Between morality and repentance: recapturing "sin" for bioethics.

Distinguishing within "sin" the dimensions of anomia, hamartia, and asthenia makes it possible to analyze in greater detail the contrary manners in which traditional and post-traditional Christianities in this issue of Christian Bioethics endeavor to recapture what was lost when secular bioethics reconstructed the specifically spiritual-context-oriented normative commitments of Christianity in one-dimensionally moral terms. Various post-traditional attempts at securing moral orientation and resources for forgiveness, both of which secular bioethics finds increasingly difficult to provide, are critically reviewed. Their engagement of secular moral concepts and concerns, and even their adoption of an academically philosophical posture and language, is presented as responsible for their failure to adequately preserve what in traditional Christianity would count as prohibited vs. permitted, and advisable vs. non-advisable, or what would allow to resolve "tragic conflicts." The deeper reason for this failure lies in post-traditional Christianity's restricting the Christian life (with its central tension between love and the law) to what can be captured by cognitive categories. As the survey of several traditionally Christian accounts of sin in bioethics makes clear, both moral orientation (along with the resolution of "tragic" conflicts) and the sources of forgiveness are available, once that Christian life is framed in terms of persons' spirit-supported practical involvement in ascesis and liturgy, and once bioethical reflections are situated in the experiential context of such involvement.     

Disability as a test of justice in a globalising world

This paper shows how most modern theories of justice could require or at least condone international aid aimed at alleviating the ill effects of disability. Seen from the general viewpoint of liberal egalitarianism, this is moderately encouraging, since according to the creed people in bad positions should be aided, and disability tends to put people in such positions. The actual responses of many theories, including John Rawls's famous view of justice, remain, however, unclear. Communitarian, liberal egalitarian, and luck egalitarian thinkers alike have to consider their attitude towards cosmopolitan ideals before they can extend their theories across national borders. The only view of justice that automatically rejects the obligation of international aid based on disability is libertarianism. This is significant for two reasons. Libertarianism is arguably the economic doctrine of globalisation; and its moral appeal to voluntary charity draws attention to the foundations of voluntary corporate social responsibility. Is the latter a prompt for greater or lesser social and political responsibility in global matters?     

Accounting for context: Future directions in bioethics theory and research

Many physicians have found that the traditional approach to bioethics fails to account for important aspects of their moral experience in practice. New approaches to bioethics theory are challenging the traditional application of universal moral principles based in liberal moral theory. At the same time, a shift in both the goals and methods of bioethics education has accompanied its “coming of age” in the medical school curriculum. Taken together, these changes challenge both bioethics educators and theorists to come closer to the details and nuances of real clinical encounters. The emerging trend emphasizes the importance of context in bioethics education and in the moral theory and research under-girding it. This article introduces one research approach examining the practical life contexts of medical students' ethical experiences and learning. It calls for increased attention to research and theory in bioethics that more adequately accounts for the ways different contexts produce significant changes in meaning and understanding in medical encounters.     

THE CONFLICTING LOYALTIES OF STATISM AND GLOBALISM: CAN GLOBAL DEMOCRACY RESOLVE THE LIBERAL CONUNDRUM?

Abstract: The cosmopolitan ideal of liberal universalism seems to be at odds with liberalism's insistence on national borders for liberal democratic communities, creating disparate standards of distributive justice for insiders and outsiders. The liberal's dilemma on the question of cosmopolitan justice would seem to be an extension of this broader conundrum of conflicting loyalties of statism and globalism. The challenge for liberalism, then, seems to be to show how the practices of exclusive membership embody the principle of moral equality. While discerning a variety of liberal reasons to give some scope to the claim that statism and globalism need not be an irreconcilable dilemma within liberalism, the essay argues that these reasons fail to provide a satisfactory resolution. Instead, the essay points out, global democracy can be the direction for both a statist and a cosmopolitan liberal, and the two camps a case not of conflicting loyalties but of multiple loyalties.     

