Scratching the Surface of Bioethics.
HÄYRY, Matti and Tuija TAKALA (Eds.)
Amsterdam/New York, NY, 2003, xii, 148 pp.
Value Inquiry Book Series 144
Values in Bioethics (ViB)
“Well written and very readable … can [chapters] can be read either as stand-alone papers or as part of the whole. Despite its title the book does more then ‘scratch the surface’ of bioethics. … while a background knowledge of the main arguments and better known writings in bioethics is definitely a help, the volume may also be useful for those making their first tentative steps in the vast array of academic literature in this field.”
Bulletin of Medical Ethics, Number 204, December 2004/January 2005
“The book contains several chapters that echo the practical ethical concerns that health professionals confront in their work. They do more than just ‘scratch the surface of bioethics’ and make the book as a whole a useful addition to the libraries of health professionals”
NURSING ETHICS - 2004 11(3)
“If the discipline of ethics can have its 'metaethics', then the discipline of bioethics can have its 'metabioethics'. This book would be a notable contribution to such a discipline … an excellent collection of essays which are accessibly written, relatively short, and highly thought provoking. Clinicians, caring professionals, philosophers, and students who have some familiarity with the bioethical literature will gain greatly from reading it. If the maturity of a discipline is evidenced by its willingness to reflect on its own assumptions and methods, then this book is a mark of such maturity in bioethics.”
Metapsychology, Dec. 2003
Is bioethics only about medicine and health care? Law? Philosophy? Social issues? No, on all accounts. It embraces all these and more. In this book, fifteen notable scholars from the North West of England critically explore the main approaches to bioethics—and make a scratch on its polished surface.
Foreword by Michael Parker
Introduction Matti HÄYRY and Tuija TAKALA: What is Bioethics All About? A Start
ONE Rebecca BENNETT and Alan CRIBB: The Relevance of Empirical Research to Bioethics: Reviewing the Debate
TWO Mairi LEVITT: Better Together? Sociological and Philosophical Perspectives on Bioethics
THREE Tuija TAKALA: The Role of Sense and Sensibility in Bioethics
FOUR Eve GARRARD and Stephen WILKINSON: Does Bioethics Need Moral Theory?
FIVE Søren HOLM: “Parity of Reasoning” Arguments in Bioethics – Some Methodological Considerations
SIX Harry LESSER: Anne Maclean’s Criticism of Bioethics
SEVEN Peter HERISSONE-KELLY: The Principlist Approach to Bioethics, and its Stormy Journey Overseas
EIGHT Charles A. ERIN: Who Needs “the Four Principles?”
NINE Matti HÄYRY: Do Bioscientists Need Professional Ethics?
TEN John HARRIS: Pro-Life is Anti-Life: The Problematic Claims of Pro-Life Positions in Ethics
ELEVEN Simo VEHMAS: The Grounds for Preventing Impairments. A Critique
TWELVE Mark P. SHEEHAN: Deflating Autonomy
THIRTEEN Paul BARROW: Autonomy: Overworked and Under-Valued
About the Editors and Contributors
ABOUT THE EDITORS AND CONTRIBUTORS
Paul Barrow. After graduating in Law from Liverpool University, Paul worked as a National Health Service Manager, concluding as Chief Executive of an Acute Hospital Trust. In 1997 he left to become Development Executive of the Institute of Medicine, Law, and Bioethics (IMLAB), where he has been involved in several research studies, run courses and conferences, and lectured to healthcare professionals on Law and Ethics in healthcare. He is a Fellow of IMLAB, and has an M.A. degree in Healthcare Law and Ethics from Manchester University. He has recently left IMLAB to train as a non-stipendiary Anglican priest at St Stephen’s House, Oxford.
Rebecca Bennett is Lecturer in Bioethics at the Centre for Social Ethics and Policy in the School of Law at the University of Manchester. She is Programme Director for the M.A./Postgraduate Diploma in Healthcare Ethics and Law by Distance Learning and a Fellow of the Institute of Medicine, Law, and Bioethics. She has published widely on diverse issues in bioethics and her current research interests include assisted reproductive technologies, testing and screening in pregnancy, HIV/AIDS, cloning, stem cell research, ectogenesis, and selective treatment of infants.
Alan Cribb is Director of the Centre for Public Policy Research, King’s College London and Editor of Healthcare Analysis: An International Journal of Healthcare Philosophy and Policy. He has published on a range of themes in healthcare ethics and professional education, and has a particular interest in the relationship between health policy and professional ethics.
