November 21, 2004

Reports of Bioethics' Demise Seem a Bit Premature

Writing in the November 13th issue of The Lancet (Vol. 364, no 9447, p.1749) Roger Cooter of the Wellcome Trust Centre for the History of Medicine at University College London offers an amazing assessment of the field of bioethics;

“Hardly wet behind the ears, bioethics seems destined for a short lifespan. Conspiring against it is exposure of the funding of some if its US centres by pharmaceutical companies; exclusion of alternative perspectives from the social sciences, retention of narrow analytical notions of ethics in the face of popular expression and academic respect for the place of emotions; divisions within the discipline (including one over its origins and meaning); and collusion with, and appropriation by, clinical medicine. To many its embrace of everything bearing on human life renders it, paradoxically, bankrupt."

I could go on (and he does a bit more) but you get the point. We are all familiar with the sad state of British University life as cut after cut decimates the ranks of the professoriate there but have things really degenerated to the point where a hack is offering this sort of loony assessment as serious analysis (and getting it published to boot)?

Every so often British physicians and university purists and their publications try to pronounce bioethics dead. This latest declaration seems to have been penned by someone who cannot, however, diagnose the difference between a field (not a discipline!) entering into middle age with all its attendant crises of self assessment and self-doubt and a field that has never been more firmly entrenched within colleges, medical schools and other institutions not only in North America but, if the numbers showing up for the International Association of Bioethics meeting in Australia are any indication, worldwide.

Just to put things right in case Professor Cooter is having a hard time seeing what is going on in the field by what must be a very dim light underwritten by the laundered drug money funding that provides his full career support;

there are no academic bioethics centers in the United States funded by pharmaceutical companies, the only centers/programs/persons funded by private sources involve right to life or political orientations inclining to the right;

it is fairly easy to find out which centers/programs, persons have accepted grants or contracts or gifts by asking them (no EXPOSURE –insert Cooter’s heavy breathing here—required),

no academic bioethics center or medical ethics program has received more than a tiny percentage of funding from drug companies (some think they ought to be providing more funding in the way of general, unrestricted gifts),

the social sciences are not excluded from bioethics and, in fact, there is some danger that empirical bioethics may come to dominate all other modes of inquiry although quantitative social science may lie outside Cooter’s ken,

there is no intolerance of the emotions on the part of bioethicists—there is however an intolerance of using emotional responses as a form of argument (what I many years ago dubbed the Yuk factor) as well there should be,

there are divisions within the field (again not discipline) as again well there should be—it is a sign of intellectual vitality perhaps not recognized among the few remaining British historians of medicine,nor is there collusion with academic medicine unless talking to one’s colleagues if one works in a medical school happens to constitute cooptation or collusion.

Cooter’s worry about bioethics' “embrace of everything bearing on human life” I leave to more level-headed students of the sexuality of intellectual life than myself.

Cooter’s bizarre screed follows hard on the heels of Carl Elliot’s discovery of a new form of argument in a just out piece in the Hastings Center Report—arguendo ad Pfizer. By intoning Pfizer repeatedly Professor Elliot seems to think he can confirm Professor Cooter’s contention that bioethics has sold itself out to Big Pharma.

Cooter, Elliot and others seem so irritated by bioethics or some bioethicists that they either have to pronounce the field finished or irrevocably tainted. My hunch is that this sort of nonsense is a sign that whatever else it is doing, bioethics is being appropriately irritating to pedants everywhere. - Art Caplan

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