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.

Recent developments in biotechnology and genetic research are raising complex ethical questions concerning the legitimate scope and limits of genetic intervention. As we begin to contemplate the possibility of intervening in the human genome to prevent diseases, we cannot help but feel that the human species might soon be able to take its biological evolution in its own hands. 'Playing God' is the metaphor commonly used for this self-transformation of the species, which, it seems, might soon be within our grasp. (...) In this important new book, Jurgen Habermas - the most influential philosopher and social thinker in Germany today - takes up the question of genetic engineering and its ethical implications and subjects it to careful philosophical scrutiny. His analysis is guided by the view that genetic manipulation is bound up with the identity and self-understanding of the species. We cannot rule out the possibility that knowledge of one's own hereditary factors may prove to be restrictive for the choice of an individual's way of life and may undermine the symmetrical relations between free and equal human beings. In the concluding chapter - which was delivered as a lecture on receiving the Peace Prize of the German Book Trade for 2001 - Habermas broadens the discussion to examine the tension between science and religion in the modern world, a tension which exploded, with such tragic violence, on September 11th. (shrink)

The author of this text argues that the methodological issues in bioethics mirrors the experience of moral pluralism in a secular society. The different methods that have been used in the field reflect the different moral views found in a pluralistic society.

The most widely debated conception of democracy in recent years is deliberative democracy--the idea that citizens or their representatives owe each other mutually acceptable reasons for the laws they enact. Two prominent voices in the ongoing discussion are Amy Gutmann and Dennis Thompson. In Why Deliberative Democracy?, they move the debate forward beyond their influential book, Democracy and Disagreement.What exactly is deliberative democracy? Why is it more defensible than its rivals? By offering clear answers to these timely questions, Gutmann and (...) Thompson illuminate the theory and practice of justifying public policies in contemporary democracies. They not only develop their theory of deliberative democracy in new directions but also apply it to new practical problems. They discuss bioethics, health care, truth commissions, educational policy, and decisions to declare war. In "What Deliberative Democracy Means," which opens this collection of essays, they provide the most accessible exposition of deliberative democracy to date. They show how deliberative democracy should play an important role even in the debates about military intervention abroad.Why Deliberative Democracy? contributes to our understanding of how democratic citizens and their representatives can make justifiable decisions for their society in the face of the fundamental disagreements that are inevitable in diverse societies. Gutmann and Thompson provide a balanced and fair-minded approach that will benefit anyone intent on giving reason and reciprocity a more prominent place in politics than power and special interests. (shrink)

American bioethics began in the late 1960s, stimulated by a plethora of new medical technologies and biological knowledge and by a scandal-induced interest in human subject research. Although it was understood that there would be ethical debate , no one thought the disputes would be ideological in character, as if part of one's voting pattern as liberal or conservative, Democrat or Republican. There were arguments, often sharp, but no culture wars.

Kevin Wm. Wildes, S.J.; Religion in Bioethics: A Rebirth, Christian bioethics: Non-Ecumenical Studies in Medical Morality, Volume 8, Issue 2, 1 January 2002, Pa.

How far may Americans properly rely on their religious beliefs when they make and defend political decisions? For example, are ordinary citizens or legislators doing something wrong when they consciously allow their decisions respecting abortion laws to be determined by their religious views? Despite its intense contemporary relevance, the full dimensions of this issue have until now not been thoroughly examined. Religious Convictions and Political Choice represents the first attempt to fill this gap. Beginning with an account of the basic (...) premises of our liberal democracy, Greenawalt moves to a comparison between rational secular grounds of decision and grounds based on religious convictions. He discusses particular issues such as animal rights and abortion, showing how religious convictions can bear on an individual's decisions about them, and inquires whether reliance on such convictions is compatible with liberal democratic premises. In conclusion, he argues that citizens cannot be expected to rely exclusively on rational, secular grounds. (shrink)

The author suggests that Christian participation in public policy deliberations about bioethical issues may be helped by structures which do not require the search for consensus (or, in particular, the kind of ‘overlapping consensus’ favoured by Rawlsians) on policy. This argument is made, first, by a general discussion of the place of religious visions within public discourse and, second, by an examination of the structure and some of the reports of the President’s Council on Bioethics (USA).

This chapter explores the view that religious claims have no legitimate place in the public forum. This exploration involves a critical re-examination of the public versus private distinction that would place religious commitments and grounds for action in a sphere isolated from that of public discourse and public choice. In the process, this chapter brings into question John Rawls's defense of a public discourse that seeks to marginalize religious commitments.

