The Facts of Bioethics

Tod Chambers's narrative, "The Fiction of Bioethics: A Précis" (2001), follows a form made famous in a letter by Émile Zola, "J'accuse." Chambers accuses Rita Charon of being a faint-hearted champion of narrative theory. Narrative theory is not "a mere helpmate to philosophy," Chambers proclaims. It is "as vital to [bioethics] as moral theory itself." Bioethicists "need to attend" to narrative theory, because they "test their ideas by applying them to cases, [which] are a narrative genre." Bioethicists, moreover, "separate the case text physically from the philosophical text ... convey[ing] that the cases are in some manner separate from their ideas: they are simply objective examples. But as narrative theorists know well ... there are no objective stories." To prove his point, Chambers accuses one of the best-known names in bioethics, James Childress, of "begging the question" because he was ignorant of narrative theory. By failing to use a mediating consciousness experiencing events within a story (a filter) to "reveal ... how the characters in the case experience the events," Childress is said to have begged the question, by omitting the very "issues raised by virtue ethics, such as motivation and discernment." If no less a figure than James Childress can be led astray by ignorance of narrative theory, and if other bioethicists wish to avoid Childress-like blunders, they must turn to narrative theory—since "no ethics case escapes narrative"—to learn "to be critical of the evidence used to test moral theories."

It is comforting to know that salvation is so readily at hand. But are bioethicists damned if they fail to master narrative theory? Chambers's argument hinges on whether Childress really "objectifies" cases or begs the question. Old-fashioned scholarly canons require that quotations be checked and contexts be analyzed. Childress's case was adduced in the context of a textbook edited by Robert Veatch as part of a philosophy textbook series "designed to be accessible to the undergraduate or graduate student" (Veatch 1989, iv). In light of the textbook format (and since cases are offset less prominently in the second edition of the textbook [1997]), it seems a stretch to suggest that, just because bioethics textbooks use offsets to differentiate case presentations from case analyses, cases are treated as "simply objective examples." After all, Chambers, who clearly asserts that "there are no objective stories," also uses offsets to present this same case in his critique of Childress. The conventions set down in the Chicago Manual of Style (Grossman 1993) are shared by narrative theorists and bioethicists alike. It seems unfair, therefore, for narrative theorists to accuse bioethicists of some form of naive objectification, simply because they follow standard conventions (especially since, as James Harold notes (2001), the analysis of "objectivity" is a central preoccupation of contemporary philosophy).

Chambers cites Childress's case as an example of how bioethicists use cases as "evidence used to test moral theories." One might expect, given the significance Chambers's accords it, that the case was important to the field, or at least to Childress. Chambers treats the case as if it was the bioethical equivalent of the Michelson-Morley experiment of 1881—which ultimately led physicists to reject ether theory. The suggestion is that the case is a pivotal test, designed to reject virtue theory. Yet, as Chambers remarks, "tales are told by [a] teller who simultaneously reveals and conceals." What has been concealed is the pedagogical context. Childress was not addressing fellow bioethicists. The case was not adduced as part of a critical test of virtue theory. It was adduced to teach students about the nature of moral principles. Later, Childress uses the case to illustrate the following claim: "Virtues include dispositions to right actions, but are not themselves sufficient to determine right actions. In Case 1 it is not clear what a virtuous physician would have done.... The determination of which virtues should be developed depends on principles of action" (Childress 1989, 45). Thus Chambers's...