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Applying the Theoretical Tools: Being Affected, Responsibility, and Risk

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Comparative Empirical Bioethics: Dilemmas of Genetic Testing and Euthanasia in Israel and Germany

Part of the book series: SpringerBriefs in Ethics ((BRIEFSETHIC))

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Abstract

Focusing on lay moralities is normatively justified by embedding bioethics in a political-philosophical framework of participation and deliberation. A major methodological and meta-ethical challenge remains regarding how empirical research can systematically inform normative bioethics. The concepts of being affected, responsibility and risk, are introduced as distinct analytical tools for an in-depth analysis of lay moralities. Both provide conceptual and discursive junctions also leading to expert discourses.

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Notes

  1. 1.

    It is noteworthy that the English translation of Aristotle’s Nicomachean Ethics used the word “responsible.” Peter French refers to Aristotle as the classical founder of our current use of responsibility, especially with regard to the question under which conditions of knowledge, choice and voluntary will one counts as a morally responsible person, or not (see extracts of Aristotle in: French 1991a, pp. 24–38).

  2. 2.

    The following description differs from Turoldo and Barilan (2008) who focus mainly on versions of professional responsibility of scholars, scientists and physicians, further categorized into context-specific, antecedent, and humanized global responsibility (see also Turoldo 2010).

  3. 3.

    Here we focus mainly on a European-North American perspective. It would be important to investigate in the future national/geographical differences between and within these stages. The discussion of individual responsibility, for example, started earlier in the US context, while in Europe it occurred rather after the first health care reforms in the 1990s (see Ter Meulen and Jotterand 2008). In other regions of the world such as India, an intense bioethical discussion about professional ethics has just started (Tandon 2005; Srinivasan and Loff 2006).

  4. 4.

    It is noteworthy that even in the latest edition of this common teaching book in bioethics, the term “responsibility” or “responsible” occurs quite often, but is nowhere explicitly discussed or defined.

  5. 5.

    We will argue that this seven-relata formula covers the most important normative aspects of the use of different models of “responsibility” in the bioethical context. In particular contexts, more relata can be useful. The number of relata can change according to the context and the level of explicity of a particular argument. However, we do not claim that for all arguments each relata must be defined, but after testing different levels, we concluded that these seven are covering most cases. With regard to this relational conception, the relata can be interpreted as variables: One can theoretically fill in the different relational categories with a particular, possibly infinite number of items. Theoretically, the number of possible relations in the model is vast and can be expressed by the formula (n = number of items): n(A) * n(B) * n(C) * n(D) * n(E).

  6. 6.

    What we often do is shifting this problem into an ex-post problem to clarify afterwards whether there was an “exception.” However, this does not solve the problem that we accuse a person guilty or the person feels guilty until someone declares the opposite. The legal context in most liberal countries has solved this by assuming the presumption of innocence, but in many non-liberal countries, the opposite is the case.

  7. 7.

    Some of these mix-ups result from anthropomorphisms or world views in which non-human moral agents exist.

  8. 8.

    Interestingly, this position bears a serious risk of clan liability the other way round: where one is judged as guilty, the collective is acquitted.

  9. 9.

    Held (1991) has shown that even random social groups can be seen as collectively responsible for not doing something. This requires that the members of such a random group are aware of the moral nature of a collective action (e.g., in a situation where joining to help a single woman would protect her from rape by two strong men, while a single person cannot be expected to save her). However, in health care, all relevant social actors are rather organized groups, such as professionals (physicians, nurses), politicians, or patient’s advocacy groups.

  10. 10.

    However, there are cases where group membership is not voluntarily chosen. For example, membership in religious, gender, or ethnic groups is often ascribed from without. In this case, the application of retrospective and prospective collective responsibility is problematic.

  11. 11.

    The case is adapted from field work findings of Silke Schicktanz in a California Memory clinic.

  12. 12.

    To illustrate how such a case already entails several levels, here is a short explanation: The individual level here is Lisa’s feeling of self-responsibility to look after her condition, to be tested and to inform perhaps others—without having any medical advantage as there is no proper treatment for AD. Regarding the family level, it includes the reactions of her family to such information, care about her, and her care for the two young boys (e.g., if genetic susceptibility is passed down at an increased risk, avoiding additional risk factors such as playing rugby or boxing by the boys might be wise). Professional responsibility comes into question when considering Lisa’s right not know, avoiding harm by not confronting her with a “bad diagnosis” (is introducing MCI therefore a solution?) as well as in the profession’s duty to intensify research to find a medical treatment. The societal responsibility covers the provision of sufficient care and avoiding social stigmatization of persons diagnosed with AD, and so on.

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Authors and Affiliations

  1. Department of Sociology and Anthropology, Ben-Gurion University of the Negev, Beersheba, Israel

    Aviad E. Raz

  2. University Medical Center, University of Göttingen, Göttingen, Germany

    Silke Schicktanz

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  1. Aviad E. Raz
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  2. Silke Schicktanz
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Correspondence to Aviad E. Raz .

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Raz, A.E., Schicktanz, S. (2016). Applying the Theoretical Tools: Being Affected, Responsibility, and Risk. In: Comparative Empirical Bioethics: Dilemmas of Genetic Testing and Euthanasia in Israel and Germany. SpringerBriefs in Ethics. Springer, Cham. https://doi.org/10.1007/978-3-319-32733-4_3

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