Normative Slogging

Both of the articles in this issue of the Hastings Center Report deal with questions that, though abstract and theoretical, are close to my heart. Both have to do with questions about moral language. What moral language will best address national and global bioethical problems—like health reform in the United States and health inequities globally—in a way that transcends the cultures that give rise to moral languages in the first place? And what moral language will be grounded in culture while also providing the leverage to change it when necessary?

The lead article, by philosophers John Arras and Elizabeth Fenton, considers whether the language of human rights might be better than that of bioethics for addressing global health issues. (As George Annas, a strong proponent of that view, argues on the facing page, it might even provide a better basis for domestic U.S. health reform—echoing a similar thesis that Mary Crowley, director of public affairs and communications at The Hastings Center, advanced in that same space in January-February 2008.) After setting out a preliminary account of what human rights are, Arras and Fenton argue that they "are insufficient for the establishment of public policy" unless they are construed in such a way that they refer not to specific, substantive goods owed to people but to fair political and legal institutions that can decide how to allocate goods to a number of competing claimants. Human rights are more label than language, they conclude: they are a good way of tagging some of the conclusions that good deliberation produces, but they do not provide a unique moral framework for deliberating about bioethical problems. For that, there is no getting around the difficult work of arguing through a welter of cultural and economic values—" normative slogging," as they call it.

The following article, derived from the presidential address by Hilde Lindemann at last year's conference of the American Society for Bioethics and the Humanities, poses the same general problem—what tools do we need for an international approach to bioethical problems?—but considers some different possible answers. Lindemann contrasts two dominant approaches within bioethics—reasoning from broad moral principles such as beneficence and respect for autonomy, and constructing stories, grounded in the particulars of culture, context, personal experience, and relationship, that illuminate appropriate conduct. She offers a defense of the second approach, arguing that what allows stories to provide moral guidance is fine, layered attention to the welter of moral terms used in their telling—another kind of normative slogging, perhaps. Lindemann hangs her discussion on the story of her own experience exploring and explicating the Dutch perspective on euthanasia and her encounter with the complicated Dutch concept of "gezelligheid."

It's a nice term, "normative slogging." I tried weakly to talk Arras and Fenton out of using it on grounds that it was too obscure, but John helpfully objected. The combination of high-flown, abstract thinking and down-to-earth, practical labor is exactly right.