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Bioethics Forum Essay

The Symbolic Value of the Bioethics and Populism Debate

In their paper “Bioethics and Populism: How Should Our Field Respond?” Mildred Solomon and Bruce Jennings have sparked an important debate about the role of bioethics in our current political climate. They warn of the risk to constitutional democracy posed by the rise of authoritarian populist regimes around the world, and they point to the recent American presidential election as an example of this troubling trend.  Solomon and Jennings argue that bioethics as a field can and should respond by working to establish a more relational view of autonomy, with greater emphasis on human interdependence, and by redoubling efforts to address structural and distributional injustices.

Franklin Miller disagrees on two counts. He contends that most of the normative concerns posed by authoritarian populism actually fall outside the domain of bioethics and that Solomon and Jennings wrongly assume that “bioethicists all do, or should, subscribe to a stance of liberal progressivism.” Importantly, Miller also points out that Solomon is the president of The Hastings Center, one of the world’s leading bioethics organizations. As such, her call for the field of bioethics to respond to “authoritarian populism” carries not only moral but also symbolic value.

It is through the lens of this symbolic aspect of the debate that those of us who may be aspiring bioethicists at the beginning of our careers read and process these words. In this exchange, key leaders of the field of American bioethics are engaging in a debate about the role of bioethics in the current political climate and what they say matters to the conception of the field as a whole. It is because of the symbolic weight of their words that I offer the following critique.

With regard to the scope of the field of bioethics, Miller appears to adhere to a relatively traditional view that bioethics pertains to issues relating to biomedical research, medicine, and public health. Solomon and Jennings believe that movements and policies affecting public discourse and democratic values also have an impact on the field of bioethics. Therefore, they argue these movements not only fall well within the purview of bioethics, they also belong to a set of issues that bioethicists ought to address in the current political moment. It is indeed vital for the field of bioethics to be seen as responsive to pressing political issues in order for the field to attract passionate, politically-minded young people. At the same time, the field as a whole need not respond largely in unison, as Solomon and Jennings suggest. A perceived expectation of a coordinated or concordant response to current political phenomena may deter prospective bioethicists with a diverse set of political views.

Miller writes that Solomon and Jennings were implying that all bioethicists should subscribe to a stance of liberal progressivism. Jennings responds, “Our view is political, but it is not partisan, and it is not ideologically committed to any particular point on the left-right ideological spectrum . . . .” While Solomon and Jennings may have intended to appeal to fundamental democratic values upon which all civic-minded people can agree, their emphasis on human interdependence and structural and distributional injustices, as Miller points out, would likely appeal more to those with a progressive, communitarian approach. Solomon, in her response to Miller, writes that rising authoritarianism will broadly threaten the health and well-being of many people in our society, for example through limited “health care for undocumented immigrants, the disproportionate incarceration of African Americans, the privileging of commercial interests over scientific validity, and the removal of regulatory protections that will threaten public safety and environmental quality.” The issues that Solomon mentions are critical social and environmental justice issues that ought to be addressed by bioethicists and others. They are also issues that tend to be prioritized by liberal progressives, and have been framed in a manner that is less politically-neutral than the authors implied.

Finally, the characterization by Solomon and Jennings of the recent election as an example of the rise of “authoritarian populism” could well be off-putting to some, who may (correctly or incorrectly) assess the forces at play during the election differently. Thus, although Solomon and Jennings insist that their views are political, but not partisan, it is extremely difficult to separate political views from partisan views in our highly politicized, partisan climate.

The difficulty of distinguishing political from partisan does not mean we should cease aiming to persuade a broader audience of our convictions. However, claiming that our views are nonpartisan and ought to appeal to every reasonable, civically-engaged bioethicist risks sending the symbolic message that those who disagree with those views do not belong in the field of bioethics. I share many of Solomon and Jennings’s concerns, particularly regarding the degeneration of informed, fact-based dialogue and the need for a renaissance in what they term “civic learning.” But if we truly want to dismantle the echo chambers that played such a harmful role in the recent presidential election, we ought to be especially encouraging of ideologically distinct views and values among those who are considering pursuing a future in bioethics. Ideological diversity – if all are held to a high standard of intellectual rigor – stimulates curiosity, creativity, and open-mindedness, and will allow the field to be even more responsive to future challenges to our rights, health, and well-being.

Michelle Bayefsky is a first-year medical student at Harvard Medical School and a former pre-doctoral fellow in the National Institutes of Health Department of Bioethics.


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