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The Multiplicity of Bioethical Expertise in the Context of Secular Liberal Democracies

Abstract

While the notion of bioethical expertise might raise a host of questions concerning moral authority it is nevertheless the case that bioethicists continue to advance well thought out, detailed and comprehensive arguments concerning the ethical implications of the biosciences and healthcare. Not to make use of such work or those who produce it when it comes to the work of government and the development of policies would seem misguided at best. Thus, in the light of existing analysis of scientific expertise and its proper contribution to democratic political processes, this essay explores the role expert bioethicists might legitimately play in the production of policy and broader public moral debates. However, given that ethics can shade into politics and, furthermore, does so in a way that is not the case for science and politics, the ethico-political limitations that constrains and constructs the exercise of bioethical expertise is examined. Particular attention is paid to the implications of this view when it comes to bioethical research predicated on religious perspectives in the context of public reason, the validity of which has recently been called into question. We conclude with the suggestion that, if they are to act as experts in political contexts, bioethicists cannot simply make expert contributions to policymaking processes, they should also acknowledge they are responsible for shaping the broader public moral discourses about science and medicine.

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Notes

  1. 1.

    Rebecca A. Fried, ‘No Irish Need Deny: Evidence for the Historicity of NINA Restrictions in Advertisements and Signs’, Journal of Social History 49, no. 4 (2016): 829–54, https://doi.org/10.1093/jsh/shv066.

  2. 2.

    Brian Wynne, ‘May the Sheep Safely Graze? A Reflexive View of the Expert-Lay Knowledge Divide’, in Risk, Environment and Modernity: Towards a New Ecology., ed. S. Lash, B. Szerszynski, and B. Wynne, (London, UK: Sage 1996), 44; S. Epstein, ‘Democracy, Expertise, and AIDS Treatment Activism’, in Science, Technology, and Democracy, ed. D.L. Kleinman (Albany, USA: State University of New York Press, 2000), 15–32; S N Lane et al., ‘Doing Flood Risk Science Differently: An Experiment in Radical Scientific Method’, Transactions of the Institute of British Geographers 36, no. 1 (2010): 15–36, https://doi.org/10.1111/j.1475-5661.2010.00410.x.

  3. 3.

    The quote from Gove is from an interview with Faisal Islam, which took place Sky News on the 3rd of June 2016. The full quote was: “I think that the people of this country have had enough of experts with organisations from acronyms saying - from organisations with acronyms - saying that they know what is best and getting it consistently wrong, because these people - these people - are the same ones who got consistently wrong.” https://www.youtube.com/watch?v=GGgiGtJk7MA [accessed 3rd of Sept 2018]

  4. 4.

    Steven Shapin, Never Pure: Historical Studies of Science as If It Was Produced by People with Bodies, Situated in Time, Space, Culture, and Society, and Struggling for Credibility and Authority (USA: JHU Press, 2010); Klemens Kappel and Julie Zahle, ‘The Epistemic Role of Science and Expertise in Liberal Democracy’, in Handbook of Social Epistemology Ed. M Fricker, P.J. Graham, D. Henderson & N.J.L.L. Pedersen (London, UK: Routledge, 2017).

  5. 5.

    N. Emmerich, ‘A Sociological Analysis of Ethical Expertise: The Case of Medical Ethics’, SAGE Open 5, no. 2 (2015): 1–14, https://doi.org/10.1177/2158244015590445; N. Emmerich, ‘A Sociological Analysis of Ethical Expertise: The Case of Bioethics’, Cogent Social Sciences 2, no. 1 (2016): 1–18, https://doi.org/10.1080/23311886.2016.1143599; N. Emmerich, ‘Elective Modernism and the Politics of (Bio)Ethical Expertise’, in Philosophies and Sociologies of Bioethics, ed. H Riesch, N Emmerich, and S Wainwright (Dordrecht, Netherlands: Springer, 2018), 23–40, https://doi.org/10.1007/978-3-319-92738-1_2.

  6. 6.

    In a 2018 editorial Professor Udo Schuklenk briefly sets out the view that theological contributions do not further the conversations and dialogue that constitute the field of bioethics. Thus, Developing World Bioethics no longer considers such contributions. Udo Schuklenk, ‘On the Role of Religion in Articles This Journal Seeks to Publish’, Developing World Bioethics 18, no. 3 (2018): 207–207, https://doi.org/10.1111/dewb.12210.

  7. 7.

    Christine M. Korsgaard, Fellow Creatures: Our Obligations to the Other Animals (Oxford, UK: Oxford University Press, 2018).

  8. 8.

    Schuklenk, ‘On the Role of Religion in Articles This Journal Seeks to Publish’.

  9. 9.

    Miriam Wiersma, Narcyz Ghinea, and Wendy Lipworth, ‘Limiting Religious Contributions – a Response to Schuklenk’, Developing World Bioethics 0, no. 0, accessed 30 January 2019, https://doi.org/10.1111/dewb.12219.

