Appropriate methodologies for empirical bioethics: It's all relative

Bioethics

Volumn 23, Issue 4, 2009, Pages 249-258

  Ives, Jonathan ^a   Draper, Heather ^a  

^a UNIVERSITY OF BIRMINGHAM   (United Kingdom)

Author keywords

Empirical bioethics; Focus groups; Integrated ethics; Is ought problem; Methodology; Normative policy orientated bioethics; Reflective equilibrium

Indexed keywords

ARTICLE; BIOETHICS; COMPREHENSION; EMPIRICAL RESEARCH; EMPIRICISM; ETHICAL THEORY; ETHICS; FATHER; HUMAN; INFORMATION PROCESSING; INTUITION; LOGIC; MALE; METHODOLOGY; MORALITY; PATERNAL BEHAVIOR; PATERNITY; PSYCHOLOGICAL ASPECT; QUALITATIVE RESEARCH; STATISTICAL ANALYSIS; THINKING;

BIOETHICS; COMPREHENSION; DATA COLLECTION; DATA INTERPRETATION, STATISTICAL; EMPIRICAL RESEARCH; EMPIRICISM; ETHICAL ANALYSIS; ETHICAL RELATIVISM; ETHICAL THEORY; FATHERS; FOCUS GROUPS; HUMANS; INTUITION; LOGIC; MALE; MORALS; PATERNAL BEHAVIOR; PATERNITY; PRINCIPLE-BASED ETHICS; QUALITATIVE RESEARCH; RESEARCH DESIGN; THINKING;

EID: 63449089656     PISSN: 02699702     EISSN: 14678519     Source Type: Journal    
DOI: 10.1111/j.1467-8519.2009.01715.x     Document Type: Article

References (56)

