pointed out, every system of philosophical or religious ethics has its own foundational assumptions about human nature and the human good, its unique historical context and questions, and its inherent conceptual limits. Bioethics is therefore enhanced by dialogue between different traditions of thought, both secular and religious, reflecting the diversity of the public square. Such dialogue requires a set of core virtues—mutual respect, tolerance, civility, and an openness to modification of one's perspectives based on the clarification of empirical fact and the persuasiveness of others. These virtues pertain not only to discourse within the Western context, but to global discourse. Whether African, Asian, Middle Eastern, or Native American, religious perspectives and the philosophical systems that have emerged from them need to be respected and engaged. Secular or religious monism—the view that only one voice is valid—eliminates meaningful dialogue, inhibits full participation, and thwarts conceptual growth.

Even within the particularistic scope of contemporary Western moral philosophy, whether utilitarian, Kantian, or contractarian, there is a need for dialogue with equally useful schools of thought, such as Aristotelian reflection on the virtues and final causality, natural law thought on essential human goods and correlative moral obligations, existential concern with the emotional underpinnings of human action such as hope or "the will to power," phenomenological description of the transition from solipsism to the "discovery of the other as other," feminist reflection grounded in the experience of women, and many other Western philosophical traditions that raise significant and yet very distinctive questions. Depth discussion requires an appreciation for different systems of moral thought, each of which raises a unique set of questions that those inculcated in other systems may miss.

Secular monists hold that religious ethics should be privatized and excluded from bioethical and public discourse; that religion should be a purely internal affair, no more relevant to public discourse than one's culinary tastes;

that religious voices result in a discordant mixture that means nothing. Public debate requires, it is said, common secular language; religious language constitutes bad taste. While it is true that religious voices can be "conversation-stoppers"—to use the philosopher Richard Rorty's pejorative term—secular voices can be just as easily so. A great many religious voices are respectful, diplomatic, and contributory to deeper levels of discourse on public issues; they are often conversation-starters rather than conversation-stoppers by virtue of raising unique questions of human nature and destiny. In a liberal and robust bioethics, an opinion is no more disqualified for being religious than for being atheistic, psychoanalytic, feminist, Marxist, or secular existentialist.

The Encyclopedia of Bioethics is unique because it has always included many voices and traditions in an effort to foster dialogue, prevent the narrowing of the field, and engage a wide international readership. This edition, like previous ones, embraces cross-cultural approaches, the full history of bioethics, comparative religious and philosophical ethics, and global perspectives. The articles on the history of medical ethics are exemplary efforts to highlight the degree to which our contemporary theories of ethics and bioethics evolve from particular social, cultural—religious, and historical contexts. Moreover, the historical articles on "the contemporary period" provide important information on developments such as population ethics in China, assisted suicide in the Netherlands, and brain death legislation in Japan.

Yet the array of materials presented is not intended to imply moral relativism, even as it conveys the substantial reality of ideational difference. Many articles, while balanced and expository, do highlight areas where those in search of a common morality can find respite. In the classical dialectic between the One and the Many, or between moral objectivism and moral relativism, there are some areas in which no agreement is either likely or necessary. There are other areas, however, such as the wrongness of genocide or the sexual abuse of children, where agreement is both expected and imperative. Most of us are partial relativists, which is also to say that we are partial objectivists. When an incompetent physician lies by claiming competence and as a result inflicts avoidable harm on a patient, or when a researcher refuses to halt a study despite the intolerable suffering of subjects as they perceive it, ethics is objective and we can speak with authority of a common morality. Yet in other areas, such as brain definitions of death or certain reproductive technologies, few would assume moral objectivism. There are also difficult disagreements as to whether we should attempt to significantly modify human nature itself through advanced biotechnology.

The third edition of the Encyclopedia was animated by the recognition that no other work presents bioethics in its fullness, both with regard to definition, methods, and contents. It is this fullness that makes the Encyclopedia of continuing international value in maintaining the open and expansive nature of the field.

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