Volume 52 No. 3 (Autumn 1985)
Arien Mack, Editor
Arthur L. Caplan, Guest Editor
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BIOETHICS
Volume 52 No. 3 (Autumn 1985) Arien Mack, Editor Arthur L. Caplan, Guest Editor |
Table of Contents Notes on Contributors Ordering information
As both Mary Midgley and Daniel Callahan observe in their contributions to this special issue, philosophy in particular and, to some extent, the humanities in general have, during the past two decades, emerged from their comfortable perch in the ivory tower of academia to try to make a contribution to the worlds of practical and policy affairs. Sociologists and other students of intellectual history have not devoted much attention to the appearance of what is sometimes termed the applied humanities, so it is difficult to say with certainty whether philosophy and other cognate areas within the social sciences and law have come out voluntarily or have emerged kicking and screaming in protest. Whichever is the case, the time seems ripe for an examination of both the appropriateness of applied work in philosophy and an analysis of the substantive contribution philosophers, theologians, and humanistically minded social scientists and lawyers have made to the resolution of practical problems.
The subject area which has attracted the interest of the greatest number of philosophers and others interested in the application of philosophical methods and skills to public affairs and policy is what has come to be known as bioethics. The moral and policy dilemmas of health care have occasioned a voluminous literature devoted to the analysis of problems in clinical practice and health policy. Philosophers suddenly find themselves working in hospitals, serving on state and federal commissions, and teaching courses in schools of medicine, nursing, and social work.
In its formative stages bioethics was consumed with the need to address itself to the moral challenges posed by advances in medical technology. During the late 1960s and early 1970s most of the philosophers who wrote on bioethics restricted themselves to such relatively narrow topics as the moral acceptability of organ procurement from cadavers, the definition of death, the moral principles that ought to be used to guide the allocation of scarce and expensive medical therapies such as kidney dialysis, and the ethical legitimacy of such practices as cloning and psychosurgery.
Today the field of bioethics has grown (and I believe matured) to encompass many more topics and issues. Philosophers, theologians, and lawyers now grapple with the examination of concepts which play a foundational or teleological role in health care. The essays by Gerald Dworkin on the meaning of acceptability of "design" in modifying behavior and by John Robertson on the concept of "competency" are illustrative of this sort of analysis.
Others working on issues in bioethics find themselves raising basic questions about the social policies that ought to prevail at local, state, and even international levels in guiding and directing the course and pace of medical research and therapy. The pieces by Thomas Murray, Hans Jonas, Ruth Macklin, and Dorothy Nelkin are examples of the ways in which the domain of bioethics has expanded to include not only issues pertaining to the initiation and termination of therapeutic technologies in clinical settings but also questions arising as a result of advances at the frontiers of biomedical research, of the enormous costs involved in attempting to provide access to all forms of health care in a fair and equitable manner, and of the cultural power and sovereignty which medicine has attained in the Western world.
This is not to say that bioethics is a field that is no longer concerned with practical problems arising in the course of the everyday practice of medicine. The essays by Helga Kuhse and Peter Singer and by Ronald Bayer examine the norms and values that ought to guide health-care professionals as they attempt to grapple with newly emerging health-care problems such as those posed by the ability to intervene to try to extend the lives of premature and handicapped newborns and the inability to reverse the terrible course of the newest nightmarish contagion to confront medicine--AIDS.
Midgley and Callahan believe that the descent from the ivory tower has been worthwhile. While they offer a number of cautionary recommendations about the ways in which ethical theory should and should not be applied in the service of practical and policy matters in health care, they each arrive at the conclusion that philosophy is much better off as a discipline as a result of its interactions with the tumultuous world of health affairs.
It has become popular in intellectual circles these days to observe that ethics has enjoyed something of a renaissance both within academia and within modern society. If that is true, it is probably, in part, a result of the contribution that those concerned with moral issues have made to academic, professional, and public discourse through their work in bioethics. Whether the benefits have been worth the intellectual effort, and whether the fruits of philosophical labor have clarified or merely muddled moral thinking in and about biomedicine, are questions to the reader will be in a much better position to reflect upon armed with the insights and reflections contained in this special issue of Social Research.
Arthur L. Caplan
Guest Editor
Table of Contents
Notes on Contributors
(at time of publication)
Ronald Bayer Associate for Policy Studies at The Hastings Center, is the author of Homosexuality and American Psychiatry (1981).
Daniel Callahan a cofounder and Director of The Hastings Center, is the author of The Tyranny of Survival (1973).
Arthur L. Caplan is Associate Director of The Hastings Center. He edited, most recently, Which Babies Shall Live? (1985).
Gerald Dworkin is Professor and Chairman of the Philosophy Department at the University of Illinois at Chicago.
Hans Jonas is Alvin Johnson Professor Emeritus of Philosophy in the Graduate Faculty of the New School for Social Research.
Helga Kuhse is Research Fellow at the Center for Human Bioethics at Monash University, Victoria, Australia. She is coauthor, with Peter Singer, of Should the Baby Live? (1985).
Ruth Macklin is Professor of Bioethics in the Department of Epidemiology and Social Medicine at the Albert Einstein College of Medicine in New York City. She wrote Man, Mind, and Morality (1982).
Mary Midgley was Senior Lecturer in Philosophy at the University of Newcastle on Tyne. Her most recent book is Wickedness (1984).
Thomas H. Murray is Associate Professor in the Institute for the Medical Humanities at the University of Texas Medical Branch--Galveston.
Dorothy Nelkin is Professor in the Department of Sociology and the Program on Science, Technology, and Society at Cornell University. Her most recent book is Science as Intellectual Property (1983).
John A. Robertson is Professor in the School of Law at the University of Texas, Austin. He wrote The Rights of the Critically Ill (1983).
Peter Singer is Director of the Center for Human Bioethics at Monash University, Victoria, Australia. With Deane Wells he wrote Making Babies (1985).
