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The Empirical Turn in Bioethics – From Boundary Work to a Context-Sensitive, Transdisciplinary Field of Inquiry

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Book cover Empirically Informed Ethics: Morality between Facts and Norms

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Abstract

The debate on facts and values in (bio)-ethics is also a debate on the contribution of the social sciences and psychology to bioethics and vice versa. This debate has recently reached a new state of reflection. It started with indifference in the early 1970s, when both ethics (philosophy, theology, law) and the (social) sciences (especially medical sociology and medical and social psychology) began to penetrate the field of biomedical science and practice from its margins. A phase of some interest, debate and cooperative efforts followed, when both disciplinary fields bloomed and became institutionalized in the late 1970s and early 1980s. The first critique of bioethical reasoning was uttered by the social sciences in the 1980s and 1990s, predominantly not expressed in bioethical but social science and theory of science journals (cf. Hoffmaster 1994). At that time, bioethics was not only established as an important scientific field outside the US, but also as a political endeavor of a pool of experts taking part, and positions in, biomedical and political institutions and debates. Today we witness a fundamental and central scientific debate on a practical, theoretical and epistemological level in the social sciences, philosophy and bioethics. This debate entails a thorough reflection of the contributions of: the social sciences to the core project of bioethics; ethics to the discussions in the social sciences; and both social sciences and bioethics to one of their (many) aims they have in common which is to analyze, reflect on and (I would stress) improve theory and practice of medicine and health care.

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Notes

  1. 1.

    William Cockerham, for example, did not mention the term ‘ethics’ in the subject index or even once even in its fourth edition of Medical Sociology in 1989.

  2. 2.

    This was fostered by research surrounding the human genome project on ethical, legal and social implications, but also in other fields of biomedicine, such as intensive care. See for example the work of Chadwick et al. (1992), Chadwick (1987) and Wertz and Fletcher (2004).

  3. 3.

    The reflections on a “phronetic” versus an “epistemic” science, a differentiation first made by Aristotle in his critique of Plato in Nicomachean Ethics, are now found in social science (e.g. Flyvbjerg 2001) and also in bioethics (e.g. Engelhard 1999). See also the discussion below.

  4. 4.

    Besides many French sociologists and philosophers, such as Jacques Derrida, Francois Lyotard, Michel Foucault, Paul Ricoeur, Paul Valéry and Pierre Bourdieu and the German sociologists and philosophers Ulrich Beck, Odo Marquard and Wolfgang Welsch, I consider Richard Rorty and Judith Butler as the most thorough and differentiated philosophers of modernism and post-modern thinking as a pluralism of rationalities and truths; See Richard Rorty’s early book on epistemology (1979) and his later book on practical philosophy (1989). In regard to ethics, Judith Butlers Adorno’s lectures (2003) describe some of the most important features of a late modern self. As some of the most important and differentiated opponents of late/post-modern thinking who share the diagnosis of late modern uncertainties in epistemology but defend some early modern features in ethics, I do consider Jürgen Habermas (e.g. 1987) and Benhabib (1992).

  5. 5.

    I depict the notion of biology as meaning in Part VI. For this debate see for example Franklin (1997), Nelkin and Lindee (1995) and Haraway (1989).

  6. 6.

    For an overview see Dahms (1994) and Von Uexküll et al. (1996). Main protagonists of the dispute on positivism were Neurath, Carnap and (in the second phase) Popper on the side of analytic philosophy and critical rationalism, Horkheimer, Adorno and (in the second phase) Habermas on the side of critical theory.

  7. 7.

    On the side of the ‘realists’, Gross and Levitt (1994) defended objective science against the, as they see it, ‘irrational postmodernists’. The science war became even more fierce when the “Sokal Hoax” took place: The publication of an article of physicist Alan D Sokal in a high impact social science journal on “Transgressing the boundaries: Towards a Transformative Hermeneutics of Quantum gravity” later revealed to be a bogus article by Sokal himself resulting in the assumption that most social science is bunk. This was answered by social scientists like Shulman accusing Sokal and other natural scientists of being “pre-kantian shamans repeating the mantra of particle physicists” (Flyvbjerg 2001: 1). For a debate on this book and reaction of social scientists see Flyvbjerg (2001) and Ashman and Bahringer (2001).

  8. 8.

    See for example Bogner (2005) as a very comprehensive description of boundary work in the field of biopolitics from a sociologist and technology assessment point of view. See also Jasanoff (1990).

  9. 9.

    For a description of boundary work from the view of a philosophical bioethicist, see Herrera (2008). For a good example of describing this boundary work in bioethics in the view of a social scientist, see Rapp (2000).

  10. 10.

    Other prominent examples of taking the naturalistic fallacy (although critically thinking about it) as a main principle of a meaningful ethical endeavour are Beauchamp and Childress (2001: 2) and Sugarman and Sulmasy (2001: 6–11).

  11. 11.

    As a psychologist on the naturalistic fallacy see Kohlberg (1971: 151, 222), cited in Biller-Andorno (2001: 22).

  12. 12.

    See this discussion also by Sulmasy and Sugarman (2001), who excellently discuss these fallacies but still have one favored way of looking at the blackbird and who, to my mind, uphold the fact/value boundary.

  13. 13.

    Birnbacher is a philosopher and ethicist, belonging to an utilitarian trait of thought, which he describes as an indirect, sensitive utilitarianism, taking ‘traditional’ (social, cultural) norms besides the utilitarian view into account (cf. Birnbacher 2006).

  14. 14.

    For the depiction of morality as a habit, drawing on Dewey’s work on human nature and conduct, see La Folette (2000). For moral habits in social psychology see also Hewstone et al. (2007).

  15. 15.

    For the discussion of this model in the field of clinical ethics, see the discussion in Sect. 15.6, especially Steinkamp et al. (2008).

  16. 16.

    Already shown in the 1960 and after, among these Moscovici and Zavalloni (1969).

  17. 17.

    Already shown in the 1950s and after, among these Asch (1952).

  18. 18.

    See above. Another survey in Germany came to the same results (Meister et al. 2005).

  19. 19.

    I would like to thank Evan DeRenzo for making me aware of this publication and of Steinkamp et al. (2008).

  20. 20.

    The authors see the Dreyfus and Dreyfus’s model as an apt description of “the moral thinking of non-ethicists” (p. 180). I do not think they are right. Clinical ethicists involved in real cases also deal with ethical issues in a non-analytic way-contrary to non-clinical ethicists in the academic field, as I depict here.

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Krones, T. (2014). The Empirical Turn in Bioethics – From Boundary Work to a Context-Sensitive, Transdisciplinary Field of Inquiry. In: Christen, M., van Schaik, C., Fischer, J., Huppenbauer, M., Tanner, C. (eds) Empirically Informed Ethics: Morality between Facts and Norms. Library of Ethics and Applied Philosophy, vol 32. Springer, Cham. https://doi.org/10.1007/978-3-319-01369-5_15

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