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On the anthropological foundation of bioethics: a critique of the work of J.-F. Malherbe

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Abstract

In this article, I critically analyze the anthropological foundation of the bioethics of philosopher Jean-François Malherbe, particularly as presented in his book, Pour une Éthique de la Médecine. Malherbe argues that such practices as organ donation and transplants, assisted reproduction, resuscitation, and other uses of biotechnologies in contemporary medicine are unethical because they go against essential human nature. Furthermore, he uses this position as a basis to prescribe public policy and institutional practice. In contrast, I argue not only that ‘human nature’ is much more malleable and adaptive to changes in technology and society than Malherbe allows, but also that his criticisms of medicine and technoscientific development overstep the bounds of the social function of philosophical ethics, which is to inform and clarify public debate. Public policy and institutional practice is thus best left to the democratic political process under the parameters of the just rule of law.

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Notes

  1. Despite his numerous interventions on the international scene, including, notably, his service on the Executive Board of the European Directory of Bioethics [18], it is difficult to identify one policy, national or international, that directly cites his theory of medical ethics. But this absence of significant references seems to indicate the difference in bioethics approaches between North America and Europe, as opposed to a lack of his influence. About this, there is much to say. However, I cannot discuss it here as it would digress from the subject of this article. On a separate note, all quotations of Malherbe in this article are my translations from the original French.

  2. Jonas asserts: “All this holds on the assumption made here that we live in an apocalyptic situation, that is, under the threat of universal catastrophe if we let things take their present course” [24, p. 10].

  3. Habermas points out: “The provocation inherent in the advances of genetic engineering that have already been realized or are realistically to be expected does as yet not go that far” [31, p. 42].

  4. Malherbe’s criticism is similar to the scepticism raised by Animal Alliance of Canada about interspecies transplant (xenograft): “The pig receives human genes. The human receives pig organs. Where does the pig end and the human begin? How much DNA does it take before one becomes the other? The answer to these questions, once ridiculous and offensive, may now just be a matter of degree” [32].

  5. On the controversies relative to genetic manipulations, read also [33–41].

  6. See [42–44] for other recent and opposing viewpoints.

  7. See also [58–70].

  8. “Physical necessity is a heteronomy of the efficient causes, for every effect is possible only according to this law, that something else determines the efficient cause to exert its causality. What else then can freedom of the will be but autonomy, that is, the property of the will to be a law to itself?” [25]. See also, “Heteronomy of the Will as the Source of All Spurious Principles of Morality” in Ibid.

  9. Which, Rousseau states in Social Contract, Or Principles of Political Right, must consist of all people who represent the general will.

  10. See an opposite position in [71, 72].

  11. According to Aristotle “the end of the medical art is health” [73, bk. 1].

  12. Malherbe himself italicizes this phrase. Everything takes place as if we have to replace, henceforth, our supreme and constitutional courts with teams of doctors.

  13. For a useful brief introduction to this tradition, see any of the editions (1968, 1973, 1978, 1981, 1987, 1996, and 2002) of Rubington and Weinberg [82].

  14. This concept comes up a number of times in Malherbe arguments without being specified.

  15. I get the impression that the doctor has to choose between his or her own knowledge and clinical experience on the one hand, and, on the other hand, the principles abstracted from metaphysics.

  16. This is my example.

  17. In the following statement, Malherbe seems to view his work as having direct implications for medical practice and public policy: “To propose to doctors conceptual tools developed by common accord and adapted to the exercise of their ethical responsibilities, such is the contribution which the philosopher hopes to bring to medicine” [1, p. 157].

  18. It is as if the individual is dispossessed of his autonomous consciousness in favor of the judgments of the expert in bioethics.

  19. Habermas has clearly seen this function: “Thanks to its multilingual character, if philosophy simply keeps the basic concepts clear it can uncover a surprising degree of coherence at a metalevel” [90, p. XXXIX].

  20. In this regard, Luc Ferry notes: “Wise men's committees and authorities which we shall want, so pluralistic as well require the most scrupulous democracy, their decisions to authorize (or to forbid) the abortive pill, the experiment on the embryo, where the increase of Zygote Intrafallopian Transfer (ZIFT) will be inevitably more just” [38, p. 47].

  21. See also [31, p. 73; 52].

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Acknowledgments

I would like to thank Lukas Sosoe for his helpful suggestions with regard to the content of this paper. I would also like to thank Michael Petrunik and Lizanne Avon for assisting this author, whose first language is French, in the editing of several drafts.

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    Henri Mbulu

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Mbulu, H. On the anthropological foundation of bioethics: a critique of the work of J.-F. Malherbe. Theor Med Bioeth 34, 409–431 (2013). https://doi.org/10.1007/s11017-013-9267-z

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