Among Bioethicists

This collection of essays marks an important milestone in the maturation of bioethics." So says Jonathan Moreno in the first sentence of his foreword to The Ethics of Bioethics (p. xiii). He does not identify the nature of that milestone, but we readers are tempted to conclude, along with editors Lisa Eckenwiler and Felicia Cohn, that "the field has come of age" (p. xix), that the "critical and . . . constructive discussion about the moral landscape of North American bioethics" (p. xxi) offered by the many well-known contributors to this anthology is sign of the maturity and wisdom of bioethics.

No one can pinpoint the birth date of bioethics: was it in 1969, the year that saw the creation of the Institute of Society, Ethics, and the Life Sciences in Hastings-on-Hudson, New York, and the establishment of the Society for Health and Human Values? Or in 1970, when Van Rensselear Potter and André Hellegers (together with Sargent Shriver) simultaneously but independently coined the term? Or in 1971, when the Joseph and Rose Kennedy Institute for the Study of Human Reproduction and Bioethics was founded at Georgetown University? Or in 1974, when the National Commission for the Protection of Human Subjects of Biomedical and Behavioral Research was assembled? It is safe to say that bioethics is about forty years old. Eckenwiler and Cohn mention "four decades" (p. xix), while Carol Levine, whose brief history of bioethics opens the collection, is more generous, claiming that bioethics (in its American incarnation) is "about 50 years old" (p. 3). This suggests a field well into adulthood. But we must not forget that, as with years in a dog's life, academic years are measured on a different scale. I estimate that three academic years equal one human year, making bioethics about thirteen or fourteen years old, a discipline (profession? occupation? interdiscipline?) in its early adolescence—a period of life marked by the search for identity, conflict with others, the decline of egocentrism, increased cognitive abilities, and the beginning of abstract thought.

Seen in this light, the essays in The Ethics of Bioethics are more like the clubhouse conversation of teenagers—questioning their place in the world and wondering who they are becoming—than they are the wise words of a mature adult. In one way or another, the authors of each of the twenty-five chapters ask: Who are we? What are we doing? What should we be doing? Carol Levine wonders about the Pandora's Box that bioethics has unleashed on the world. Robert Baker quarrels with "anti-code skeptics" about the need for a code of ethics for those who do ethics ("We need one!" "No, we don't!" "Do too!" "Do not!"). Carl Elliott, James Lindemann Nelson, and Mark Kuczewski worry about the identity of "moral experts" and the influence of moral expertise on others. R. Alto Charo and Griffin Trotter argue about who is shaping the agenda of bioethics: the political right or the political left? ("Yes, you are!" "No, I'm not!") Several authors worry about who bioethicists are becoming: What does it mean to be an "insider" in the world of medicine and medical research (Debra De Bruin, Virginia Sharpe, Haavi Morreim)? What are our obligations to others (Mary Faith Marshall, Françoise Baylis, Laurie Zoloth)? What should we be doing (Leigh Turner)? Are we hypocrites, criticizing others but unable to see the log in our own eye (Catherine Myser)? How can we be better (Allen Buchanan, James Childress, Hilde Lindemann)?

In making this observation about the maturity of bioethics, I am not suggesting that the folks who populate bioethics are adolescents. Rather, I am asserting that the disciplines we work in influence how we work. Academic fields vary in their degrees of self-confidence, cohesiveness, and collegiality, attributes that shape and are shaped by the behavior of those who labor in those fields. The research of a colleague who is studying how the publication of negative findings varies among scientific disciplines provides...