Christian bioethics, secular bioethics, and the claim to cultural authority.

Though the papers in this volume for the most part address the question, "What is Christian about Christian Bioethics", this paper addresses instead a closely related question, "How would a Christian approach to bioethics differ from the kind of secular academic bioethics that has emerged as such an important field in the contemporary university?" While it is generally assumed that a secular bioethics rooted in moral philosophy will be more culturally authoritative than an approach to bioethics grounded in the contingent particularities of a religious tradition, I will give reasons for rejecting this assumption. By examining the history of the recent revival of academic bioethics as well as the state of the contemporary moral philosophy on which it is based I will suggest that secular bioethics suffers from many of the same liabilities as a carefully articulated Christian bioethics. At the end of the paper I will turn briefly to examine the question of how, in light of this discussion, a Christian bioethics might best be pursued.     

Feminism, law, and bioethics

Feminist legal theory provides a healthy skepticism toward legal doctrine and insists that we reexamine even formally gender-neutral rules to uncover problematic assumptions behind them. The article first outlines feminist legal theory from the perspectives of liberal, cultural, and radical feminism. Examples of how each theory influences legal practice, case law, and legislation are highlighted. Each perspective is then applied to a contemporary bioethical issue, egg donation. Following a brief discussion of the common themes shared by feminist jurisprudence, the article incorporates a narrative reflecting on the integration of the common feminist themes in the context of the passage of the Maryland Health Care Decisions Act. The article concludes that gender does matter and that an understanding of feminist legal theory and practice will enrich the analysis of contemporary bioethical issues.     

Suffering, meaning, and bioethics.

Suffering evokes moral and metaphysical reflection, the bioethics of suffering concerns the proper ethos of living with suffering. Because empirical and philosophical explorations of suffering are imprisoned in the world of immanent experience, they cannot reach to a transcendent meaning. Even if religious and other narratives concerning the meaning of suffering have no transcendent import, they can have aesthetic and moral significance. This understanding of narratives of suffering and of their custodians has substantial ecumenical implications: chaplains can function as general custodians of narratives and sustainers of a generic religious meaning. This understanding is contrary to traditional Christianity, which discloses a transcendent significance of human suffering found in a very particular history involving particular persons: Christ as the second Adam through the submission of the second Eve has taken on our nature so that we can be united with God. Human suffering is tied to human sin, not simply as a punishment for sin, much less as an opportunity to discharge a supposed temporal punishment due to sin. Human suffering is the result of our rebellious free choices. It provides an opportunity for humility and submission, so that, united to the cross of Christ, sin can be forgiven and suffering set aside in the Resurrection. Knowledge of this framing context for all human suffering is accessible not through rational argument. It is a knowledge garnered through repentance, purification of the heart, illumination by God's grace, and unification with God. Christian bioethics is embedded in the narrative of suffering, which is part of the history of salvation and which encompasses and places all of medicine in its terms.     

Nanotechnologies, bioethics and human dignity

Nanoscale science, research, and technology present a complex set of circumstances. First of all, this field involves many different subjects, including biology, chemistry, physics, and environment sciences. Secondly, although scientists are working increasingly at a molecular level, nanotechnology is about much more than a reduction of scale. Indeed, nanoscience and Nanotechnologies offer an unprecedented ability to control and manipulate nature, offering hope for progress. Ethical perspectives vary considerably in this field, but commentators and researchers share a concern about a specific worrisome issue: the lack of appropriate ethical and legal principles and processes (associated with issues including health risks, human body manipulation, and private life violation), to guide nanotechnological R&D, commercialization, and final use. Some authors partially reject this concern by suggesting that Nanoscience and Nanotechnologies do not constitute an autonomous category, and that they are instead just the operative result of combining other traditional areas of study. However the nanotechnological debate brings up the semantic and content issues of bioethics and foments a contentious discussion emphasizing human dignity. Issues include enhancement versus therapeutic intervention, traceability versus privacy, and societal benefits versus risks. From these preliminary considerations, we will move on to discuss (I) the traditional, although still controversial, relationship between bioethics and human dignity, and (II) return to the subject of nanotechnology. We will discuss how today in Europe, although still indefinite, the principle of respect for human dignity is a welcomed contributor to "ethical vigilance" about the uncertain development of new nano-scale technologies. We will also note how U.S. strategy in this regard is simply lacking and appears only as a purely discursive "key issue in long term ".     

Spirituality,health care,and bioethics

This article explores the relationship of spirituality to health care and bioethics in terms of the need and efforts of people to make sense of their lives in the face of illness, injury, or impending death. Moving beyond earlier associations with specific religious traditions, spirituality has come to designate the way in which people can integrate their experiences with their sense of ultimate meaning and related values. The holistic model of health care also affirms that one should not simply treat a body in pain, but respond to the suffering of the whole person within his or her full life. A narrative emphasis in ethics also maintains that ethical decisions occur within the framework of interacting life-stories, each of which embodies a certain core vision and set of values. In each instance it is the life stories of people, their lived narratives, that provide a common thread. The telling of these stories and the discernment of the lived spirituality they contain may assist persons in the process of achieving understanding, making decisions, and finding purpose in the experience of illness, injury, or disability.Maureen Muldoon, Ph.D., is Associate Professor in the Department of Religious Studies, University of Windsor, Windsor, Ontario, and Norman King, Ph.D., is Professor in the same department.     

