Bioethics Forum Essay

The Value of Bioethics Against Authoritarian Populism

Populism has been influencing public discourse and election outcomes in several countries recently. The degree to which populism has a sway on elections varies with the electoral system in each country but the impact is likely to be substantial regardless of electoral outcomes.

Reflecting on this phenomenon, Mildred Solomon and Bruce Jennings published an essay in the Hastings Center Report expressing concern about authoritarian populism and its implication for the field of bioethics. I agree with their concern. Here I will explain my agreement and weigh in on the comments they received in recent postings on Bioethics Forum by Frank Miller, Michelle Bayefsky, and Robert Baker.

The major criticism of their paper is that Solomon and Jennings have taken a problematic partisan turn, reflecting a liberal perspective, which represents a shift from The Hastings Center’s longstanding position as a bioethics center that serves a nonpartisan role.  In all three of their commentaries, Miller, Bayefksy, and Baker note that The Hastings Center has helped the field of bioethics carve out a space for ethical discussion that is removed from the political fray. Miller and Baker, in particular, argue that a shift from a nonpartisan, analytical stance to a more partisan, advocacy stance is unnecessary and risky for the field: unnecessary because the problems that Solomon and Jennings focus on lie beyond the health-focused terrain that bioethics ought to address, and risky because such a shift will alienate those who do not share a liberal-leaning perspective.

I would agree that the field of bioethics needs to be welcoming to individuals with a wide spectrum of philosophical and political points of view. However, I read Solomon and Jennings’ essay as fostering just such tolerance and inclusiveness. They say, for example, that bioethics can bring forward both conservative and progressive views of fairness, and that it should encourage a deeper conversation of values from all political persuasions.

In responding to the essay by Solomon and Jennings, commentators also argued that it is unwise to venture beyond the limits of what might be considered traditional bioethical topics because it may invite undue controversy. But the assumption that the field of bioethics, even narrowly defined, will be free of controversy is implausible. Bioethics is no freer of widely divergent points of view than the political arena is. Bioethicists disagree about when a human life starts, whether it is acceptable to conduct science on embryonic stem cells, how to define death, whether it is acceptable to take organs from someone before death, and so on. Thus sticking with what might be considered traditional bioethics topics will not serve to avoid controversy.

Furthermore there are reasons for bioethicists to pursue ethical analysis of issues that go beyond the boundaries of the biological and medical sciences. Health is a function of a wide range of factors that lie outside the confines of the biological sciences.  When addressing a broader array of factors that affect health and well being, bioethicists join the ranks of medical practitioners who have recognized that restriction of their expertise to a biomedical model of disease is not sufficient for successful health improvement as acknowledged in the shift toward a bio-psycho-social model of illness. Similarly experts in public health have recognized the need to address the social determinants of health such as income, housing, education, and the quality of one’s neighborhood to effectively reduce health disparities.

In addition to sharing their view about the broad scope for bioethics, I would agree with Solomon’s and Jennings’s argument that the field of bioethics as a whole should be concerned about authoritarian populism. Authoritarian populism is not a phenomenon that has arisen exclusively among right-leaning politicians or movements – and not a phenomenon that should worry liberals alone. Populist movements have existed and do exist on both sides of the political spectrum in various countries. While Marine Le Pen in France and Geert Wilders in Holland are right-wing populists, Hugo Chavez in Venezuela was an authoritarian populist on the left. And regardless of the political orientation, authoritarian populism is a very worrisome political phenomenon.

In his book What is Populism?  Jan-Werner Müller defines populism in very specific and precise detail. The label “populist” should not be assigned to candidates or officials merely because they are popular politicians whose ideas one disagrees with.  Populists are antipluralists who claim to be in an exclusive position to represent the people. Populists consider their opponents to be aligned with immoral and corrupt elite. They consider their opponents to be enemies of the people. Populists expect their supporters to believe them – evidence is not needed to prove their points of view and evidence cannot be effectively brought to bear to disprove the truth they claim. The people they represent are not all the people, but rather a homogeneous few whom they have chosen, who endorse them, and who then become identified as the only people of consequence.

If we accept this definition of populism, some who have been called or who call themselves populists would not deserve the label. But those who do deserve the label should be considered worrisome to bioethicists, regardless of their moral philosophies and political views.

Bioethics is a shared activity that involves analyzing how human values and ideas about fairness, respect, benefit, and harm do and should shape practices, institutions, and cultures, as well as the social impacts of the biological sciences, medicine, public health, and other policies that may affect health. The field is filled with controversies that defy consensus, but as Jonathan Moreno argues, consensus resides in the shared vision we have about the proper conditions for debate: diverse views should get a fair hearing.

Populism, as Müller and other scholars, such as Cas Mudde, of the University of Georgia, define it, is quite concerning for the field of bioethics because populism does not welcome and support the sort of unfettered discourse that goes on when the field of bioethics is thriving. The kind of discourse bioethicists pursue will not have any traction in the public arena unless the public is willing to open-mindedly entertain ideas across the moral and political spectrum. Bioethics requires an interest in seeking out the truth and a willingness to pursue moral discourse that is based on reason. This requirement calls upon the public and its leaders to be tolerant, inclusive, and respectful of one another. Bioethicists, while often critical or cautious about particular scientific projects, are fundamentally respectful of the pursuit of scientific truth, while authoritarian populists are not necessarily so inclined.

Along with expressing their concerns, Solomon and Jennings suggest how bioethicists might address troubling aspects of authoritarian populism. The broad strokes include: scholarly attention to the common good, taking scholarly analysis to the public square, working with others to participate in public life, and promoting community deliberation. While they fill in the details of these recommendations in ways that some might disagree with, this overall formula is not prejudiced toward a particular moral point of view, and, if carried out effectively, is likely to foster a less fractious society.

Marion Danis is a Hastings Center Fellow.