1. 'Normative principles' should not be confused with the 'four principles' approach in bioethics, or with any other kind of monolithic principlism. By 'normative principle' we simply mean a statement of principle that requires a certain kind of action in a certain set of circumstances, and this could be very generic or very particular, stemming from a commitment to utilitarian, deontological, feminist, virtue etc. principles.
2. J. Ives. 2007. Becoming a Father/Refusing Fatherhood: How Paternal Responsibilities and Rights are Generated. PhD thesis, University of Birmingham.
3. A. Hedgecoe. Critical Bioethics: Beyond the Social Science Critique. Bieothics 2004; 18(2): 120-143;
4. See also, for example: A. Molewijk et al. Empirical Data and Moral Theory, A Plea for Integrated Empirical Bioethics. Med Health Care Philos 2004; 7: 55-69;
5. L.Van der Scheer & G. Widdershoven. Integrated Empirical Ethics: Loss of normativity? Med Health Care Philos 2004; 7: 71-79: M. Goldenburg. Evidence Based Ethics? On Evidence-Based Practice and the 'Empirical Turn' from Normative Bioethics. BMC Medical Ethics 2005; 6(11);
6. E. Haimes. What Can Sociology Contribute to the Study of Ethics? Theoretical, Empirical and Substantive Considerations. Bioethics 2002; 16(2): 89-113;
7. R. de Vries et al. Social Science and Bioethics: the Way Forward. Socio! Health 111 2006; 28(6): 665-677;
8. P. Borry, P. Schotsmans & K. Dierickx. The Birth of the Empirical Turn in Bioethics. Bioethics 2005; 19(1): 49-71;
9. R. Ashcroft. Constructing Empirical Bioethics: Foucauldian Reflections on the Empirical Turn in Bioethics Research. Heath Care Analysis 2003; 11(1): 3-13.
10. C. Herrera. Is it Time for Bioethics to Go Empirical? Bioethics 2008; 22(3): 137-146.
11. We distinguish between philosophical bioethics that employs primarily conceptual analysis and argument and empirical bioethics where data collection and analysis combine (in various ways) with conceptual analysis and argument. We accept that there are other philosophical approaches that are less abstract and more grounded in human relations (e.g. feminist bioethics, relational theory etc.), and this discussion is not directed at those.
12. Hedgecoe 2004, op cit. note 3, p. 138.
13. Herrera 2008, op cit. note 4.
14. Although Hedgcoe's analysis proposes to go beyond the traditional social science critique, and does, we still consider his 'critical bioethics' to be part of this body of work, as its aim is to critique what it perceives to be current practice in bioethics from the perspective of the social sciences.
15. This term is borrowed from Mike Parker, and expanded further in: J. Ives. Encounters with Experience: Empirical Bioethics and the Future. Health Care Analysis 2008; 16: 1-6.
16. J. Ives et al. Becoming a Father/Refusing Fatherhood: An Empirical Bioethics Approach to Paternal Responsibilities and Rights. Clinical Ethics 2008; 3(2): 75-84.
17. Ives et al. 2008, op cit. note 10.
18. For example see: R. Weinberg. The Moral Complexity of Sperm Donation. Bioethics 2008; 22(3): 166-178; G. Fuscaldo. Genetic Ties: Are They Morally Binding? Bioethics 2006; 20(2): 64-76;
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22. H.T. Engelhardt. 1996. The Foundations of Bioethics. Oxford: Oxford University Press;
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26. For example of this apparent conflation, see: Borry, Schotsmans &. Dierickx, (2005) op cit. note 3, p. 60;
27. and S. Reiter-Theil. Does Empirical Research Make Bioethics More Relevant? 'The Embedded Researcher' as a Methodological Approach. Med Health Care Philos 2004; 7: 17-29.
28. Indeed, we have been guilty of making the same error: H. Draper & J.Ives. 2007. Cognition, Brain, Behaviour. 2: 319-330.
29. The is/ought problem was first described by David Hume: D. Hume. 2000. A Treatise of Human Nature. D. Norton & M. Norton, eds. Oxford: Oxford University Press: 3.1.1(27) and has since been described as 'Hume's Guillotine' in one classic discussion of the problem, see M. Black. The Gap Between 'Is' and 'Should'. Philos Rev 1967; 73(2): 165-181. The similar (but distinct) problem of the naturalistic fallacy was formulated by G.E. Moore and is used to describe the 'mistake' that is made when a philosopher tries to prove an ethical claim by directly appealing to some definition of the word 'good' in terms of natural properties (such as 'desired', 'pleasant' or 'conducive to happiness'), and is based on the claim that 'ethical facts' are not 'natural facts', see G.E. Moore. 2000. Principia Ethica. Cambridge: Cambridge University Press. The conflation of the two is understandable, but it is as well to note that in this discussion we focus on the 'is/ought' problem only.
30. Hedgecoe, op cit. note 3, p. 131.
31. B. Hoffmaster. 2001. Introduction. In Bioethics in Social Context. B. Hoffmaster, ed. Philadelphia: Temple University Press: 2.
32. It is ironic that Hedgecoe, as a sociologist, seems to have failed to locate his critique of the is/ought problem within a contextual framework of what philosophers understand the problem to be, but, rather has based his critique upon what he assumes the problem is, or should be, given his particular theoretical and disciplinary perspective - dismissing the philosophical perspective as merely 'a personal opinion'.
33. Ashcroft notes that the incorporation of empirical data into ethical argument often takes the form of a hypothetical imperative, where an argument of the form 'if P then X' is made, and then empirical data is used as evidence that P. See: Ashcroft, op cit. note 3, p. 4.
34. DeVries and colleagues argue that the theoretical debate is 'generating much heat and little light', and that it is time to stop debating over the theory of empirical ethics and to get out into the field and start doing it. DeVries et al. op cit. note 3, pp. 667-668.
