Bioethics Forum Essay
Bioethics’ Best Response to Populist Polemics: Sticking to Its Roots
In a recent article in the Hastings Center Report two leading bioethicists, Mildred Solomon and Bruce Jennings, called on fellow bioethicists to “come to the aid of civil liberties and political rights,” and to use their scholarship to “clarify how . . . individual well-being is bound up with justice.” As a citizen I too am alarmed by a populist polemic that proclaims a “post-truth” era in which “alternative facts” can shoulder aside actual facts. Yet I am also concerned by Solomon and Jennings’ proposal that we bioethicists shift the focus of our research and of our field from ethical issues arising within and about biomedicine and health care to more general political issues about civil liberties, political rights, justice, and well-being.
Their proposal cuts against the grain of the history of our field. Founders of the two earliest bioethics institutes, Daniel Callahan and Andrè Hellegers, sought to focus the nascent field on issues raised by scandalous research (such as the Tuskegee Syphilis Study) and by the protests of patients, patients’ families, and patients’ rights groups (in the Dax Cowart, Karen Ann Quinlan, and similar cases, and by the National Welfare Rights Organization’s protests). In doing so they moved these issues out of the political arena by defining them as questions of “ethics.” Their characterization of the issues as ethical rather than political allowed their institutes to draw on the expertise of interdisciplinary teams whose political views spanned the spectrum from conservative to progressive. They involved biomedical scientists (like Hellegers himself), health care professionals (such as Beecher, Engelhardt, Gaylin, and Pellegrino), lawyers (like Annas, Capron, and Katz), and philosophers and theologians (like Beauchamp, Childress, Fletcher, Jonsen, Reich, Thomasma, Ramsey, Veatch, and Callahan himself).
This strategy of construing the issues addressed by the nascent field as ethical—fortuitously assisted by the Supreme Court’s 1973 Roe v Wade decision, which shifted the burden of the abortion controversy to the courts—was remarkably successful. It laid the foundation for a burgeoning field that cut through fogs of hyperbole to offer carefully reasoned consensus statements on morally disruptive technologies and on the ethics of the health professional-patient and researcher-participant relationships significantly influenced professional societies, courts, various branches of government, the media, and public opinion.
I do not believe that the current ascendency of populist politics offers bioethicists a good reason to abandon our traditional focus on the ethics of biomedicine and health care. To the contrary, we should not undermine our own claims to impartiality or expertise by politicizing our research or our field—which, to reiterate, was founded by conservatives and progressives working in concert. Our best response to populist polemics is “tending to our knitting” by conducting careful research that informs the public, deflates hyperbole, confronts “alternative facts” with actual data, and replies to “post-truths” with solid evidence.
Robert Baker, a Hastings Center Fellow, is founding director emeritus of the Clarkson University-Icahn School of Medicine at Mount Sinai bioethics program and the William D. Williams Professor of Philosophy at Union College.