This Is Bioethics. Udo Schüklenk
1.7 Theologians will be able to tell us what a respective religion would make of the problem at hand. Legal experts could tell us what the law currently says with regard to any of these issues; they might even bravely venture into an analysis suggesting that the law ought to be changed, if they find it to be a violation of their country’s constitutional values. Health care professionals should be able to enlighten us with regard to what their professional values have to contribute to these difficult questions. Sociologists do what sociologists do best, they will ask other people, say taxi drivers, philosophy students, or a representative sample of a given group of people, what their take is on these questions. None of these discipline‐specific responses is capable of enlightening us in a moral or ethical sense. The problems flagged earlier can all be read as asking fundamental ethical questions, namely: Is it ethical to alter the human genome? Is it moral to use sentient animals for clinical research purposes? Is abortion immoral? Is the criminalization of assisted dying ethically defensible? Bioethics relies first and foremost on ethics to sustain reasonable defensible answers to these questions. However, it is not the type of ethics that many armchair philosophers would recognize as traditional philosophical ethics. There can be no doubt that bioethical reasoning is not as deep or watertight as, for instance, meta‐ethical reasoning aims to be. Rather, with few notable exceptions, it aims to use the normative frameworks, that we will be looking at, as a rough guide indicative of where, say a utilitarian analysis would lead us when we consider the morality of abortion and infanticide. These frameworks are also useful as tools of critical analysis. They offer us some pretty good guidance and guidance justification on the types of criteria that we might apply when we go about asking, for instance whether abortion is a morally good or bad thing. They could even help us taking a considered ethical stance on markers of fetal development that are frequently argued over by activists and legislators alike. Say, does the moment of conception confer moral standing on the developing human? Or, does the capacity to feel anything matter? Does it matter whether an embryo would be capable of surviving outside the pregnant woman’s womb? These are the types of questions that ethical theories can indeed shed new light on.
1.8 Before we try to get a quick overview of major ethical theories that exert today a significant influence in bioethics, let us briefly address a few other preliminary issues, namely, that of the place of religion in ethics, the relationship between the law and ethics, the challenge ethical relativism poses particularly in the context of bioethics, and the not completely irrelevant question of why we should bother being ethical to begin with.
1.1 Religion and Ethics
1.9 In the 1850s, the American Medical Association (AMA) was busy developing the content of its Code of Medical Ethics. At the time James L. Phelps, an influential Christian doctor in New York, tried to insert in this code a professional obligation for doctors to preach the truth of the Christian gospel. He referred to ‘the paramount duty of the profession to their patients not only as regards their body in disease, but also the higher interests of the immortal soul. And hence, also the just claim of religion, the great anaesthetics of the immortal mind, to be considered an element of medicine or the healing art’ (Baker, 2013, 181).
1.10 His fellow doctors at the AMA rejected his approach. They aimed instead for a secular code of medical ethics, and also a secular interpretation of professionalism for its members. Their reasons were entirely pragmatic, as you will notice when you read their rationale: ‘the principles promulgated by this code have been assumed as a common ground upon which every member of the Association may stand, without reference to the distinctive principles or doctrines which distinguish the various religious societies existing among the vastly extended and diversified population of our country’ (Baker, 2013, 181).
1.11 There are a number of problems with religious approaches to ethics. An obvious one is that many competing religions and claims about God or gods exist. It is in the nature of these claims that they cannot be tested. They rely entirely on belief. Given that we cannot know which of these gods – if any – is the right one, we are better off, in assuming with Plato that even if a God or gods exist, they would also need sound ethical reasons for their ethical judgments. Many people doubt the very idea that a God exists, mostly because of the enduring nature of the terrible evil that persists in the world. This just does not seem to gel well with the idea of an all‐knowing, all‐powerful and good God of most monotheistic religions. In any case, we do not have to settle the difficult question of whether a God or gods exist, thanks to an ancient Greek philosopher, Plato.
1.12 Plato created about 380 years before reportedly the historical Jesus was born a now‐famous dialogue aimed at addressing various questions to do with the relationship between God or gods and ethics. The dialogue is called Euthyphro11 and plays out between Plato’s teacher, Socrates and the said Euthyphro. The story essentially takes place at a plaza in front of a court house. Euthyphro busily prosecutes no less than his father for manslaughter committed on a murderer.
1.13 Euthyphro’s relatives thoroughly disagree with his actions. When Socrates (i.e. Plato’s protagonist) questions Euthyphro, he replies, criticizing his relatives, ‘Which shows, Socrates, how little they know what the gods think about piety and impiety.’ The dialogue goes on for some time, and during the course of it Socrates makes among others a crucial point that is salient to the question of the relationship between religion and ethics: He asks whether something is good because the God or the gods approve of it, or does God (or do the gods) approve of it because it is good. This is a crucial question, because if something is good only because God or the gods approve of it, ultimately what is good would depend entirely on God’s or the gods’ preferences. For all we know God (or the gods) could have approved of Euthyphro’s actions. Slavery might be ok, too. This take implies that the act in question is neither intrinsically good nor bad, because it is entirely dependent on what God’s or the gods’ take is on the issue at hand. It is doubtful that you consider this answer persuasive. Surely, if God or gods exist, they need to have some sort of ethical reason for saying that something is morally wrong. Their answer cannot be completely arbitrary.
1.14 This leads us to an alternative answer to the question. That answer suggests that some actions are good or bad as such, and that we are able to evaluate such acts by means of using the tools of ethical analysis. Or, as Gordon Graham suggests, ‘Plato’s arguments in Euthyphro seems [sic!] to show that … religion cannot logically serve as a ground for morality’ (Graham 2004, 185–188).
1.15 There are other problems, too. Most religious authoritative scriptures, such as for instance the Qur’an12 or the Bible13, do not actually provide us with clear guidance to address most ethical questions that we face during our lives. Even if, miraculously, all of us would agree tomorrow that one of these two documents, and not the Hindu’s Bhagavat Gita14 is the true God’s source of wisdom, we would discover that it actually would not help us to solve the ethical problem our NGO‐manager faces. We might as well go back to Plato then and try to figure out ourselves what is right and what is wrong, what is a good action and what is a bad one.
1.16 To what extent then will religious arguments feature in this book? Not to a great extent. It is true that extensive literature, for instance on the stances of Roman Catholicism, Judaism and Islam on assisted dying, exists. However, these kinds of arguments will not be dealt with in great depth in this book. The main reason for this is that these kinds of arguments are only of relatively uncontroversial moral significance to a subset of people, namely those who subscribe to the views expressed on this issue in the authoritative guidance documents published by these faiths. Obviously,