This review essay examines H. Tristram Engelhardt, Jr.'s The Foundations of Bioethics, a contemporary nonfeminist text in mainstream biomedical ethics. It focuses upon a central concept, Engelhardt's idea of the moral community and argues that the most serious problem in the book is its failure to take account of the political and social structures of moral communities, structures which deeply affect issues in biomedical ethics.
The distinction between clinical research and clinical practice directs how we partition medicine and biomedical science. Reasons for a sharp distinction date historically to the work of the National Commission for the Protection of Human Subjects of Biomedical and Behavioral Research, especially to its analysis of the “boundaries” between research and practice in the Belmont Report (1978). Belmont presents a segregation model of the research-practice distinction, according to which research and practice form conceptually exclusive sets of activities and interventions. This (...) model is still the standard in federal regulations today. However, the Commission’s deliberations and conclusions about the boundaries are more complicated, nuanced, and instructive than has generally been appreciated. The National Commission did not conclude that practice needs no oversight comparable to the regulation of research. It debated the matter and inclined to the view that the oversight of practice needed to be upgraded, though the Commission stopped short of proposing new regulations for its oversight, largely for prudential political reasons. (shrink)
This review essay examines H. Tristram Engelhardt, Jr.'s The Foundations of Bioethics, a contemporary nonfeminist text in mainstream biomedical ethics. it fo-cuses upon a central concept, Engelhardt's idea of the moral community and argues that the most serious problem in the book is its failure to take account of the political and social structures of moral communities, structures which deeply affect issues in biomedical ethics.
In this essay, I proceed by, first, laying out H. Tristram Engelhardt's argument for the principle of permission as the proper foundation for a secular bioethic. After considering how a number of commentators have tried to undermine this argument, I show why it is immune to some of these advances. I then offer my own critique of Engelhardt's project. This critique is two pronged. First, I argue that Engelhardt is unable to establish his own foundation for a secular bioethic. This (...) inability leaves him with only contingent points of departure for a secular bioethic, some of the more salient of which he has ignored. Second, I argue that even if Engelhardt's project succeeds, it is in danger of being irrelevant in a practical sense because it ignores important contextual dimensions of the peculiar enterprise we call bioethics. Ultimately, the proper foundations for a relevant secular bioethic, I argue, must appeal to certain contingent features of the context that gives rise to the need for it. (shrink)
The article discusses the relationship of the axiological foundations of modern bioethics with casual and even incidental effects of the activity of scholars in the late Middle Ages and the Renaissance. The author examine the ability of humanists to influence the formation of values system as well as the possibility of instrumentalizing these values in social practices. The study determines the entire causal complex that led to the formation of a special tradition of non-religious substantiation of values associated (...) with the teaching and study of ancient languages in the context of the functioning of political and legal institutions and cultural and historical traditions of European states. The author considers the origins and meaning of humanism and the gradual change of its content as well as the transformation of humanistic experience into a tool of constructing ideals and values and an element of social technology. A special place is given to the analysis of attempts to form meta-ethics and bioethics within the framework of the value system of post-Soviet Russian society and the role of humanistic ideas in this process. On the example of the development of modern European philosophical thought, the controversial and problematic nature of various interpretations of humanism is shown, and the thesis of the historical conditionality of the ideals of humanism and its connection with some certain paradigms of metaphysic is confirmed. The central theme of the article is the problem of the relationship between the historical and conceptual, conditional and unconditional, contextual and universal in the heritage of the late medieval humanism. Technologization paths and contexts for the interpretation of humanistic ideas in modern Russia are outlined. The paper determines the ways of harmonization of humanitarian values and the system of their social and legal legitimation. On the example of the educational policy of higher education in recent decades, achievements and failures in the process of forming a new value system are analyzed. This value system could be used as a basis for legislative practice and state policy that would allow determining the basis of modern bioethics, which is of great importance for the development of Russian society and further improvement of the moral and legal foundations of its existence. (shrink)
Much recent work on the ethics of new biomedical technologies is committed to hidden, contestable views about the nature of biological reality. This selection of essays by Tim Lewens explores and scrutinises these biological foundations, and includes work on human enhancement, synthetic biology, and justice in healthcare decision-making.
The first fundamental English-language study in bioethics, this book gives a lucid analysis of, and powerfully argued resolutions to, conflicts of values that arise in medicine. It also provides salutary emphasis upon the obligations of health-care professionals to respect the moral autonomy of patients or their guardians. It is fundamental, however, because it does more: it is concerned with rationally choosing among competing orderings of goods and harms which are involved not only in the proper practice of medicine but (...) in any diversity of views about the good life. Engelhardt frames his concern in terms of universal grounds for ethically obligating rational agents within a peaceable community. In what follows, I largely prescind from issues of bioethics to attend to issues more congenial to the interests of this journal's readers. (shrink)
The United Nations Scientific, Education and Cultural Organisation (UNESCO) Universal Declaration on Bioethics and Human Rights (UDBHR) expresses in its title and substance a controversial linkage of two normative systems: international human rights law and bioethics. The UDBHR has the status of what is known as a ‘non-binding’ declaration under public international law. The UDBHR’s normative foundation within bioethics (and association, for example, with virtue-based or principlist bioethical theories) is more problematic. Nonetheless, the UDBHR contains socially important (...) principles of technology transfer and transnational benefit (articles 14, 15 and 21). This paper is one of the first to explore how the disciplines of bioethics and international human rights law may interact in the UDBHR to advance the policy relevance and health impact of technology transfer and transnational benefit principles. It investigates their normative ancestry in the UDBHR, as well as relevant conceptual differences between bioethics and public international law in this respect and how these may be relevant to their conceptual evolution and application. (shrink)
The book includes all 15 long forgotten articles on bioethics and ethics written by Jahr from 1927 to 1947 in English translation. (Series: Practical Ethics / Ethik in der Praxis - Studies / Studien - Vol. 37).