Widows, women, and the bioethics of care.

Widows, women, and the bioethics of care must be understood within an authentic Christian ontology of gender. Men are men and women are women, and their being is ontologically marked in difference. There is an ontology of gender with important implications for the role of women in the family and the Church. The Christian Church has traditionally recognized a role for widows, deaconesses, and female monastics, which is not that of the liturgical priesthood, but one with a special relationship to care and therefore with particular implications for health care and a Christian bioethics of care in the twenty-first century. In the shadow of early male mortality, women as wives should turn to support their husbands and as widows to support those in need. Widows, in becoming authentic Christian monastics, can bring into the world an icon of rightly ordered women providing rightly ordered Christian care for those in need. They can enter the moral vacuum created by misunderstandings of the place of women and the service vacuum created by a disappearance of religious nuns in Western health care facilities with a presence that is at one with the Church of the Fathers.     

Pragmatism,bioethics and the grand American social experiment

There is tension in bioethics between two strains of pragmatism. The most prominent strain, following John Dewey, proposes a content-rich ethos of controlled, collective moral inquiry. A second strain, descending from Charles Peirce and Josiah Royce, favors an open-ended approach where diverging moral communities evolve without extensive inter-communal oversight. This essay defends the second strain. The Deweyan approach, I argue, exhibits a problematic quasi-foundationalist character insofar as it canonizes a dubious constellation of "liberal" political values and seeks to establish these values by interposing a consensus of moral experts where genuine inter-communal dialogue, and compromise, would be more fruitful. I hold that the alternative approach of Peirce and Royce is preferable, and truer to the fundamental commitments of classical American pragmatism. Recognizing the epistemic fallibility of various content-rich moral-political formulations, Peirce and Royce hope to cultivate and sustain moral inquiry by allowing each moral community (1) to generate and test its own moral system (as long as it does so peaceably) and (2) to freely make or refuse to make collaborative arrangements with other moral communities. This approach is illustrated in a brief discussion of the Oregon Medical Experiment.     

Cognitive enhancement, human evolution and bioethics

The goal of this article are three-fold. The first is to explore the relations between the properties designated by the terms "human", "post-human," "Transhuman", and to clarify the corresponding "isms". The second is to scrutinize the current techniques for cognitive enhancement in order to assess their relations with the three categories just mentioned, and, with the specific ethical issues that they are raising. The third is to examine whether general ethical principles could be invoked either in favor of or against, the normative proposals of post- and trans-humanism, and to consider how compatible the types of enhancement presently developed are with respect to these principles.     

Death,medicine & bioethics

The assumptions of philosophy need scrutiny as much the assumptions of medicine do. Scrutiny shows that the philosophical method of bioethics is compromised, for it shares certain fundamental assumptions with medicine itself. To show this requires an unorthodox style of philosophy — a literary one. To show the compromised status of bioethics the paper discusses some seminal utilitarian discussions of the definition of death, of whether it is a bad thing, and of when it ought to occur.     

Baiting bioethics

Various criticisms of bioethics are reported and evaluated in an effort to determine what it is reasonable to expect of this rapidly developing field and what should be its future directions. Specific charges by Renée Fox, Judith Swazey, and William Bennett are explored. Fox and Swazey contend that bioethics champions individualism and pays little attention to social relationships, that bioethicists distance themselves from the human settings where ethical issues are experienced, and that bioethics pretends to a false validity. Bennett indicts bioethics on the grounds that it promotes ethical relativism and moral indifference. Gorovitz argues the case against these contentions but urges ethicists systematically to assess their critics' statements.     

Reflections on the interface of bioethics, public policy and science

This paper discusses the role of ethical considerations in the formulation of public policies aimed at shaping the scientific agenda. Specifically, new and controversial public policy issues will confront us in the twenty-first century as the result of developments on the frontiers of biomedical science. Some of the anxieties in the ethical arena generated by the rapid pace of these developments are likely to result in efforts to place constraints on the shape of the scientific agenda and the application of new knowledge. Our moral propositions, therefore, will be tested and re-tested in their application to evolving social, cultural, and historical circumstances and the ever-changing technological context.     

Post-Christian bioethics

Agreeing in large part with Cameron, Robert D. Orr nonetheless raises some questions. He points out the theological origins of bioethics in the 1960s, while admitting that the field has since become secularized. Autonomy's challenge to Hippocratic paternalism has brought real benefits but also abuses. Bioethics addresses more than procedural matters; it deals in issues of real substance.