In Honour of Daniel Callahan: A Medieval Disputation on Bioethics

Article excerpt

The General Meeting of the Hastings Center was held on June 7th and 8th, 1996 in Tarrytown, New York to honor Daniel Callahan, the Co-Founder and President of the Center, who retired from its Presidency on Sept. 1, 1996. During the meeting, which was structured as a "medieval disputation," the participants debated many of the issues that Dr. Callahan pursued throughout his career. The list of speakers at that meeting, which read like a Who's Who of American bioethics, included Renee Fox, Norman Daniels, William May, Strachan Donnelley (The President-Elect of the Hastings Center), David Rothman, Leon Kass, Judith Wilson Ross, Ezekel Emanuel, Bruce Jennings, Barbara Keonig, Bonnie Steinbock, Thomas Murray, Alexander Morgan Capron, Robert Veatch and Willard Gaylin.

The topics in dispute were classic and current issues in bioethics: "Bioethics: Discipline or Ideology?"; "Values in Health Reform: Is Justice Enough?"; "Nature as a Source of Moral Guidance"; "Does Clinical Ethics Distort the Discipline?"; "Does Bioethics Reinforce Legalism?"; and "Bioethics Beyond Autonomy: Responsibility and the Good Society". In turn, three different disputants responded to each of Callahan's proposals on the six topics. The following summary gives a taste of the discussion that was spirited, challenging, confrontational, conciliatory, insightful and humorous.

Bioethics: Discipline or Ideology?

Callahan proposed that bioethics debates reflect cultural wars; that we can predict a bioethicist's view from his or her background and characteristics, for instance, religion, age, culture, etc.; and that bioethics is not a matter of analysis but of ideology. He argued that we should avoid the formal legitimation of ethical expertise and that the appropriate stance for a bioethicist is one of neutrality not advocacy.

Professor David Rothman, Professor of History, Bernard Schoenberg Professor of Medicine and Society, Center for the Study of Society and Medicine, Columbia College of Physicians and Surgeons, New York, linked the history of the development of American bioethics with the evolution of the civilrights model of advocacy and adversarial challenges. Because of this link, Rothman believes that the initial alliance of bioethics with lawyers in the United States was no accident. In his view, bioethics used to identify with vulnerable minorities and saw itself as working "from the bottom up, not the top down", but he believes that this is changing. The discussants challenged this view of the origins of bioethics on the grounds that one needed to look not only at the development of American bioethics, but also at the global development of this discipline. Other countries that had no event similar to the civil rights movement of the 1960s also had developed a system of bioethics.

Professor Renee Fox, Annenberg Professor of the Social Sciences, University of Pennsylvania, Philadelphia, reviewing the broad range of issues now thought to come within the field of bioethics, noted that it was becoming even more diffuse because of the expansionary use of the terms, ethics and ethicist. There had been a rise in interest in moral problems in the United States - a trend that she called the "ethicization of America". Fox warned that bioethics arises from, and therefore has the trappings of, the culture in which it is found. Our aim should be to forge an ethics for a global society that is sufficiently neutral and universal. One barrier to this is that bioethics has an aloof and strained relationship with the social sciences, mainly because of the principlism of analytic philosophy (its reliance on the application of pre-determined moral principles, pre-eminently in bioethics, autonomy, beneficence and justice, to resolve ethical dilemmas) that has dominated United States bioethics. This principlism also causes other barriers, for example, the principle of individual autonomy has not received the same emphasis in other cultures and other societies. …