The virtue ethics approach to bioethics

Bioethics

Volumn 25, Issue 4, 2011, Pages 192-201

  Holland, Stephen ^a  

^a UNIVERSITY OF YORK   (United Kingdom)

Author keywords

Diversity; Methodology; Virtue ethics; Virtue politics

Indexed keywords

ARTICLE; BIOETHICS; CULTURAL ANTHROPOLOGY; ETHICAL THEORY; HUMAN; MORALITY; POLITICS;

BIOETHICS; CULTURAL DIVERSITY; ETHICAL THEORY; HUMANS; POLITICS; VIRTUES;

EID: 79955022829     PISSN: 02699702     EISSN: 14678519     Source Type: Journal    
DOI: 10.1111/j.1467-8519.2009.01758.x     Document Type: Article

References (36)

1. K. StohrContemporary Virtue EthicsPhilosophy Compass200611
2. For example, Hursthouse baulks at the naive identification of virtues with single-track dispositions or character traits. See R. Hursthouse2007Virtue Ethics. In Stanford Encyclopedia of Philosophy. [Accessed Dec2008
3. J. OakleyVarieties of Virtue Ethics. Ratio19969128 152
4. This is clear from the recent applications of virtue ethics in bioethics listed below, of which McDougall's contribution, discussed in detail in the next section, is typical
5. E. Pellegrino & D. Thomasma2003The Virtues in Medical PracticeOxford Oxford University Press; cf. L.A. Jansen. The Virtues in their Place: Virtue Ethics in Medicine. Theor Med2000221261 276
6. In my view, recommending regulatory policy which, incidentally, includes addressing relevant research ethics issues is bioethics' principal remit: this concords best with how the discipline developed in response to ethical challenges presented by biotechnological developments, and helps differentiate the subject from cognate disciplines such as medical ethics. But the argument of this paper does not require this view and, undeniably, bioethics is concerned with important matters not directly related to regulating biomedical procedures
7. See, for example, Ren-Zong Qiu, ed. 2004. Bioethics: Asian Perspectives. Dordrecht: Kluwer; B. Hoffmaster, ed. 2001. Bioethics in Social Context. Philadelphia: Temple University Press; R. Tong, G. Anderson & A. Santos, eds. 2000. Globalizing Feminist Bioethics: Crosscultural Perspectives. Boulder Colorado: Westview; M.J. Iozzio, ed. Considering Religious Traditions in Bioethics: Christian and Jewish Voices. Scranton, PA: University of Scranton Press. For a more detailed discussion of relevant forms of diversity, see S. Holland. Recent Work: Bioethics.Philosophical Books 2006I don't advocate or defend diversity; the point is to clarify the methodology problem diversity creates for bioethics2006473245 254
8. E. Herne, B. Koeing, L.J. Moore & P.A. MarshallThe Difference that Culture can Make in End-of-Life Decision Making. Camb Q Healthc Ethics1998727 40
9. [A]t a minimum, self-rule that is free from both controlling interference by others and from limitations, such as inadequate understanding, that prevent meaningful choice. T.L. Beauchamp & J.F. Childress. 2001. Principles of Biomedical Ethics (5th edn.). Oxford: Oxford University Press: 58.10C. Durante. Bioethics in a Pluralistic Society: Bioethical Methodology in Lieu of Moral Diversity. Med, Health Care Philos200912135 47
10. See, for example, D.C. Ainslie. Bioethics and the Problem of Pluralism. Soc Philos Policy G. McGee, ed. 2003. Pragmatic Bioethics (2nd edn.) Cambridge, Mass: MIT Press2002191 28
11. R. Hursthouseop. cit. note 2
12. J. McDowell1995Two Sorts of Naturalism. In Virtues and Reasons. R. Hursthouse, G. Lawrence & W. Quinn, eds. Oxford: Oxford University Press: 149 179, for a sustained effort to expand the notion of the natural to allow room for a latter day account of human nature; M. Nussbaum. Non-relative Virtues: an Aristotelian Approach. Midwest Studies in Philosophy 1988; XIII: 32 53, for a classic defence of non-relativistic virtue ethics despite the obvious fact of cultural variation; and P. Foot. 2001. Natural Goodness. Oxford: Clarendon Press, for an exploration of natural normativity.
13. Issues to which virtue ethics has recently been applied include: prenatal genetic enhancements (C. Farrelly, Virtue Ethics and Prenatal Genetic Enhancement. Studies in Ethics, Law, and Technology Article 4 saviour siblings the sale of transplant organs clinical research treating despite dissent Gardiner op. cit.,public health practice in general specific public health activities, such as harm reduction programmes nursing practice In general and specific nursing dilemmas 298 300200711
14. R. McDougallActing Parentallyan Argument against Sex Selection. J Med Ethics200531601 605
15. McDougall's further point is that it is a mistake to restrict reproductive ethics to harm-oriented frameworks, such as procreative liberty: the virtue ethics approach reveals actions as morally wrong despite a claim on, for example, the grounds that the child in question has a life worth living and a numerically distinct child would have been born had the action not been undertaken that no harm is perpetrated
16. Farrelly, op. cit. note 14 and Fox, op. cit. note 14, on virtue ethics and genetic enhancements
17. For example, perhaps it is not entirely clear what the future-agent-focused parent would do [so we] need a richer characterization of this parental virtue to determine exactly what it requires in this situation (McDougall 2007, op. cit. note 15, p. 190). This is an example of the applicability problem, discussed more fully below2007
18. Oakley claims that [a]mong the areas of bioethics which have received considerable attention from virtue ethicists are abortion, euthanasia and the practice of health care (J. Oakley. A Virtue Ethics Approach. In A Companion to Bioethics. H. Khuse & P. Singer, eds. Oxford: Blackwell:But it turns out that the virtue ethicists in question attend to either (i) personal decisions concerning these matters or (ii) issues in professional ethics centring on health professionals' character and conduct: i.e. not to the societal question as to how to regulate the relevant biomedical procedures. This point extends to oft-cited classics, such as P. Foot. Euthanasia. Philos Public Aff 1977; 6: 85 112: the former is aimed principally at a pregnant woman's decision to terminate, the latter at personal responses to a request by a competent person to be killed199891 92