Toward a liberal socialist cosmopolitan nationalism

I explicate and defend a form of liberal socialist nationalism. It is also a nationalism which is cosmopolitan. Explication and explanation are crucially in order here, for it is not unreasonable to believe that ‘cosmopolitan nationalism’ and ‘liberal socialist nationalism’ and even ‘liberal nationalism’ are oxymoronic. Against that I argue that there is a straightforward understanding of these concepts and their relations to each other that does not have inconsistencies or even paradoxes. Liberal socialism properly understood goes well with cosmopolitanism (both moral and institutional), and there are plausible and attractive forms of both liberalism and socialism that go together. Moreover, the only candidate for a nationalism that would survive careful reflective inquiry is a liberal nationalism: a nationalism which is neither ethnic nor civic. It is widely believed, however, that even a liberal nationalism is incompatible with cosmopolitanism. I contend in a series of arguments that in contexts where nationalism is rightly on the agenda the form that it should take is that of a liberal nationalism, and it is further argued that to be viable, nationalism requires cosmopolitanism.     

Whose tradition? Which Enlightenment? What content? Engelhardt, Hauerwas, Capaldo, and the future of Christian bioethics.

The development of a content-full Christian bioethics requires an analysis of the particular contents and traditions which different Christians bring to morality. For Hauerwas, the content of Christian ethics is the speech and practices of the community. For Engelhardt, only a content-full tradition, such as the Orthodox tradition, will be able to arrive at closure on the moral issues presented by the contemporary practice of medicine. Capaldi calls, in contrast, for a Kantian society of autonomous self-legislators whose responsible freedom is grounded in a cosmic order that must be explicated and retrieved in particular practices. The manner in which we view our own traditions and the shortcomings of modernity determine the content that Christianity brings to bioethics.     

Christian Bioethics in a Western Europe after Christendom

Europe has taken on a new, post-Christian, if not a somewhatanti-Christian character. The tension between Western Europe'sever more secular present and its substantial Christian pastlies at the heart of Western Europe's current struggle to articulatea coherent cultural and moral identity. The result is that WesternEuropean mainline churches are themselves in the midst of anidentity crisis, thus compounding Western Europe's identitycrisis. Christian bioethics in Europe exists against the backdropof these profound cultural cross currents that define the Europeancondition, engender conflicts regarding the meaning of beingWestern European and being Christian, and bring the public significanceand role of Western European bioethics, especially Western EuropeanChristian bioethics, into question. The dominant culture ofthe public forum is post-Christian and post-traditional, althoughtraditional Christianity still asserts its voice. Denis Müllerin his paper has clarified the choice between a traditional-fundamentalistChristian Bioethics and a revisionist, progressive ChristianBioethics.     

The indeterminacy failures of moral cosmopolitanism and liberal nationalism

Much of the discussion on cosmopolitanism and nationalism has focused on their different normative views. The purpose of this article is to shift the attention away from the normative debate to the metatheoretical argument about how we determine moral and political principles independently of each other. I argue that the discussion among proponents of cosmopolitanism and contextualist models boils down to latent methodological and metatheoretical assumptions about what selection of facts are considered politically relevant. In the article, I explore what I call ‘the indeterminacy failure’ of moral cosmopolitanism, that is, the view according to which moral principles fail to determine what political-institutional level might be preferable; and the ‘indeterminacy failure’ of liberal nationalism, that is, the view according to which national identity fails to determine moral principles. In opposition to dichotomist cosmopolitan models (including various nonideal types of moral cosmopolitanism) and alternative contextualist approaches (including the practice-dependence thesis and liberal nationalism), I promote a ‘split-level’ model that is set to avoid the difficulties in the other approaches. The split-level corrects the indeterminacy failures of cosmopolitanism and contextualism by distinguishing clearly between the level of moral theorising and the level of political theorising.     

Bioethics in a liberal society--political, not moral

This paper argues for the importance of the political context of a society for bioethics. In particular, I argue that in a liberal constitutional society, such as the one we find ourselves in, no particular moral perspective is granted a privileged position. Rather, individuals are allowed to live their lives according to values they adopt for themselves, and the rights granted to protect this ability "trump" social consensus, and place boundaries on the social application of personal moral beliefs and values.     