  10. 10.

    H.M. Collins and R. Evans, Rethinking Expertise (Chicago, USA: University of Chicago Press, 2007); H.M. Collins and R. Evans, ‘The Third Wave of Science Studies: Studies of Expertise and Experience’, Social Studies of Science 32, no. 2 (1 April 2002): 235–96, https://doi.org/10.1177/0306312702032002003.

  11. 11.

    R. Evans, ‘Science and Democracy in the Third Wave: Elective Modernism Not Epistocracy’, in Expertise and Democracy (Oslo, Norway: ARENA, Centre for European Studies, University of Oslo, 2014), 85–102, https://sv.uio.no/arena/english/research/publications/arena-publications/reports/2014/report-01-14.pdf#page=92.

  12. 12.

    Whilst Collins and Evans prefer to use Wittgenstein’s phrase form of life, I prefer Winch’s mode of social life. It strikes me as more clearly admitting that the boundaries between the forms of life under discussion are not absolute and that individuals may inhabit multiples of modes of social life. Indeed it seems to me that any modern form of (human) life is constituted by multiple modes of social life. Collins and Evans would, I think, accept both of these points and, furthermore, are clear about the degree to which they are dependent on Winch’s view of Wittgenstein. Collins and Evans, Rethinking Expertise, 23; H.M. Collins, ‘Studies of Expertise and Experience’, Topoi, 2016, 1–11, https://doi.org/10.1007/s11245-016-9412-1; H.M. Collins, ‘The Core of Expertise’, Phenomenology and the Cognitive Sciences 12, no. 2 (2012): 412–13, https://doi.org/10.1007/s11097-012-9277-8.

  13. 13.

    H.M. Collins, ‘Are Experts Right or Are They Members of Expert Groups?’, Social Epistemology 32, no. 6 (2018): 351–57, https://doi.org/10.1080/02691728.2018.1546346.

  14. 14.

    Steven Shapin, The Scientific Life: A Moral History of a Late Modern Vocation (University of Chicago Press, 2008); L. Daston and P Galison, Objectivity (New York, USA: Zone Books, 2007).

  15. 15.

    H.M. Collins, M. Weinel, and R. Evans, ‘The Politics and Policy of the Third Wave: New Technologies and Society’, Critical Policy Studies 4, no. 2 (2010): 185–201, https://doi.org/10.1080/19460171.2010.490642; H.M. Collins and R. Evans, Why Democracies Need Science (Cambridge, UK: Polity Press, 2017).

  16. 16.

    Collins and Evans, Rethinking Expertise; Collins, Weinel, and Evans, ‘The Politics and Policy of the Third Wave’.

  17. 17.

    Whilst the technical phase is presented as preceding the political phase, it seems both undeniable and theoretically unproblematic that in the context of actually developing a policy, we often have occasion to reenter the technical phase in order to seek out further expert testimony before returning to a political phase.

  18. 18.

    Collins, Weinel, and Evans, ‘The Politics and Policy of the Third Wave’, 188.

  19. 19.

    Collins, Weinel, and Evans, 188.

  20. 20.

    Collins, Weinel, and Evans, ‘The Politics and Policy of the Third Wave’; Collins and Evans, Why Democracies Need Science.

  21. 21.

    The point here is that whilst the overarching political system may be democratic, whilst particular parties may be organized along (more or less) democratic lines, and whilst there maybe various points in the process of governing that one can point to as democratic, certain practices entailed by the actual business of government are political in the pragmatic sense of the word. Consider a vote that takes place in the UK’s main political chamber, The House of Commons. Such events are part of and reflect the UKs democratic structure. However, they are also deeply partisan; MPs largely voting along party line and, particularly in cases where the vote is likely to be close, being pressured by party whips to ensure that they do so. Such pressure may include a degree of horse-trading regarding future votes, bills, and debate time.

  22. 22.

    Consider the claims made in a recent article in which Peels argues that the epistemic values that inform the sciences and the humanities differ only in terms of the respective weight or emphasis they are accorded, and not in terms of their substantive nature. Rik Peels, ‘Epistemic Values in the Humanities and in the Sciences’, History of Humanities 3, no. 1 (2018): 89–111, https://doi.org/10.1086/696304.

  23. 23.

    Bioethics is not a science, at least not in the Anglo-American sense of that term. However, one might appeal to an older definition of science, this being any systematized body of knowledge. R. Smith, Being Human: Historical Knowledge and the Creation of Human Nature (Manchester, UK: Manchester University Press, 2007). One might also note the particular relevance of this definition to the human sciences, a range of disciplines within which one might position bioethics, particularly in its more interdisciplinary guises.

  24. 24.

