Rethinking Autonomy: A Critique of Principlism in Biomedical Ethics

Chapter 4 Autonomies, Virtue, and Social Change

Chapter 4 Autonomies, Virtue, and Social Change Virtue is the basic nature of human spirit. Human beings are endowed by Heaven at birth with a virtuous essence, consisting of compassion, righteousness, propriety, and wisdom. . . . With the virtue of compassion, things are empathized with genuine feeling, with righteousness the validity of a fact is determined, with propriety there is deep reverence, with wisdom moral imperatives are seen clearly. —Miyaki Sekian (in Najita 1987:155) 4.1. Self, Virtue, and Character In Chapter 3, I used the word virtue, but the concept presents problems when thinking about comparative ethics. From a cross-cultural perspective , we need to ask the question: What do we mean when we talk about virtues or virtuous behavior? I am not asking if there are specific equivalent virtues when we talk about different cultural contexts, although that is an important question. Rather I am concerned with whether or not the concept of virtue itself is equivalent across different cultures. Obviously, the nature of virtue—seen as a decontextualized feature of “the good”—has been debated and discussed by philosophers since Plato and Aristotle, and I am not going to rehash the intellectual history of that discussion here. Rather, my starting point is one of the key think79 80 Rethinking Autonomy ers in the revival of virtue ethics, Alasdair MacIntyre. Although I am not interested in promoting the agenda of virtue ethics (in fact, I think the entire project has some serious flaws related to its tendency toward ethnocentric concepts of self and person), MacIntyre’s notion of virtue as a cultural category is important, because although the idea that there are parameters demarking good or virtuous behavior seems to arise generally in human societies, the parameters themselves can vary significantly. One of the problems with the idea of virtue is that it normally is tied closely to the notion of a paradigmatic sense of human character as the basis for understanding and identifying morally good behavior (Statman 1997:10), despite the fact that the definition and nature of character often is assumed rather than analyzed and explained in detail.1 Because there is no universal definition for the nature of human being, the manner in which character is understood, or whether there is any base-level character of humans to be understood at all, also can vary.2 Where I find Macintyre’s notion of virtue useful is in the idea of social embeddedness. Virtues are concepts of good that we use to define our “relationships to those other people with whom we share the kind of purposes and standards which inform practices” (MacIntyre 1981:191). This definition of virtue removes the concept from its dependency upon character as a paradigmatic feature of humans, and instead recognizes that character, like virtue, is something constructed and contested within the confines of particular social settings. The reasonableness of this perspective should be readily evident if we think about sport or business in American society. Most football fans would likely perceive aggressiveness as a positive character feature for a defensive back, and many business people see aggressiveness as a positive feature of social interactions aimed at achieving a particular end. However, in many contexts, such as teaching or listening, aggressiveness is not viewed as 1. A good example of this is Watson’s (1997) essay “On the Primacy of Character,” in which he discusses the importance of character in relation to virtue and explores the idea of character utilitarianism, but never actually defines what character is. 2. In some societies, as Adelson (2000:3) points out in her discussion of Cree concepts of well-being, the idea of the person, and thus the health of the person, is intimately tied to the surrounding land. In such a cultural milieu, the notion of what constitutes character and thus virtue will have different features and structures from that which is typical in the West, where this type of connection to the land generally does not exist, although ideas that link ethics to the land have been proposed by thinkers such as Aldo Leopold (1949). 81 Autonomies, Virtue, and Social Change particularly desirable. In fact, the value of aggressiveness as a feature of character is either ambiguously defined or contested in American society; it can be seen as both a positive and negative feature of one’s character, depending upon the social context in which one is operating. This ambiguity is not...