The Fiction of Bioethics: Cases as Literary Texts (review)

Tod Chambers. The Fiction of Bioethics: Cases as Literary Texts. New York: Routledge, 1999. xv + 207 pp. Clothbound, $70. Paperback, $22.95.

Bioethicists have paid curiously little serious critical attention to the forms of their own discourse. Instead, they often write their cases in ways that at once support and disguise their prior philosophical positions. In The Fiction of Bioethics, Tod Chambers provides a much-needed model for a more reflexive bioethics. Applying the instrument of rhetorical analysis to a careful reading of some classic ethics cases, he reveals the literary methods philosophers regularly use to persuade both author and audience. Chambers doesn't argue that philosopher-ethicists should abandon the normative judgments and moral principles of ethics. Rather, he argues convincingly that all of us who do the work of ethics, regardless of our disciplinary training, must become competent in the skills of rhetorical analysis. This imperative means that we should be capable of examining how features of writing style can establish authority and convince listeners and readers of the "truth" of their ideologies, even without making explicit arguments for those ideologies. To bring rhetorical analysis and literary theory to bear this way on the discourse of ethics is to reaffirm a claim already staked and mined in other disciplines. In law, politics, history, and anthropology, most scholars acknowledge that facts derive from persuasion as much as from discovery or syllogistic rigor. The same certainly holds true for bioethics. Chambers makes accessible a cohesive set of well-used intellectual tools for rhetorical self-criticism.

The starting point for Chambers's provocative, lively, intelligent book is his observation that bioethics cases, the basic data of the discipline, are performances or re-tellings of lived events, whose moral implications derive from their authors' rhetorical purposes. Chambers chides philosopher-ethicists for often failing to acknowledge that their apparently real-life cases "are not themselves 'the moral world,' but rather representations of that world" (p. 9, Chambers's emphasis). He maintains that a serious attempt to interpret meaning in case studies must follow from an understanding that they are fictions, narrative constructions designed to persuade readers to a particular philosophical viewpoint. From the common practice of setting the case itself apart visually on the page from the philosophical analysis to the general custom of adhering to the narrative convention of verisimilitude, case presentations promote a "fact/value distinction" that maintains the illusion of a transparent, unmediated rendering of lived events. A rigorous narrative analysis of the data of bioethics, Chambers argues, is necessary to reveal the inevitable constructedness of the "real" cases bioethicists use to think through moral issues. Drawing on the resources of literary theory, he examines the traditional narrative conventions of point of view, voice, plot, characterization, setting, time, and authorship for the ways authors use them to impose a world view on readers. Since bioethics relies on cases to test the validity of its theories, writers and readers alike need to be critically aware of the rhetorical force these literary devices exert on the way these cases are written and read.

The book's twelve chapters are distinguished in part by the wide range of texts Chambers draws on to develop and support his contentions. From literary theory, for example, he pulls together insights and methods of analysis from such critics as Gerard Genette on types of narrators and narratives, Susanne Langer on perspective, Barbara Hernnstein Smith on narrative closure, Victor Turner on performance, and Paul Ricouer on narrative time, lucidly explaining their relevance to the case under scrutiny.

Alongside an august literary company are examples from popular culture that include film, detective novels, television sitcoms, science fiction, fairy tales, and videodiscs, each culled to support a broad conception of the persuasive techniques upon which all forms of fiction rely. The focus of each chapter, though, is a series of readings of ethics cases, most of them well known in the field, that map onto the literary theory with...