“Both bioethics and medical ethics together have, in many ways, failed as fields,” laments the editor of the Journal of Medical Ethics, Oxford’s Julian Savulescu. His diagnosis is that an illogical moralism dominates nearly all bioethical issues and that debates are conducted in philosophical darkness. He concludes gloomily that “From time to time, we ought to ask how well we are doing. In my own career, apart from promoting people's careers, I am only aware of two instances where my work did some good.” He even says that he feels, at least sometimes, that “there is no future for medical ethics”.
His disappointment is particularly poignant because the issue in which his reflections appear is a special 40th anniversary splash of the JME.
One example of the moral ignorance which pains Professor Savulescu is the moral obligation that people have to donate their organs after their death. To him, this is almost a self-evident ethical precept:
“Why? Because this is not just an easy rescue, it is a zero cost rescue. Organs are of no use to us when we are dead, but they are literally lifesaving to others. Nonetheless, most people choose to bury or burn these lifesaving resources, and are allowed to. Yet the state extracts death duties and inheritance taxes, but not the most important of their previous assets—their organs. The failure to meet even our most minimal moral obligations is damning. It represents the failure of modern practical ethics.”
At some points in his essay, Savulescu seems almost despondent:
“I left a promising career in medicine to do bioethics because I had done philosophy in 1982 and attended Peter Singer's lectures in practical ethics. The field was new and exciting and there were original proposals and arguments. Singer, Glover, Lockwood, Parfit and others were breaking new ground, giving new analyses and arguments. Now medical ethics is more like a religion, with positions based on faith not argument, and imperiously imposed in a simple-minded way, often by committees or groups of people with no training in ethics, or even an understanding of the nature of ethics.
“What medical ethics needs is more and better philosophy—and a return to the adventurousness and originality of its pioneering days. There have been successes—euthanasia and better treatment of animals to mention just two. But the field has in many ways dried up or become dominated by moralists bent on protecting privacy and confidentiality at great cost and ‘getting consent’, and in other ways ‘protecting basic human rights and dignity’. Medical ethics isn't sufficiently philosophical, and when it is philosophical, it's the bad arguments or a narrow range of arguments that often seem to make a difference. And there is the attempted scientification of ethics in empirical ethics, a kind of sociological ethics, surveying people's opinions and practice. But this can never directly lead to answering the question: what should we do?”
From this, it appears that Professor Savulescu believes that Singer’s “practical ethics” is ethics and that being “philosophical” is being utilitarian. He concludes with the lapidary maxim, “Good ethics requires good philosophy.” No doubt philosophers of every stripe will agree with him there. The question which the article fails to address is whether Singer and Savulescu’s utilitarianism is good philosophy.
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