Negotiating International Bioethics: A Response to Tom Beauchamp and Ruth Macklin
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Negotiating International Bioethics:
A Response to Tom Beauchamp and Ruth Macklin

Can the bioethical theories that have served American bioethics so well, serve international bioethics as well? In two papers in the previous issue of the Kennedy Institute of Ethics Journal, I contend that the form of principlist fundamentalism endorsed by American bioethicists like Tom Beauchamp and Ruth Macklin will not play on an international stage. Deploying techniques of postmodern scholarship, I argue that principlist fundamentalism justifies neither the condemnation of the Nazi doctors at Nuremberg, nor, as the Report of the Advisory Committee on the Human Radiation Experiments (ACHRE) demonstrates, condemnation of Cold War radiation researchers. Principlist fundamentalism thus appears to be philosophically bankrupt. In this issue of the Journal, Beauchamp and Macklin reject this claim, arguing that I have misread the ACHRE report and misunderstood Nazism. They also argue that the form of post-postmodern negotiated human rights theory that I proffer is adequate only insofar as it is itself really fundamentalist; insofar as I take postmodernism seriously, however, I mire international bioethics in relativism. In this response, I reaffirm my anti-fundamentalism, provide further evidence in support of my reading of the ACHRE report, and defend my post-postmodern version of rights theory. I also develop criteria for a minimally adequate theoretical framework for international bioethics.

Universal Morality Reconsidered 1

Paradoxically, the need for content-full universal moral principles tends to be most deeply felt and most adamantly asserted in the face of striking evidence of their absence. People are inspired to claim that Nazis must accept the universal principle that doing harm is wrong because they are appalled by the horror of the Holocaust. Yet the event itself provides palpable evidence that the Nazis saw no wrong in doing harm. One has the suspicion that claims of universalism [End Page 423] confound philosophical aspirations with empirical observations. This distinction makes a significant difference because empirical claims can be disconfirmed by data, whereas philosophical claims can only be challenged on the level of theory.

I am, like Tom Beauchamp and James Childress, a common morality theorist. Thus, I believe, as they do, that ethics “relies heavily on ordinary shared moral beliefs for its content, rather than relying on pure reason, natural law, a special moral sense, and the like” (Beauchamp and Childress 1994, p. 100). For most of human history sexism and slavery were considered moral. They certainly were the norm. Thus, if one looks to common morality as the source of moral content, empirical claims of moral universalism appear suspect. Insofar as one would condemn sexism and slavery, one needs to find some theoretical justification for condemnation that goes beyond a consensus on moral content (hence my embrace of the structural analogue of human rights theory).

Beauchamp, however, takes a very different view. He asserts in his critique of my position, that: “it is an institutional fact about the substance of morality (not merely [as Baker claims] the formal features of the concept of morality and not merely my view of it) that it contains fundamental and shared precepts. It is by appeal to this shared moral substance that persons are enabled to make justifiable cross-temporal and cross-cultural judgments” (Beauchamp 1998, p. 395). Beauchamp is thus claiming that it is both an empirical and a conceptual truth there is common core underlying the morality of all societies. He fleshes this claim out in another passage.

[T]he term morality refers to norms about right and wrong human conduct that are so widely shared that they form a stable . . . communal consensus. . . . These standards sometimes vary from society to society, but embedded in the beliefs of all moral societies are the core dimensions of morality: Persons must keep their promises, must respect the rights of others, must not kill or cause harm to innocent persons, must not abuse children, and the like. All morally committed persons are comfortable with these norms and do not doubt their relevance and importance.

(Beauchamp 1998, p. 394)

Insofar as Beauchamp is making an empirical claim in this passage, the examples cited are problematic. “Promise keeping,” for example, cannot be a cultural universal because the practice is...