SAINTLY SACRIFICE: THE TRADITIONAL TRANSMISSION OF MORAL ELEVATION

Abstract This paper combines the social psychology concept of moral elevation with the evolutionary concept of traditions as descendant‐leaving strategies to produce a new explanation of the role of saints in Christianity. Moral elevation refers to the ability of prosocial acts to inspire people to engage in their own acts of charity and kindness. When morally elevating stories and visual depictions become traditional by being passed from one generation to the next, they can produce prosocial behavior advantageous to survival and reproduction among many generations of descendants. Traditions that increase the number of descendants in future generations can be seen as descendant‐leaving strategies. Stories and visual depictions of the sacrifices of saints appear to be designed to produce states of moral elevation, and they have been transmitted from one generation to the next for many centuries. We propose that this ability of sacrificing saints to inspire future generations to engage in prosocial acts has contributed to the continuation and spread of Christianity.     

Just Annexation

Fabre defends a human rights‐focused cosmopolitan theory of peace. One would expect that, given this view, she would be in favour of human rights‐promoting annexations by liberal states. However, she distances herself from this view, adopting the common‐sense view that annexing states ‘act ultra vires’. I argue that her core cosmopolitan view motivates a different and, in principle, much more positive view of four types of annexations. In the course of defending this view, I take a critical look at her appeal to perverse moral incentives and the notion of a cosmopolitan ethos.     

European values in bioethics: why,what, and how to be used?

Are there distinctly European values in bioethics, and if there are, what are they? Some Continental philosophers have argued that the principles of dignity, precaution, and solidarity reflect the European ethos better than the liberal concepts of autonomy, harm, and justice. These principles, so the argument goes, elevate prudence over hedonism, communality over individualism, and moral sense over pragmatism. Contrary to what their proponents often believe, however, dignity, precaution, and solidarity can be interpreted in many ways, and it is not clear which reading would, or should, be favored by popular opinion. It is therefore dangerous to think that any one understanding of "European", or any other, values could be legitimately imposed on those who have different ideas about morality in health care and related fields. Bioethical principles should be employed to promote discussion, not to suppress it.     

Liberal Nationalism and Cosmopolitan Justice

Many liberals have argued that a cosmopolitan perspective on global justice follows from the basic liberal principles of justice. Yet, increasingly, it is also said that intrinsic to liberalism is a doctrine of nationalism. This raises a potential problem for the liberal defense of cosmopolitan justice as it is commonly believed that nationalism and cosmopolitanism are conflicting ideals. If this is correct, there appears to be a serious tension within liberal philosophy itself, between its cosmopolitan aspiration on the one hand, and its nationalist agenda on the other. I argue, however, that this alleged conflict between liberal nationalism and cosmopolitan liberalism disappears once we get clear on the scope and goals of cosmopolitan justice and the parameters of liberal nationalism. Liberal nationalism and cosmopolitan global justice, properly understood, are mutually compatible ideals.     

Sources of Kant’s Cosmopolitanism: Basedow,Rousseau, and Cosmopolitan Education

The goal of this essay is to analyse the influence of Johann Bernhard Basedow and Rousseau on Kant’s cosmopolitanism and concept of cosmopolitan education. It argues that both Basedow and Kant defined cosmopolitan education as non-denominational moral formation or Bildung, encompassing—in different forms—a thin version of moral religion following the core tenets of Christianity. Kant’s encounter with Basedow and the Philanthropinum in Dessau helps to understand the development of Kant’s concept of cosmopolitanism and educational theory ‘in weltbürgerlicher Absicht’. Rousseau’s role is more complex: he clearly influenced Kant; he is usually considered a precursor of modern nationalism and national education; and recent studies have stressed the cosmopolitan dimension of his educational programme. I claim that the dilemma of education according to Rousseau is that one has to choose between education of homme or education of citoyen, and that there is no way to avoid or go beyond this stark alternative. Kant’s reinterpretation of Rousseau is favourable and creative and has found many followers up to the present, but is misleading, as he ignores the dilemma and imposes his own conception of cosmopolitanism, of cosmopolitan education and of (possible) progress in history on Rousseau while claiming that this was actually Rousseau’s message.     

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.     