    I say ideally as, whilst both are possible, slipping from an ethical discourse into a political exchange seems easier than slipping from a scientific discourse into a political debate. Certainly ethical debates seem more proximate to political debates than is the case for scientific debates. This may, however, be a misguided assumption.

  25. 25.

    Like any other culture or intellectual field bioethics is not a uniform phenomena but contains a certain level of diversity. Similarly it is open to change and development. Thus, the question of what bioethics is cannot be fully settled. Nevertheless, the field has sufficient unity to bear the name bioethics, something that reflects the unity or, at least, (inter)relatedness of its constitutive practices and those that pursue them. Interestingly, Schuklenk’s ruling about the place of religious thought in Developing World Bioethics can be understood in terms of such work, and those that produce it, being seen as incompatible with bioethics as a mode of social life. Of religious ethics being something other than bioethics, regardless of the questions being addressed. See footnote 6 and comments elsewhere in this essay.

  26. 26.

    For a fuller exposition of bioethical expertise in the context of medical ethics, bioethics and democratic politics see, respectively, Emmerich ‘A Sociological Analysis of Ethical Expertise: The Case of Medical Ethics’; ‘A Sociological Analysis of Ethical Expertise: The Case of Bioethics’; ‘Elective Modernism and the Politics of (Bio)Ethical Expertise’.

  27. 27.

    Emmerich, ‘A Sociological Analysis of Ethical Expertise: The Case of Medical Ethics’; Emmerich, ‘A Sociological Analysis of Ethical Expertise: The Case of Bioethics’.

  28. 28.

    N. Emmerich, ‘What Is Bioethics?’, Medicine, Health Care and Philosophy 18, no. 3 (2015): 437–41, https://doi.org/10.1007/s11019-015-9628-7.

  29. 29.

    Sir Immanuel Jakobovits, Jewish Medical Ethics: A Comparative and Historical Study of the Jewish Religious Attitude to Medicine and Its Practice (Bloch Pub. Co., 1975).

  30. 30.

    Schuklenk, ‘On the Role of Religion in Articles This Journal Seeks to Publish’.

  31. 31.

    Collins and Evans, Rethinking Expertise, 120.

  32. 32.

    Stated more clearly, my point is that we should not rule out the possibility that such individuals will draw on their scientific expertise in some way other than to reinterpret or revise expert testimony provided in the technical phase. For example, the politician who is understood to have some level of scientific expertise will find that it can be useful exercised as a rhetorical, which is to say political, tool. It may also mean that contributions made in the technical phase are less likely to be misunderstood as, one would hope, an individual with scientific expertise acting within the political phase will be able to highlight and rectify any (good faith) misunderstandings, albeit by drawing attention to and reinforcing the substance of contributions made in the technical phase.

  33. 33.

    Collins and Evans, Rethinking Expertise.

  34. 34.

    Similar thoughts can be applied to the use of natural language more generally. That this is the case is an important facet of Collins’ account of expertise and his broader social theory. H.M. Collins, ‘Language and Practice’, Social Studies of Science 41, no. 2 (2011): 271–300, https://doi.org/10.1177/0306312711399665.

  35. 35.

    See: http://nuffieldbioethics.org/ [Accessed 10th October 2018] and https://bioethicsarchive.georgetown.edu/pcbe/ [Accessed 10th October 2018].

  36. 36.

    Denis Berthiau, ‘Law, Bioethics and Practice in France: Forging a New Legislative Pact’, Medicine, Health Care, and Philosophy 16, no. 1 (2013): 105–13, https://doi.org/10.1007/s11019-012-9406-8.

  37. 37.

    See: https://www.alliancevita.org/en/2017/10/timetable-for-revising-french-bioethics-law/ [Accessed 10th October 2018].

  38. 38.

    R.C. Fox and J.P. Swazey, ‘Medical Morality Is Not Bioethics: Medical Ethics in China and the United States’, Perspectives in Biological Medicine 27, no. 3 (1984): 336–60; R.C. Fox and J.P. Swazey, Observing Bioethics (USA: Oxford University Press, 2008); John H. Evans, The History and Future of Bioethics: A Sociological View (New York, USA: Oxford University Press, 2012).

  39. 39.

    As opposed to the application of theories belonging to moral philosophy to substantive ethical problems. Whilst this is what label applied ethics might appear imply, it is actually a relatively uncommon feature of the literature. Applied ethics should be taken as a particular approach or set of approaches to ethical argument, all of which share a kind of family resemblance.

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Correspondence to Nathan Emmerich.

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Emmerich, N. The Multiplicity of Bioethical Expertise in the Context of Secular Liberal Democracies. Soc 56, 481–488 (2019). https://doi.org/10.1007/s12115-019-00402-4

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Keywords

  • Expertise
  • Democracy
  • Politics
  • Policy-making
  • Morality
  • Ethics
  • Biosciences