By Morten Magelssen and Søren Holm
“Imagine that the natural sciences were to suffer the effects of a catastrophe. A series of environmental disasters are blamed by the general public on the scientists. Widespread riots occur, laboratories are burnt down, physicists are lynched (…) Later still there is a reaction against this destructive movement and enlightened people seek to revive science, although they have largely forgotten what it was. But all that they possess are fragments (…) Nobody, or almost nobody, realizes that what they are doing is not natural science in any proper sense at all”.
Thus began After Virtue (1981), Alasdair MacIntyre’s (1929-2025) sweeping critique of modern moral philosophy. For, as MacIntyre was quick to make clear, his evocative story was not really about natural science, but rather an allegory about morality. Today, in discussing moral issues we use “fragments of a conceptual scheme” uprooted from the contexts in which they were original meaningful:
“We possess indeed simulacra of morality, we continue to use many of the key expressions. But we have – very largely, if not entirely – lost our comprehension, both theoretical and practical, of morality”.
These are bold – if not outrageous – claims today, as they were in 1981. Is MacIntyre onto something? Consider for instance the assisted dying debate. In this important debate nuanced arguments are presented by both sides. Yet the debate is also frustrating, not least because it appears interminable. Stock arguments have been recycled over the years and are hurled at opponents, who, entirely unimpressed, answer with their own set of opposing, and valid, arguments.
According to MacIntyre, such features of ethics debates – the interminability, and the shrillness – stem from our inability to provide fundamental rational justification for our viewpoints. One who is adept at handling the “simulacra of morality” might bolster their stance with carefully picked theory fragments – a bit of human rights here, a slice of Kant’s categorical imperative there, seasoned with some utility maximization in places. In this way they mask the fundamental rational arbitrariness of the position they try to defend with arguments that are, on the face of it, valid. If MacIntyre is right, then something is rotten – and it affects academic bioethics as much as public debate.
Yet most of bioethics has taken little heed of MacIntyre’s critique. Little wonder, perhaps, as it is so hard to swallow. If MacIntyre is onto something, however, we should look carefully at how we do bioethics and how we should start doing it differently.
In addition to his “critical project”, MacIntyre also has a “constructive project” which can furnish bioethics with an approach based on a careful analysis of practices and the virtues inherent in those practices. This approach may be particularly suited to analyse issues such as medical virtues and vices, the power struggle between the internal goods of medicine and the external goods of healthcare institutions, and conditions for moral agency and proper decision-making in the age of AI. For MacIntyre these questions should not be answered by thinking of ‘the virtues of medicine’ in the abstract, but concretely by thinking about the virtues inherent in the specific practices of these health care professionals in this specific context.
In our paper in the Journal of Medical Ethics, we argue that bioethicists would do well to interact more with MacIntyre’s critical and constructive moral philosophy. There is significant untapped potential for work in bioethics inspired by MacIntyre. We give examples of further uses of MacIntyre under the five headings critical, diagnostic, revisionist, normative, and hermeneutic.
MacIntyre was often read as a conservative, and sometimes dismissed on that basis. But his arguments are in many ways just as radical as they are conservative. Perhaps his most useful gift to bioethics is a set of questions that you can put to any argument, including your own: what tradition does this premise come from, who would not accept it, and what moral tradition is their resistance to your argument rooted in? Try this out on an apparently interminable debate, and you might see things that you haven’t seen before.
Paper title: MacIntyrean bioethics: reappraisal and outline of a research program
Authors: Morten Magelssena, Søren Holma,b, Eilev Hegstadc and Skylar Christoffersend
Affiliations: aCentre for Medical Ethics, University of Oslo, Oslo, Norway; bThe University of Manchester, Manchester, UK; cCenter for the Study of Professions, Oslo Metropolitan University, Oslo, Norway; dHarvard University, USA
Competing interests: None