Charles A. Erin holds a B.Sc. (Hons) in Physics (Wales), an M.Sc. in Nuclear and Elementary Particle Physics (London), an M.Sc. in Technical Change and Industrial Strategy (Manchester), and a Ph.D. in Applied Philosophy (Manches-ter), and is Senior Lecturer in Applied Philosophy at the Centre for Social Ethics and Policy in the School of Law at the University of Manchester. He is Program Director of the M.A. in Healthcare Ethics and Law, and has written on diverse issues in Biomedical Ethics. His current research interests focus on property issues related to the human body.
Eve Garrard is Lecturer in Ethics and Philosophy in the Centre for Professional Ethics at Keele University. Before moving to Keele, she worked for several years for the Open University, and has a strong interest in teaching philosophy to adult beginning students. Much of her teaching is now to healthcare (and other) professionals. Her research interests are in moral theory and applied ethics, including bioethics, and also philosophical issues arising out of the Holocaust. She has recently published papers on the nature of evil and forgiveness.
John Harris is Sir David Alliance Professor of Bioethics and Academic Director of the Institute for Medicine, Law, and Bioethics at the University of Manchester. In 2001, he was elected a Fellow of the United Kingdom Academy of Medical Sciences (FMedSci), the first philosopher to have been elected to Fellowship of this new National Academy, established to serve “the medical sciences in the same way as the Royal Society serves the natural sciences (and) the British Academy serves the humanities.” He is a member of the United Kingdom Human Genetics Commission and of the Ethics Committee of the British Medical Association. He was one of the Founder Directors of the International Association of Bioethics and a founder member of the Board of the Journal Bioethics and a member of the Editorial Board of the Journal of Medical Ethics and many other journals. He frequently appears on radio and television both in the United Kingdom and overseas to discuss Biomedical Ethics and related issues. In the last five years he has directed four major projects for the European Commission under their Biomedical and Health Research Programme (DG XII). A new major project for the European Commission (EUROSTEM) began in February 2002. Under his direction, it will investigate and monitor ethics and policy issues surrounding the progress of human stem cell research.
Matti Häyry is Head of the Centre for Professional Ethics and Professor of Moral Philosophy at the University of Central Lancashire. He has taught phi-losophy and bioethics in various Finnish Universities since 1985, and co-ordinated research projects in bioethics at the University of Helsinki. He has been a permanent adviser on bioethics to the Finnish National Research and Development Center for Welfare and Health since 1991, and has participated in the work of legislative committees at the Finnish Ministries of Justice and Health. His publications include Critical Studies in Philosophical Medical Ethics (1990), Liberal Utilitarianism and Applied Ethics (1994), Playing God: Essays on Bioethics (2001), and many articles on bio-ethics and general philosophy in academic journals and edited collections.
Peter Herissone-Kelly is a Research Assistant in the Centre for Professional Ethics at the University of Central Lancashire. He has a B.A. in Philosophy from Bolton Institute, a B.Phil. in Philosophy from the University of Oxford, and a background in philosophical logic and metaphysics. He is currently working on a Ph.D. thesis to be entitled Kant on Rational Agency.
Søren Holm is Professor of Clinical Bioethics at the University of Manchester, and Professor of Medical Ethics at the University of Oslo. He holds degrees in medicine, philosophy and healthcare ethics, and two doctoral degrees. He is a former member of the Danish Council of Ethics, which advises the Danish Government and Parliament on bioethical issues.
Harry Lesser is a Senior Lecturer in Philosophy at the University of Manches-ter. He is author of several articles in the field of Medical Ethics, some being in journals and some being contributions to books, and editor of the collection Ageing, Autonomy, and Resources (Ashgate, 1999). He has particular interests, in both teaching and research, in the philosophy of psychiatry, and in issues concerning ageing and the elderly. He is currently working on papers on personal identity and dementia, and on research on the quality of life in old age.
Mairi Levitt is Principal Lecturer in Social Ethics at the Centre for Professional Ethics, University of Central Lancashire. Her research focuses on ethical and social issues arising from the new genetics, including public attitudes and understanding and empirical methods of investigating ethics. She recently or-ganised a “Gene Week” as a public consultation exercise with a local newspa-per, funded by the Wellcome Trust, and is a partner in a three year multidisci-plinary European Union project on empirical methods in bioethics. Recent pub-lications include articles in New Genetics and Society, Journal of Medical Ethics, Journal of Medicine, Healthcare and Philosophy, Journal of Beliefs and Values, and the British Medical Journal.
Mark P. Sheehan is a Lecturer in Philosophy in the Centre for Professional Ethics at Keele University. His research interests are in metaethics, “metabio-ethics,” and research ethics. His most recent publications include a pair of articles on practical reasoning in primary care for the British Journal of General Practice.
