Bioethics in Pluralist Societies

BIOETHICS IN PLURAUST SOCIETIES H. TRISTRAM ENGELHARDT, JR.* I. Introduction The last 2 decades have been marked by a growing interest in bioethics . This is not to say that there was not an active interest in such issues prior to this time. There is a long history of Roman Catholic and Jewish concerns with contraception, sterilization, and the care of dying individuals, to name only a few topics [1-3]. Indeed, die current literature in bioethics was in great measure spawned by die contributions of Protestant theologians such as Paul Ramsey, Joseph Fletcher, and Harmon Smith [4-6]. Furthermore, Christian and Jewish religious thinkers continue to contribute in significant ways to this literature. However, even in the contributions ofthese dieologians, one finds much reflection on bioethics which is not in the genre of Judeo-Christian religious thought in sensu stricto but which falls more in the genre of philosophy. In fact, the field of bioethics has involved the development of a secular philosophical bioethics, that is, a bioethics not direcdy dependent on particular religious convictions. Secular ways ofunderstanding sexuality, contraception, abortion, and die definition of death have been drawn from new biomedical and bioethical approaches and viewpoints. They are already shaping our lives and our culture. Bioethics has evolved in a pluralist context spanning nations and cultural groups within nations. It has developed not as a Christian or Judeo-Christian medical ethics but as a part of our cultural traditions that attempts to transcend the idiosyncrasies of our culture: philosophy and the other secular humanities. These traditions have recent roots in the Enlightenment and more profound roots in our pagan past. That past engendered our concept ofphilosophy as an attempt to understand the nature of man and of the human condition on the basis of reason An earlier version of tins paper was presented as die Will Judy Lecture at Juniata College, Huntington, Pennsylvania, March 25, 1981. ?Joseph and Rose Kennedy Institute of Ethics, Center for Bioethics, Georgetown University , Washington, D.C. 20057.© 1982 by The University of Chicago. All rights reserved. 0031-5982/83/2601-0315$01.00 64 I H. Tristram Engelhardt,Jr. ¦ Bioethics in Pluralist Societies and generally demonstrable facts about man, without reliance on a particular revelation or a particular culture. Secular bioethics now possesses an importance which it could not have had in the past. First and foremost, in the past, the interests of religion had not been placed by public policy within the broader concerns of maintaining a peaceable community. What I sketch here are the consequences of a commitment to a peaceable community that is not totalitarian in the ways of Khomeini's Iran, the Soviet Union, or Christian states under die Inquisition. A commitment to the peaceable community involves a commitment to framing an understanding of how a society will deport itself in conditions when one view of the good life, or of the nature of man, will not be imposed by force on all. Beyond and before the commitment to the peaceable community are some of its roots in the flow of history. Our communities have become more explicidy heterogeneous, including vocal non-Christians, atheists, homosexuals, and others who in various ways exempt themselves from the dominant orthodoxies of the Christian West. Furthermore, the "Christian" West has become but one of the many traditions on a planet populated by Muslims, atheist Communists, Hindus, Buddhists, and others who do not share traditional Christian cultural commitments. These other cultures have also been touched by die lure of a peaceable community and frightened by the heterodoxies it allows. They, too, are finding their own communities in various degrees explicitly and stridendy pluralistic. Moreover, they, as we, are in a world that is pluralistic in its roots and commitments. They have suffered, as we have, from the future shock engendered by the successful technological revolutions of this century. The passage into a starkly secular world is a painful one for all those who believe in a religion or in the beauty and power of their particular culture. Such believers are faced with the difficult prospect of living always within two worlds: that of their private conscience and diat of public morality. The distance between these...