The Status of Bioethics

There’s been a couple of things that’ve appeared on the net over the last few days that have revivified something that’s been niggling away at the back of my mind for quite a long time now: the status of bioethics as an academic discipline.

First there was Brian Leiter’s blog post.  Commenting on the oddness that has been overtaking the American Journal of Bioethics for the last couple of weeks (Not been keeping up?  Christian Munthe and Carl’s posts on the Fear and Loathing in Bioethics give a pretty good account), he points out that “[b]ioethics already has a fairly dim reputation in academic philosophy” – and he’s right: it does, even without the alleged strangeness at the AJoB.

And then there’s this interview with Hilde Lindemann in 3:AM Magazine, with this eye-catching passage:

A few years ago I was at a metaethics workshop, and over breakfast a male colleague and I made a game of ranking the different specialties in philosophy according to how prestigious they were – a ranking with a precise inverse correlation to gender. Here’s the list we came up with:

Philosophy of Mind, Philosophy of Language, and Metaphysics: The alpha-dominant philosophy, done by Real Men

Epistemology and Philosophy of Science: Done by manly enough men

Metaethics: Done by men who aren’t entirely secure in their masculinity

Ethics, Social and Political Philosophy: Done by girls

Bioethics: Done by stupid girls

Feminist philosophy, of course, is not philosophy at all.

The status of bioethics isn’t the primary concern of the interview, but it’s what jumped out at me; and – speaking as someone whose PhD was in metaethics in a very mind-and-language department, and who subsequently got work in bioethics – the ranking seems to be about right.  (I was warned at the start of my career that setting out down a bioethics path would make it hard to get a job in a “proper” philosophy department in future – a prediction that I think has something to it.  David Hunter’s recent move to a proper philosophy department is the exception that proves the rule, notwithstanding that his previous job was with a very good bioethics place.)

Bioethics employs philosophers, and makes use of philosophy; but it’s not enormously highly regarded as a discipline by philosophers.  Why should that be?  Does it matter?

Off the top of my head, I can think of a range of possible reasons of varying plausibility.

It might be because bioethics is “contaminated” by the real world.  Maybe the real world is for policymakers, not philosophers; they should follow in philosophers’ wake, but it’d be a mistake for philosophers to think that they have to get their hands dirty.  And maybe the suspicion is that being contaminated by the real world means making intellectual compromises – pure lines of thought can’t be followed, but have to be tempered by what’s politically acceptable.

There might be a degree of professional jealousy: bioethicists pop up on Radio 4 much more frequently than do meta-ethicists or logicians.  (This is the least powerful explanation, though there might be a grain of truth in it for some.  Incidentally: I’m still open to invitations…)

But there’s another possibility, and that’s that philosophy-department philosophers look down on bioethics because the standard of philosophy just isn’t very high.  And this possibility might be associated with a fourth: that bioethics is just too weighed-down with all kinds of other stuff.

I wouldn’t want to say which of these – if any – is the best explanation.  But there’s a part of me that wonders whether there might be something to the third and fourth points.  There are some very good philosophers working in the discipline; and some very good applied philosophy gets done under its banner.  But, every so often, there is some utter dreck that surfaces.  (I’m not going to identify anything: but we’ve probably all read papers that we think to be terrible, or seen conference papers that were just embarrassing for all present; we might even have reviewed and rejected papers for one journal and then see them pop up in another.)  And there’s quite a lot that, though it deals with matters of moral concern, isn’t really ethics as a philosopher would understand it.

In this light, while bioethicists’ openness to survey papers might be useful inasmuch as it throws a light on the context in which moral debates happen, it’s easy to see why non-bioethicists might struggle to see the point.  And these papers do, at least sometimes, go beyond their remit: it’s a bit of a parody to say that they go from a finding about what most medics think about a subject to policy recommendations in the space of a sentence – but we’ve all seen papers that come closer to matching that parody than we might like to admit.  Finally, though principlism might have its place, it does also pop up where it probably shouldn’t, and can be treated rather dogmatically.  (To nod towards, and subvert, Raa Gillon in the JME a few years ago: ethics doesn’t need principles.  It generates them, tests them, analyses them, criticises them, modifies them, worries about them… but it doesn’t need them.)

Oh, there’s one other possible explanation, which I’ve noted on these pages before (see here and here) – and that’s that anybody at all can call himself a bioethicist.  And while it’s true that the same applies to philosophers, or chemists, or whatever, there is a quality-control problem inasmuch as that bioethicists are frequently employed by medical or health institutions, and de facto are scrutinised by people whose expertise is not in ethics.  This gives shelter to incompetence.  Not – of course – to say that bioethicists employed by medical schools are incompetent: the majority is fine, and a substantial number is great.  But if an incompetent person happened to blag their way into a job (as sometimes does happen) it’s possible that they might take longer to ferret out than they would if they’d been in a department with different expertise.

Does it matter?  Some people working within bioethics might deny that it does.  They might point, for example, to the fact that bioethics is proudly interdisciplinary – perhaps even a non-discipline.  It welcomes philosophers, but also lawyers, sociologists, theologians, medics, and just about anyone else.  Having a low reputation among philosophers doesn’t matter because bioethics isn’t philosophy.  That’s not what we’re about, the thought might go.

Except that this doesn’t work.  Chemistry isn’t philosophy, either; but it doesn’t have a low reputation.  And the defence really doesn’t cover work in bioethics that is, inescapably, philosophy but philosophy of a low quality.

As to the question of whether it matters: I think it does.  I’m not blind to the possibility that that’s just because I still think of myself as a philosopher, and so would like to think that I stand a chance of having the respect of my peers.  And if they’re going to have a low opinion of me, I’d like that to be because they think I’m not very good at what I do, rather than because I do it at all.

But I also think that there’s more to it than that.  Even if – for the sake of the argument – we accept that bioethics isn’t reducible to philosophy, it doesn’t follow that philosophy is just one tool in the bioethical box.  Rather – for reasons that I’m hoping to publish in the near-ish future – it is central to bioethics, and vitally important.  You could have bioethics without at least some of the other disciplines that fit into the tent at the moment; but you couldn’t have it without philosophy.  Philosophy is uniquely capable of making sense of what we think, why we think it, and whether we should continue thinking it.  Bioethics is, obviously, a kind of ethics; and while ethics may be scrutinised as a discipline by other disciplines, and while moral behaviour might be scrutinised by other disciplines, ethics’ home – qua ethics – is within philosophy.

That’s why it matters if bioethics is poorly regarded by other philosophers.  Philosophers are the people best able to assess the standard of philosophical endeavour; and if the standard of philosophy within bioethics is low, and granted the importance of philosophy, then we’ll be faced with a danger that the general intellectual standard of bioethics is low, too.

OK – so I’ve sort of given away the gist of what I think I’ll be saying at the IAB in the symposium that David Hunter has put together with James Wilson and me (and Tom Beauchamp’ll be joining us!  And Mikey Dunn!  It’ll be the highlight of the conference…).  But Leiter is, I fear, kind of right.  Bioethics has allowed itself to be caught in the shallows.