For at least two decades, the role of theology in public matters has been governed by what might be termed a “liberal consensus”. This consensus, shared by policymakers, theologians, philosophers, and the public, has two parts. First, that law and public policy need to be considered in terms of individual liberties and rights. Second, that the only appropriate “public” language in which to justify, qualify, and reconcile liberties and rights should be neutral, secular, and rational. The thesis of this chapter (...) is that such a framing of the issues is outmoded. To begin with, the “secular” sphere is not neutral, since all participants inevitably come from communities which have identity. Therefore, it is appropriate to use religious narratives and language, or those of any moral tradition, as long as they are not propounded dogmatically or in a way that undermines democratic process and participatory politics. (shrink)

Western society today is less unified by a set of core values than ever before. Undoubtedly, the concept of moral consensus is a difficult one in a liberal, democratic and pluralistic society. But it is imperative to avoid a rigid majoritarianism where sensitive personal values are at stake, as in bioethics. Bioethics has become an influential part of public and professional discussions of health care. It has helped frame issues of moral values and medicine as part of a more general (...) effort to find consensus about some of the most perplexing questions of our time. But why is it thought that a moral consensus is important or that it deserves respect? How does moral consensus acquire legitimacy in a society that includes diverse value systems? How is moral consensus possible and how do small groups help create or distort consensus processes? Written by a medical school professor trained in philosophy, this timely work tackles these questions from philosophical, historical, and social scientific standpoints. It begins by describing the traditional ambivalence about consensus in Western culture as well as the uncertain relationship in modernity between consensus and expertise. After outlining the current bioethical consensus, the book gives philosophical and political analyses of the idea of consensus, then assesses the role of consensus in national ethics commissions and in the ethics committee movement. Moreno constructs an original, naturalistic philosophy of moral consensus, referred to as "bioethical naturalism", and then applies sociology and social psychology to actual consensus processes. The book concludes with an account of bioethics as a consensus-oriented social reform movement. This insightful volume will be essential reading for bioethicists, philosophers, physicians, members of ethics committees, and all those concerned with ethical and social issues in health care. (shrink)

"Whole brain death" (neurological death) is well-established as a legal standard of death across the country. Recently, New Jersey became the first state to enact a statute recognizing a personal religious exemption (a conscience clause) protecting the rights of those who object to neurological death. The Act also mandates adoption through the regulatory process of uniform and up-to-date clinical criteria for determining neurological death.

In this article I explore the underlying political philosophy of public bioethics by comparing it to technocratic authority, particularly the technocratic authority claimed by economists in Mexico in the 1980s and 1990s. I find that public bioethics - at least in the dominant forms - is implicitly designed for and tries to use technocratic authority. I examine how this type of bioethics emerged and has continued. I finish by arguing that, as claims to technocratic authority go, bioethics is in an (...) incredibly weak position, which partly explains why it has never gained the degree of public legitimacy that other technocracies have gained. I conclude by arguing for a "technocracy-lite" orientation for public bioethics. (shrink)

A new political movement has arisen in bioethics, self‐consciously distingushed from the rest of the ield and characterized by a new way of writing and arguing. Unfortunately, that new method is mean‐spirited, mystical, and emotional. It claims insight into ultimate truth yet disavows reason.

In recent essays, Jürgen Habermas endorses an account of political liberalism much like John Rawls'. Like Rawls, he argues that laws and public policies should be justified only in neutral terms, i.e. in terms of reasons that people holding conflicting world-views could accept. Habermas also, much like Rawls, distinguishes reasonable religious citizens, whose views should be included in public discourse, from unreasonable citizens in his expectation that religious citizens self-modernize. But in sharing these Rawlsian features, Habermas is vulnerable to some (...) of the same objections posed to Rawls. In this article I assess Habermas' ability to overcome two objections frequently posed to Rawls: (1) that religious citizens are unfairly expected to split their identities in public discourse, and (2) that the burdens of citizenship are asymmetrically distributed. I conclude that while he may be able to overcome the second, the first remains a problem for him. (shrink)

This chapter discusses the various meanings of the two critical ideas in this book and compares them. These critical ideas are “religion” and “public bioethics”. The chapter focuses most of all not on the different religious roles, but on what we think “public bioethics” is or should be.

This new series of books brings thoughtful, biblically informed perspectives to contemporary issues in bioethics.

In this paper I argue that Care theory has the resources to offer an insightful and original theoretical perspective on issues in medical ethics. The paper begins with a discussion of the sort of theory Care is, and argues that it closely resembles virtue theory. After a discussion of cammon features of Care theories, I respond to a few of the criticisme that have been levied against the theory. The final section of the paper is a discussion of the question (...) of neutrality in public moral discourse. Care theory is not a neutral theory with regard to questions of the nature of the good life for humans, but I argue that this should not preclude Care from playing a part in the public debate over policy decisions. (shrink)