19. Legalizing a biomedical procedure is used throughout as an example of societal regulatory policy only for the sake of brevity. This does not imply that the point of bioethics is to recommend a yes/no answer to the single question, should we legalize such-and-such a procedure? No doubt ultimate policy will tend to be of the rather thick-grained kind enshrined in biomedical law (see below); but bioethical discussion and recommendations can be much more detailed and fine-grained
20. J. McDowellVirtue and Reason197962331 350
21. J. Dancy2004Ethics without Principles
22. Another way of interpreting it is that there are dilemmas in bioethics because neither of the conflicting answers to the question as to whether to undertake a biomedical procedure in a specific set of circumstances is the correct one. But this is problematic because whether there are moral dilemmas and, if so, what the virtue ethicist should say about them, are contentious: see R. Hursthouse. 1998. Normative Virtue Ethics. In How Should One Live? Essays on the Virtues. R. Crisp, ed. Oxford: Oxford University Press: 291998
23. This clears up a complication. A morally optional action is a permissible action that the virtuous agent can decline without impugning their virtue. So a morally optional biomedical procedure would be permissible even if the virtuous agent always declines to choose it. But this is ruled out because the kinds of procedures investigated in bioethics are contestable in just the sense that it is not the case that they are morally optional in all circumstances (if they were, they wouldn't need investigating
24. A rejoinder is that the truly virtuous agent would take into account considerations relevant to societal regulation of a biomedical procedure in deciding whether to go in for it (for example, the truly virtuous agent would be aware of slippery slope objections to legalizing euthanasia). But this is implausible. It's not just that it makes the exercise of virtue too demanding; more importantly, it redirects the agent's attention from the salient considerations that define their circumstances to broad consequences of types of actions, and this collapses virtue ethics into the kind of consequentialist thinking to which it was supposed to be a refreshing contrast
25. Although the main focus in this paper is the application of virtue ethics to bioethics, pessimism about a virtue ethics approach to other areas of public policy seems well placed. For example, Hursthouse suggests that environmental virtue ethics is concerned with articulating and defending the green belief [that a fairly radical change in the way we engage with nature is imperative] in virtue ethics terms, rather than in the terms of its two rivals, utilitarianism and deontology. R. Hursthouse. 2007. Environmental Virtue Ethics. In Working Virtue: Virtue Ethics and Contemporary Moral Problems. R.L. Walker & P.J. Ivanhoe, eds. Oxford: Oxford University Press: 155. But this is an environmental metaethical question (how do we ground the green belief?) rather than an exercise in normative environmental ethics (which would specify our duties and obligations concerning the environment).
26. It is worth reiterating the point made at the outset that the argument of this paper does not count against the application of virtue ethics to other of bioethics' objectives, such as describing and prescribing ethical aspects of everyday professional practice and contributing to a consideration of the good professional life
27. Institutions other than the state regulate biomedicine, such as hospitals and universities, but, typically, they are implementing the state's regulatory decisions (if not, they would be too idiosyncratic to warrant substantive discussion).
28. Hursthouse, op. cit. note 2. Hursthouse is referring to M. Nussbaum. 2006. Frontiers of Justice: Disability, Nationality, Species Membership. Cambridge, Mass: Harvard University Press; R. Hursthouse. After Hume's Justice. Proc Arist Soc 1990199119229 245
29. Specifically, three unsolved problems of justice involving disabled people, international justice, and nonhuman animals
30. Swanton points out how strikingly different this kind of justification is from others familiar in the liberal tradition, such as the fact of vulnerability. C. Swanton. Commentary On Michael Slote's Virtue Ethics and Democratic Values. J Soc Philos199324238 49
31. This is indicated by the fact that the relevant sources of future directions Hursthouse recommended in her 2007 entry on virtue ethics in the Stanford Encyclopedia of Philosophy are from the early as Swanton puts it, little has been done on the application of virtue-ethical theory to political philosophy. Ibid1990
32. Kihlbom raises exactly the right issue: virtue ethics essentially concerns the development and flourishing of individual characters and how these individuals ought to live their lives [it] would say nothing about how societies ought to be arranged or how groups ought to act. See U. Kihlbom. Guidance and Justification in Particularistic Ethics. Bioethics But the reasonable response he suggests only illustrates that more work is needed in this area because, after pointing out that members of public institutions are made up of individuals, he comments: In the spirit of virtue ethics, it might furthermore be suggested that political actions should aim at the human good, which in part is human flourishing or the development of virtues2000144294
33. B. HookerThe Collapse of Virtue Ethics20021422 40Conversely, this point is connected to the development of those rivals in ways inspired by the post-war revival of interest in virtue
34. This is the second of Solomon's three internal objections to virtue ethics. See D. Solomon. Internal Objections to Virtue Ethics. Midwest Studies in Philosophy198813437 439
35. This worry is exacerbated by the fact that some states notably those the authority of which is religious based will be anything but unclear when guiding action, despite seeming to lack any legitimacy from a neo-Aristotelian virtue political perspective
36. Hursthouse,91, op. cit. note 28 Hursthouse here follows M. Nussbaum. 1989. Recoiling From Reason: Review of Alasdair McIntyre's Whose Justice? Which Rationality? in the New York Review of Books, 7 December1990237 238