35. For a discussion of this line of objection see, for example, P. Pettit. 2001. The Consequentialist Perspective. In M. Baron, P. Pettit & M. Slote, eds. Three Methods of Ethics. Oxford: Blackwell: 151-155.
36. See: C. Korsgaard. 1998. The Right to Lie: Kant on Dealing with Evil. In Ethical Theory 2: Theories about how we should live. J. Rachels, ed. Oxford: Oxford University Press.
37. For a good overall introduction to the ways in which Utilitarians have responded to these kinds of intuitive criticisms, including the development of 'rule' and 'indirect' utilitarianism, see: G. Scarre. 1996. Utilitarianism. London: Routledge. Scarre himself defends utilitarianism against this line of objection by appealing to the harmful nature of 'self-debasing' actions, thus accommodating the intuition that certain kinds of action ought to be avoided within the utilitarian framework.
38. Korsgaard, op cit. note 20.
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41. T. Bayne. Gamete Donation and Parental Responsibility. J Appl Philos 2003; 20(1): 77-87.
42. We do not claim to have invented this approach - but noted that it had been used to good effect elsewhere. See: P. Alderson, B. Farsides & C. Williams. Examining Ethics in Practice: Health Service Professionals' Evaluations of In-hospital Ethics Seminars'. Nursing Ethics 2002; 9(5): 508-520.
43. The approach also bears a resemblance to the method of 'Moral Case Deliberation': B. Molewijk et al. Implementing Moral Case Deliberation in a Psychiatric Hospital: Process and Outcome. Med Health Care Philos 2007; 11(1): 43-56.
44. Analytic induction is an iterative process that requires hypothesis development and testing to be performed concurrently with data analysis. As a hypothesis is developed it is both tested retrospectively against existing datasets and tested in future data collection, with hypotheses that do not fit being rejected. According to Silverman, Analytic induction is a combination of two distinguishable techniques: The constant comparative method, and deviant case analysis: D. Silverman. 2004. Interpreting qualitative data. Methods for analysing talk, text and interaction. London: Sage.
45. 'Reflective equilibrium' was a process first introduced by Nelson Goodman in reference to the way in which rules of inference in inductive or deductive logic are justified. The concept was introduced into moral philosophy, and made well known, by John Rawls in his A Theory of Justice.
46. See: N. Goodman. 1955. Fact, Fiction andForecast. Cambridge, Mass: Harvard University Press; J. Rawls. 1971. A Theory of Justice. Cambridge, Mass: Harvard University Press.
47. Sim, for example, portrays the focus group facilitator as someone who exerts 'mild, unobtrusive control' over the group, who adopts a passive role thereby allowing the discussion to be group led, see: J. Sim. Collecting and Analysing Qualitative Data: Issues Raised by the Focus Group. J Adv Nurs 1997; 28(2): 345-352. Burrows and Kendal claim that effective facilitation is achieved by creating an atmosphere of nonthreatening and supportive genuine interest, in which participants are able to share their thoughts and feelings in an open climate, see: D. Burrows & S. Kendall. Focus Groups: What Are They and How Can They Be Used in Nursing and Health care Research. Soc Sci Health 1997; 3(4): 244-253.
48. J. Smithson. Understanding and Analysing Focus Groups: Limitations and Possibilities. Social Research Methodology 2000; 3(2): 103-119.
49. There is also a political element to this kind of question that cannot be ignored. Funders may prefer to fund established teams as a means of ensuring that their money is, from one point of view, spent effectively. This approach may, however, lead to talented individuals or new perspectives withering on the academic vine due to lack of resources.
50. See, for example A. Tashakkori & J.W. Creswell. The New Era of Mixed Methods. Journal of mixed methods research 2007; 1(1): 3-7;
51. J.W. Creswell. 2003. Research design: Qualitative, quantitative and mixed method approaches. Thousand Oaks, CA: Sage;
52. R.B. Johnson, A.J. Onwuegbuzie & L.A. Turner. Towards a Definition of Mixed Methods Research. Journal of mixed methods research 2007; 1(2): 112-133; J.C. Greene. Is Mixed Methods Social Enquiry a Distinctive Methodology? Journal of mixed methods research 2008; 2(1): 7-22.
53. Erica Haimes has made an interesting link here to post-modernist writers such as Zygmunt Bauman, who recognize the significance placed upon universality and unification by modernist philosophers, whilst suggesting that the effects of post-modernism on ethics might lead to 'radically new' understandings of moral phenomena. What Haimes seems to be suggesting, drawing on Bauman, is that ethics in the postmodern era need not, perhaps, be troubled by the claims of universality or the search for a unifying theory of morality. See: E. Haimes. What Can the Social Sciences Contribute to the Study of Ethics? Theoretical, Empirical and Substantive Considerations. Bioethics 2002; 16(2): 89-113;
54. and Z. Bauman. 1993. Postmodern Ethics. Oxford: Blackwell. We mention this not because we take Haimes or Bauman to be authoritative on what the aims of philosophy should be, but because it is interesting to note that this debate can be located within a larger intellectual movement, to note how the call for empirical, contextualized bioethics may be influenced by the wider post-modern critique, and to draw attention to the fact that the slide into relativism that many think may occur if we allow ethical theorizing to be influenced by what people actually do value is not necessarily something that is universally feared, and should not be taken for granted as being a negative thing.
55. J. Harris. 2004. Introduction: The importance of Bioethics. In Bioethics. J. Harris, ed. Oxford: Oxford University Press: 10.
56. H. Draper et al. Healthcare Worker's Attitudes to Working During Pandemic Influenza: A Multi-method Study. BMC Public Health. 2008; 8.