Perspectives in Biology and Medicine

BIOETHICAL ESSENTIAUSM AND SCIENTIFIC POPULATION THINKING COLLEEN D. CLEMENTS* Introduction In the history of biological thinking, a workable understanding of what should be meant by "species" was retarded by the philosophic construct of essentialism [I]. Mayr defines essentialism as a Platonic "emphasis on discontinuity, constancy, and typical values ('typology')," with the variable world of phenomena being "nothing but the reflection of a limited number of fixed and unchanging forms" (eide or essences) [1, p. 38]. It was ndt until biologists began to look at individuals as populations rather than as embodiments of essences that Darwin's theory of evolution became the unifying synthesis for scientific questions in biology. This paper draws an analogy between that conceptual breakthrough in the life sciences and the current problems with medicai ethics thinking and its application in medicine. The basic frame ofcontemporary philosophic ethical theories specifically requires universalizabiliiy [2-5]· This requirement, which by definition eliminates situational ethics or actual case-grounded ethics, is an ethical essentialism. Such an essentialism cannot be properly applied to the life sciences, or to medicine in particular, because these sciences are conceptually based ort populations of individuals or events and not on classes of essences. Even the use of casuistry cannot correct this difficulty, since casuistic thinking starts from universal principles and fits the cases to the principles; covertly reinterprets or translates such principles without seeming to reject them, as in killing by "just" warfare; or pays lip service to principles but is a technique for converting to situational ethics. The patient, in medical science, is really an individual person, both medically and ethically, but philosophic ethics The author acknowledges, conversations and correspondence with Derek Freeman, Roger Sider, Norman Pointer, Ernst Mayr, E. O. Wilson, and Joseph Fletcher. ?Assistant professor of psychiatry, University of Rochester Medical Center, 300 Crittenden Boulevard, Rochester, New York 14642.© 1985 by The University of Chicago. AU rights reserved. 003 1-5982/85/2802-043 1$0 1 .00 188 I Colleen D. Clements ¦ Bioethical Essentialism is not based on empirical populations and reduces individuals morally to units of a universal class. Constructing the Analogy There are two tasks to be done in order to establish the analogy between biological essentialism and ethical essentialism and in order to draw the implication that a new ethical thinking is required in order to do medical bioethics. First, we need to describe historical biological essentialism and discuss its inability to adequately handle the actual data of the biologists. We then need to compare this with the philosophic requirement that an ethical principle by definition must be universalized to all members of the particular class under consideration (events, persons, cases). We next need to contrast this with the more fruitful conceptual approach of population and stochastic thinking and to argue that such a situational approach will also be more fruitful for medicine and medical bioethics. But second, we need to "biologize" ethics, in the best sense of that term. We need to show that the essentialist thinking of contemporary philosophic ethics is not historically the only alternative. We need to show that defining ethics as strictly essentialist is arbitrary and that other definitions are more suitable pragmatically. Finally, we need to identify the unjustified assumptions in the humanities, and in philosophy in particular, that créate such an epistemological dualism between ethical ways of knowing and biological ways of knowing. This is a complex research program, an ongoing one not to be completed in one paper. But we can certainly sketch the argument outline here and refer to the body of our work so far [6-14]. The Biological Species and the Ethical Action Guide As Ernst Mayr argues, it was really the species problem that led to the rejection of essentialism and the adoption of the population concept, and we can equally argue that it is the problem of ethical action guide and the questions it raises which should lead to the rejection ofessentialism and the adoption of the population concept in medical ethics. The essentialist concept in biology required four features: a species is made up of similar units sharing in the same exact essence, each species is absolutely divided from any other, each is unchanging...