The Ethics of Bioethics: Mapping the Moral Landscape

24 Social Moral Epistemology and the Role of Bioethicists

c h a p t e r t w e n t y - f o u r Social Moral Epistemology and the Role of Bioethicists a l l e n b u c h a n a n , ph.d. As a species of practical ethics, bioethics aims not just at achieving a better understanding of ethical problems, but at understanding ethical problems in ways that contribute to morally better actions and policies. Given that the ultimate aim of bioethics is practical, those who claim the title of bioethicist ought to think hard about whether the modes of understanding they characteristically employ are adequate to the practical task. In this chapter I argue that the conventional methodologies bioethicists employ are deficient from the standpoint of the practical aim of bioethics, because they do not incorporate what I have elsewhere labeled social moral epistemology. I also want to argue that social moral epistemology is a valuable tool for self-examination by bioethicists—and that bioethicists have a responsibility to apply social moral epistemological analysis not just to the problems they characteristically grapple with, but also to themselves. social moral epistemology: a brief introduction Social epistemology is the comparative evaluation of the eªciency and e¤ectiveness of institutions and social practices in promoting the formation, preservation , transmission, and e¤ective utilization of true beliefs (Goldman 1999).1 To take only a few examples, social epistemologists critically evaluate the comparative advantages of adversarial versus inquisitorial criminal proceedings as mechanisms for the discovery of truth, try to determine which practices of a scientific community are most e¤ective for progress in scientific knowledge, and examine the e¤ectiveness of alternative democratic institutions in providing relevant information to policy makers. Social moral epistemology, in its most inclusive form, is the comparative evaluation of the eªciency and eªcacy of alternative institutions and social practices in promoting the formation, preservation, and e¤ective utilization of true beliefs so far as true beliefs facilitate right action or reduce the incidence of wrong action (Buchanan 2002). A special department of social moral epistemology is the comparative evaluation of social practices and institutions that promote (or impede ) the functioning of the moral virtues, so far as their functioning depends upon an agent having relevant true beliefs. For example, the virtue of sympathy does not function properly when one’s ability to recognize the humiliation that one’s behavior inflicts on certain people is undercut by the belief that they are not fully human. More generally, webs of false beliefs about supposed natural di¤erences between men and women or blacks and whites can result in excluding some individuals from the scope of certain moral principles or from the moral community altogether. The processes by which individuals come to have and to sustain such beliefs are social: They learn them, and they learn to disregard evidence that conflicts with them, through the operation of various social practices and institutions. Social moral epistemology is a normative enterprise, because it evaluates—not merely describes or explains—the epistemic performance of social practices and institutions. It is a species of moral epistemology because its concern is not with true belief generally but with true beliefs so far as they play a role in right action. The nature of social moral epistemology and its potential for strengthening bioethics will be made clearer by considering two examples of the ways in which this methodological approach can be applied within bioethics and then suggesting how it can be employed to cast a critical light on bioethics itself and on the role of bioethicists. the relevance of social moral epistemology to bioethics: two examples Understanding Medical Paternalism as an Epistemic-Institutional Phenomenon Medical paternalism is usually defined as the view that physicians may withhold information (e.g., of a grim diagnosis) or even lie to patients, or otherwise preempt their making a free, informed choice regarding medical care, when this is done for the good of the patient. In the early years of bioethics, philosophers o c i a l m o r a l e p i s t e m o l o g y a n d b i o e t h i c i s t s 289 bioethicists, including this author, advanced powerful objections against medical ethics as a moral view. In other words, they proceeded as if the bioethicist’s...