From species ethics to social concerns: Habermas’s critique of “liberal eugenics” evaluated

Three arguments of Habermas against “liberal eugenics”—the arguments from consent, responsibility, and instrumentalization—are critically evaluated and explicated in the light of his discourse ethics and social theory. It is argued that these arguments move partly at a too deep level and are in part too individualistic and psychological to sufficiently counter the liberal position that he sets out to criticize. This is also due to limitations that prevent discourse ethics from connecting effectively to the moral and political domains, e.g., through a discussion of justice. In spite of these weaknesses, Habermas’s thesis is of major relevance and brings up neglected issues in the discussion about eugenic reproductive practices. This relevance has not been duly recognized in bioethics, largely because of the depth of his speculations of philosophical anthropology. It is argued that Habermas’s notion of the colonization of the lifeworld could provide the analytical tool needed to build that bridge to the moral and political domain.     

Universalism, particularism and the ethics of dignity.

This paper explores the problem of universalism and particularism in contemporary ethics, and its relationship to Christian bioethics in particular. An ethic of human dignity is outlined, which, it is argued, constrains moral discourse in the broad sense--thus meeting the demands of universalism--but which is at the same time amenable to a variety of particularist interpretations--thus acknowledging the current shift toward historicism, traditionalism, and culture. The particularist interpretations that are of central concern here are those provided by historic Christianity. The eventual goal is to indicate how a Christian conception of human dignity can have universal normative relevance both as a standard against which to assess competing particularist conceptions, and as a practical guide for everyday living. A Christian conception of dignity will in turn have significant implications when addressing contemporary issues in bioethics. These are ambitious goals, and a full explication of the ideas presented will not be possible in this context. Nevertheless, there is value in getting a bird's-eye view of the landscape before one goes about scaling the mountains and exploring the valleys. The present essay is intended as a general geography of the moral terrain in which an ethic of dignity in general, and a Christian perspective on dignity in particular, can provide normative guidance.     

Can public virtues be global?

ABSTRACT

An important issue within the field of global ethics is the extent or scope of moral obligation or duties. Cosmopolitanism argues that we have duties to all human beings by virtue of some common property. Communitarian ethics argue that one's scope of obligation is circumscribed by one's community or some other defining property. Public virtues, understood to be either a property that communities possess to function well or a moral excellence constitutive of that community, offer an interesting challenge to this binary by positing moral goods or excellences that are constitutive of a community yet global in application. Virtues such as tolerance, charity, moderation, or benevolence might be examples of such goods or excellences endorsed by a community but applied to individuals who are not members of the community, or, as in the case of environmental ethics, even to entities that are not moral agents. Unlike cosmopolitan ethics, the scope of the obligation does not depend on identifying universal properties, such as rationality, human dignity, or utility, but could be defined entirely by and within a community.     

Towards a Christian bioethics.

Rather than revealing itself as a single, unified, ecumenical faith, Christianity is sundered with Christians united neither in one communion nor in one baptism. Christian Bioethics seeks to examine the traditional content-full moral commitments which the Christian faiths bring to life, sexuality, suffering, illness and death within the contexts of medicine and health care. Seeking to understand the differences which separate the bioethics of Roman Catholics, Protestants, and the Orthodox, Christian Bioethics explores the manners in which the faiths diverge. The failure of the Enlightenment project to disclose a content-full communality that would bind mankind has left much to be reconsidered by Christians who face new ethical dilemmas in the novel guise of advances in health care technologies.     

Moral philosophy and theology: why is there so little difference for Roman Catholics?

The cardinal question in Christian moral theory and bioethics is whether the knowledge that Christians have (1) by grace and (2) by revelation (e.g., regarding the character of human and cosmic history as reaching from creation through the Incarnation and the Redemption to the Second Coming and the restoration of all things) makes a crucial contribution to understanding morality, as for example issues such as the good death and the morality of physician-assisted suicide and euthanasia. This article argues that such a contribution is made by grace and revelation. The reduction of Roman Catholic moral theology and bioethics to secular bioethics is explored, as well as the necessity of the unique knowledge possessed by Christians for adequate end-of-life decision-making.