Journal of Bioethical Inquiry, Volume 6, Number 4 (December 2009)
Guest Editor: Rob Irvine
John Coggon, Richard Huxtable, and Cameron Stewart
Paul R. Ehrlich
A few years ago, I wrote on the need for expansion of the environmental areas of bioethics, and covered some of the topics touched on here. Sadly, although it is possible to find some notable exceptions, bioethics does not provide much of an ethical base for considering human-nature relationships. Here I’m not going to deal with these philosophical issues or others about the nature of ethical decision-making. The rapid worsening of the human predicament means that applied ethical issues with a significant environmental connection (what I call “ecoethics”), must be dealt with without waiting for the more interesting theoretical issues to be resolved. I define ecoethics very broadly to deal with dilemmas over a vast range of scales, and believe they now should penetrate virtually all areas of human activities. Ecoethics must struggle with issues of intra-generational (and interperson/group/nation) equity and the dilemmas of discounting by distance (valuing distant persons/events/costs/benefits less than those closer to the observer in physical or mental distance). Ecoethics also deals with the difficult dilemma of inter-generational equity—of discounting the future. That is especially troublesome when actions today can have significant environmental consequences 50 or more generations from now. Here I would like to highlight the ubiquity of those questions and the importance of seeking answers.
Alexander K. Lautensach
The deep and lasting changes to human behaviour that are required to address the global environmental crisis necessitate profound shifts in moral foundations. They amount to a change in what individuals and societies conceive of as progress. This imperative raises important questions about the justification, ends, and means of large-scale changes in people’s ethics. In this essay I will focus on the ends—the direction of moral change as prescribed by the goal of sustainable human flourishing. I shall present a meta-ethical critique of anthropocentrism and propose that only an ecocentric ethic can support the sustainable flourishing of humanity. This proposition does not necessarily contradict itself. My claim will be that the values subsumed under the broad concept of anthropocentrism are categorically counterproductive, informing an undesirable concept of “progress.” I support this claim with two lines of argument. On the one hand, the end values of anthropocentrism are shallow and the “flourishing of humanity” is ill-defined. The conceptual constraints of anthropocentrism itself preclude a more concise definition which would take into account the utter dependence of the flourishing of humanity on the health of ecological support structures. On the other hand, pursuing the values that inform the actions of anthropocentrists (which may be identical with the “flourishing of humanity”) leads to unintended and undesirable outcomes, even from the view of the anthropocentrist herself. Those problems are not encountered with an ecocentric ethic, and the conceptual steps necessary to adopt it are not insurmountable.
Lori Gruen and William Ruddick
In the late 1960s Van Rensselaer Potter, a biochemist and cancer researcher, thought that our survival was threatened by the domination of military policy makers and producers of material goods ignorant of biology. He called for a new field of Bioethics—“a science of survival.” Bioethics did develop, but with a narrower focus on medical ethics. Recently there have been attempts to broaden that focus to bring biomedical ethics together with environmental ethics. Though the two have many differences—in habits of thought, scope of concern, and value commitments—in this paper we argue that they often share common cause and we identify common ground through an examination of two case studies, one addressing drug development, the other food production.
Jennifer A. Knight, Elizabeth J. Comino, Elizabeth Harris, and Lisa Jackson-Pulver
ncreasingly, the role of health research in improving the discrepancies in health outcomes between Indigenous and non-Indigenous populations in developed countries is being recognised. Along with this comes the recognition that health research must be conducted in a manner that is culturally appropriate and ethically sound. Two key documents have been produced in Australia, known as The Road Map and The Guidelines, to provide theoretical and philosophical direction to the ethics of Indigenous health research. These documents identify research themes considered critical to improving the health of the nation’s Indigenous peoples. They also provide values that, from an Indigenous perspective, are foundational to an ethical research process. This paper examines these research themes and values within the context of a current longitudinal birth cohort study of Indigenous infants and children in south-west Sydney: the Gudaga Study. Considerable time and effort have been invested in being true to the values stated in these documents: reciprocity; respect; equality; responsibility; survival and protection; and spirit and integrity. We have learnt that it is vital to be true to these values when conducting Indigenous health research—to quite literally “walk the talk”.
Jacob M. Appel
The Dutch rules governing neonatal euthanasia, known as the Groningen Protocol, require parental consent for severely disabled infants with poor prognoses to have their lives terminated. This paper questions whether parental consent should be dispositive in such cases, and argues that the potential suffering of the neonate or pediatric patient should be the decisive factor under such unfortunate circumstances.
This paper examines the power relations in “patient-centred communication”. Drawing on the work of Michel Foucault I argue that while patient-centred communication frees the patient from particular aspects of medical power, it also introduces the patient to new power relations. The paper uses a Foucauldian analysis of power to argue that patient-centred communication introduces a new dynamic of power relations to the medical encounter, entangling and producing the patient to participate in the medical encounter in a particular manner.
Yvonne Lau and Chrystal Jaye
In the United States, disease screening is offered to the public as a consumer service. It has been proposed that the act of “consumption” is a manifestation of agency and that the decision to consume is an exercise of autonomy. The enthusiasm of the American public for disease screening and the expansion in the demand for all sorts of disease screening in recent years can be viewed as an expression of such autonomy. Here, we argue that the enthusiasm for disease screening witnessed in the American public today may be more a reflection of the constraint on autonomy than its facilitation. It is our opinion that the articulation of socio-historical processes has contributed to a moral imperative which is reflected in the decision making of individuals around disease screening. We suggest medical and health professionals have a responsibility to facilitate the exercise of individual autonomy in health care decision making as an integral component of professional obligation. These professionals need to problematise healthcare activities that constrain individual autonomy.
Paul A. Komesaroff
Allison Neyhart Rubin
Katrina A. Bramstedt
Brian William Head