Toward a Social Bioethics Through Interpretivism: A Framework for Healthcare Ethics.

Dougherty, R., & Fins, J. (2023).

Cambridge Quarterly of Healthcare Ethics, 1-11.

doi:10.1017/S0963180123000452

Abstract

Recent global events demonstrate that analytical frameworks to aid professionals in healthcare ethics must consider the pervasive role of social structures in the emergence of bioethical issues. To address this, the authors propose a new sociologically informed approach to healthcare ethics that they term “social bioethics.” Their approach is animated by the interpretive social sciences to highlight how social structures operate vis-à-vis the everyday practices and moral reasoning of individuals, a phenomenon known as social discourse. As an exemplar, the authors use social bioethics to reframe common ethical issues in psychiatric services and discuss potential implications. Lastly, the authors discuss how social bioethics illuminates the ways healthcare ethics consultants in both policy and clinical decision-making participate in and shape broader social, political, and economic systems, which then cyclically informs the design and delivery of healthcare.

My summary: 

The authors argue that traditional bioethical frameworks, which focus on individual rights and responsibilities, are not sufficient to address the complex ethical issues that arise in healthcare. They argue that social bioethics can help us to better understand how social structures, such as race, class, gender, and sexual orientation, shape the experiences of patients and healthcare providers, and how these experiences can influence ethical decision-making.

The authors use the example of psychiatric services to illustrate how social bioethics can be used to reframe common ethical issues. They argue that the way we think about mental illness is shaped by social and cultural factors, such as our understanding of what it means to be "normal" and "healthy." These factors can influence how we diagnose, treat, and care for people with mental illness.

The authors also argue that social bioethics can help us to understand the role of healthcare ethics consultants in shaping broader social, political, and economic systems. They argue that these consultants participate in a process of "social discourse," in which they help to define the terms of the debate about ethical issues in healthcare. This discourse can then have a cyclical effect on the design and delivery of healthcare.

Here are some of the key concepts of social bioethics:

• Social structures: The systems of power and inequality that shape our society.
• Social discourse: The process of communication and negotiation through which we define and understand social issues.
• Healthcare ethics consultants: Professionals who help to resolve ethical dilemmas in healthcare.
• Social justice: The fair and equitable distribution of resources and opportunities.

Ancient Ethical Theory

By Richard Parry
The Stanford Encyclopedia of Philosophy
Substantial Revision August 13, 2014

While moral theory does not invent morality, or even reflection on it, it does try to bring systematic thinking to bear on the phenomenon. Ancient moral theory, however, does not attempt to be a comprehensive account of all the phenomena that fall under the heading of morality. Rather, assuming piecemeal opinions and practices, it tries to capture its underlying essence. It is the nature of such an enterprise to evaluate and criticize some of these opinions and practices but that is not its primary goal. Ancient moral theory tries to provide a reflective account of an essential human activity so one can grasp what is of fundamental importance in pursuing it. In historical order, the theories to be considered in this article are those of Socrates as presented in certain dialogues of Plato; Plato in the Republic; Aristotle; the Cynics; Cyrenaic hedonism; Epicurus; the Stoics; and Pyrrhonian skepticism.

The entire post is here.

Drone Ethics is Easy

By Mike LaBossiere
Talking Philosophy
Originally published on May 16, 2014

When a new technology emerges it is not uncommon for people to claim that the technology is outpacing ethics and law. Because of the nature of law (at least in countries like the United States) it is very easy for technology to outpace the law. However, it is rather difficult for technology to truly outpace ethics.

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It is, however, worth considering the possibility that a new technology could “break” an ethical theory by being such that the theory could not expand to cover the technology. However, this would show that the theory was inadequate rather than showing that the technology outpaced ethics.

Another reason that technology would have a hard time outpacing ethics is that an ethical argument by analogy can be applied to a new technology. That is, if the technology is like something that already exists and has been discussed in the context of ethics, the ethical discussion of the pre-existing thing can be applied to the new technology. This is, obviously enough, analogous to using ethical analogies to apply ethics to different specific situations (such as a specific act of cheating in a relationship).

The entire article is here.

The Ethics of Care: An Interview with Virginia Held

3:AM Magazine
Interview by Richard Marshall

Here are some excerpts:

3:AM: You’ve developed an ethical theory around ‘care.’ You see this as an alternative to the dominant ethical theories of the last couple of centuries. It’s important to you that it isn’t an ethics to be added on to Kantianism or utilitarianism or virtue ethics. Can you say something about why it is so important that a care ethics is not an adjunct but is a fresh start? The Kantian Christine Korsgaard has placed reciprocity and human relations at the heart of Kantianism. Onora O’Neill has argued that justice and care are not opposed. In the light of these views, would you still defend the break, or would you be happier to see it as a continuation?

VH: I don’t find it satisfactory merely to add some considerations of care to the traditional moral theories for reasons similar to why it is not enough to simply insert women into the traditional structures of society and politics built on gender domination. Feminists should understand that the structures themselves have to change. The history of ethics shows it to be a very biased enterprise. Very roughly, what men have done in public life has been deemed important and relevant to moral theory, and what women have done in the household has been considered irrelevant. I think it plausible to see Kantian ethics and utilitarianism as expansions to the whole of morality of what can be thought appropriate for law and for public policy.

I have come to see, in contrast, caring relations as the wider network, and the ethics of care as the comprehensive morality, within which we should develop legal and political institutions. Caring relations should be guided by the ethics of care, which we can best understand and which is most applicable in contexts of families and friendship. But we can and should also have weaker forms of caring relations with all persons, and within these, the more limited institutions of law should be guided, roughly, by Kantian norms, and the more limited political institutions by utilitarian ones. Yes I see the legal and political as importantly different, and both as significantly different from the contexts of family and friendship. This is a very oversimplified statement of a complex position but I try to clarify and delineate these matters in my written work.

3:AM: So ‘care’ is at the heart of this new ethic but it isn’t to replace justice. So how do you get from care to justice in your system? Do we end up losing the common use of ‘care’ for a more term of art, technical use, as is the wont with philosophers? And isn’t that a cheat?

VH: Yes, various Kantians are trying to acknowledge the concerns of care, and various philosophers interested in the ethics of care are trying to combine it with Kantian ethics. I think the ethics of care has the resources to be an alternative moral theory that can include persuasive aspects of Kantian ethics and also of utilitarianism and virtue theory. It’s nevertheless a feminist ethics that includes the goal of overcoming gender domination, in our thinking as well as our institutions. And I see it as the more comprehensive view. Korsgaard and O’Neill are still Kantians, though more persuasive ones than some traditional Kantians. I think ethics should start with a vast amount of experience (the experience of caring and being cared for) overlooked by traditional moral theories, and see how the many important and valid concerns of other moral theories can be brought into care ethics. I think it is a strength of care ethics that it is based on experience. It is experience which everyone has had: no one would have survived without enormous amounts of care, in childhood at least. Most women, and increasingly men, have also had a great deal of experience providing care, especially for children.

The entire interview is here.

Virginia Held has written: Feminist Morality: Transforming Culture, Society, and Politics, Justice and Care: Essential Reading in Feminist Ethics, and The Ethics of Care: Personal, Political and Global.