Tuija Takala is Docent in Practical Philosophy at the University of Helsinki, Finland and Visiting Academic at the University of Manchester. She has taught philosophy at the Universities of Helsinki and Kuopio in Finland. Her research interests include political philosophy and applied ethics, particularly bioethics. Her publications include Genes, Sense, and Sensibility: Philosophical Studies on the Ethics of Modern Biotechnologies (2000), and articles in Bioethics, Cambridge Quarterly of Healthcare Ethics, Journal of Medical Ethics, and The Journal of Medicine and Philosophy.
Simo Vehmas works as a Research Fellow of Special Education at the Univer-sity of Turku, Finland. He has written about the moral significance of disability in the light of various bioethical topics such as infanticide, abortion, and genetic information. He has published in several international journals in the fields of applied ethics and disability studies.
Stephen Wilkinson is Senior Lecturer in Ethics and Philosophy in the Centre for Professional Ethics at Keele University. His research papers have addressed topics including the allocation of health service resources, selective abortion, separating conjoined twins, and the nature of mental illness. A paper on this last topic won the Philosophical Quarterly International Essay Prize in 1999. He has recently completed a book on the ethics of commercializing the human body (Bodies for Sale, Routledge, 2003) and is Program Director of Keele’s new professional doctorate in Medical Ethics, the D.Med.Eth, as well as of its long-standing M.A. in Medical Ethics and Law.
In their introduction to this fascinating and informative book, Matti Häyry and Tuija Takala invite us to consider the question, “what is bioethics all about?”At first glance this seems a very strange question to be asking at the beginning of a book on bioethics, and at the beginning of the twenty-first century when bioeth-ics is literally everywhere. The questions of bioethics are posed for us in headlines on the front pages of every national newspaper. They are the topic of television documentaries every week, and are debated in the parliaments of every country that has one. We are acquainted with the questions of bioethics intimately, even if the answers to such questions are themselves disturbingly elusive. What is the moral status of the embryo? Should cloning be banned? Are genetically modified crops going to solve the problem of world hunger, or damage the global ecosystem beyond repair? Is euthanasia ever morally accept-able? These questions seem both to be new and to have been with us forever. Bioethics is one of the most important and contemporary social phenomena of our time, discussed in every pub and classroom, but its questions are also somehow timeless. Nevertheless, despite the familiarity of the key questions of bioethics, the editors’ claim seems right to me. There is indeed a sense in which the question “what is bioethics all about?” is a vitally important and timely one to ask. Why is this?
One reason lies in the seemingly essentially contested nature of so many of these questions. Will it ever be the case that we have resolved the question of the moral status of the embryo, or come to a conclusion about the morality of euthanasia? Or are these the kind of profound philosophical questions so intim-ately part of the human condition, like those of birth, death, love, and loss, that will continue to challenge each and everyone of us to work out our own an-swers in the context of our own experience of that condition? Are they answer-able at all in any generalizable sense? If not, what indeed is bioethics all about?
Another reason why the editors’ question is so timely is that bioethics has become an increasingly important aspect of policy making, both in government and in the day to day practice of medicine. In these contexts, the use of bio-ethics is not merely an academic exercise. It is expected to have instrumental value, to produce results, to solve problems. At the same time as bioethics has been taken into the mainstream of public life however, the methods and aims of bioethics are being increasingly contested. Which bioethical approach is the right one? Should we be thinking in consequentialist or deontological terms? If we are unable to avoid having to consider both, or even to consider four com-peting principles, how are we to resolve the seemingly intractable tensions and conflicts between them in the making of practical decisions? In relation to the use of bioethics in this instrumental sense too then, the question “what is bioethics all about?” seems apposite.
Finally, the question, “what is bioethics all about?” is also increasingly be-ing asked from a sociological or political perspective. What are the social origins of bioethics? Why has it become so influential as an academic discipline in such a short time? Why is so much governmental funding targeted at bio-ethics? Why are the professions involving bioethics in their training?
An interesting aspect of this larger sociological question, in the United Kingdom at least, is the question of why it is that so much excellent and import-ant bioethics work is being carried out in the academic institutions of the North West of England? The chapters that go to make up the content of this volume are ample evidence of the quality and international nature of this work. Matti Häyry and Tuija Takala are to be congratulated on having assembled such a fine collection of authors, and for asking them collectively and individually to address the question of what bioethics is and ought to be all about. In so doing, they help us to see that we have thus far indeed only just “scratched the surface of bioethics.” There is much interesting and important work to be done. No doubt much of the best of it will continue to be carried out in the North West.
Dr Michael Parker
Reader in Medical Ethics
The Ethox Centre