A View From the Borderlands of Philosophical Bioethics and Empirical Social Science Research: How the ‘Is’ Can Inform the ‘Ought’

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Notes

¹. Beauchamp and Childress (1989) outline these as: Threshold Element: 1) Competence (“gatekeeper” to the informed consent process); Information Elements: 2) Disclosure of Information, and 3) Understanding of Information; Consent Elements: 4) Voluntariness, and 5) Authorization.

². Thus, although I agree with Carter (2009) that “empirical work is deeply infused with theory” (76), I would add the caveat that ‘which theory matters,’ and ‘bioethics theory’ should always be a core focus.

³. Lieban (1990) offers an early analysis of the evolution and focus of medical anthropology as an emerging subdiscipline of sociocultural anthropology, before it engaged much with ‘Western’ biomedicine and bioethics, or even overtly and systematically engaged with ‘non-Western’ or ‘folk bioethics,’ which is a nice illustration of how the theories and foci of disciplines and subdisciplines (here medical anthropology and ‘ethnoethics’) originate and continue to evolve as their own disciplinary theories and methods evolve.

4. This ethnographic research (Myser 1994) involved 18 months (1988–1990) in maternal-fetal and neonatal clinics in Sweden, India, and the United States. I conducted in-depth, structured, and open-ended interviews of 250 healthcare professionals, mostly physicians; conducted participant observation in clinics and patient care meetings; and triangulated resulting data with relevant bioethics, social science, health professional, governmental and public policy publications to study and analyze the ethical concepts of ‘personhood,’ ‘quality of life,’ and ‘best interests’ as understood and applied by health professionals and parents/family members in selective pregnancy termination and neonatal nontreatment decisions. Needless to say, I do not regard this data first published in my 1994 dissertation to be authoritative in describing 2009 ‘realities,’ and would for different purposes prefer more updated data. However, I only employ it for the limited purposes of serving as an example of how empirical research can inform ethics theory. As such, it still allows me to make valid points for these limited purposes.

⁵. I note as a caveat that I am only able to share radically truncated data in the scope of this brief article.

⁶. This theologian-philosopher's concept of ‘quality of life,’ as ‘relational potential,’ along with philosophers Helga Kuhse and Peter Singer's concept of ‘speciesism’ (both directly echoed in my empirical research data among physicians with no knowledge of this philosophical literature, Myser (1994), raises intriguing questions about Kon's (2009) claim that “philosophical inquiry relies on empirical data… generated solely by the experiences, perceptions, and ideas of the philosopher” (59) and Carter's (2009) similar claim that “philosophers, who have access only to their own experience, may produce normative theories relevant largely to their own experience” (76). Although it is beyond the scope of this brief commentary to pursue it, one question that might be posed to Kon (2009) and Carter (2009) on this basis relates to the possibility that shared human ‘experiences, perceptions, and ideas’ (notwithstanding additional training in the discipline of philosophy) might also underlie McCormick and Kuhse and Singer's bioethics theories. At the very least, Kon (2009) and Carter (2009) would have to concede that their claim raises further epistemological and empirical questions, calling for further empirical testing and/or demonstration.

⁷. See Myser (1994) pp. 181–182; 209–214; 254–261.

⁸. Clinical assessments and measurements in particular would benefit from multidisciplinary approaches including, e.g., psychologists, physicians, other social scientists, and philosophers.

⁹. If we reached similar conclusions about marriage, for example, on a similar basis of ‘inability to predict future feelings and commitments’, no one might ever marry with any reasonable confidence. More seriously, the possibility of ‘outliers’ (some of whom I believe I have met in my clinical ethics consulting practice) to the empirical studies in question would itself lead me to more tempered conclusions, assuming I had read and critically analyzed the data, and found it reliable and applicable in a particular circumstance in the first place.