Final Report (all chapters)

elatively modest. Canada and Australia recently have established similar regulatory bodies, but
their enabling legislation does not assign bioethicists a prominent role, and their composition
does not reflect efforts to professionalize broad societal conflicts.
It is undeniable that this strategy has a considerable appeal, most likely fueled by a deepseated
mistrust in the ability of modern democracies to resist their worst temptations. Even such
a fervent defender of representative democracy as Ralf Dahrendorf has come to the conclusion
that parliaments are ill-suited to resolving complex ethical dilemmas, and has recommended a
politically independent body of highly regarded individuals as a preferable alternative. 16
The professionalization of modern bioethical dilemmas would be a mistake for several
reasons. Bioethics, just like other disciplines in the social sciences and humanities, has seen the
development of numerous and conflicting theoretical perspectives. As a discipline, bioethics is
simply incapable of providing politicians with uncontroversial answers. For why should a
particular ethical paradigm be preferred to another? It is fair to say that no rules exist to select
one ethical paradigm from the plethora of available ethical positions. And a plethora it is. Even a
cursory examination of the bioethical literature brings to the light such perspectives as
principlism, specified principlism, casuistry, and narrative ethics, just to name a few. 17 The
plurality of approaches in bioethics is a testimony of the richness of this relatively new academic
field, but it also makes it impossible for bioethics to play a privileged role in policy-making.
A genuinely pluralistic ethics advisory board could play a useful role in contemporary public
debates about reproductive technologies and biomedical research provided that it does not
attempt to produce consensus positions on questions for which a consensus simply does not
exist. Making majority and minority recommendations available to policy-makers and ensuring
that the underlying assumptions informing these positions are made transparent would be much
more valuable than a thinly disguised consensus report. As we have argued in chapter 2, poor
policy choices are more likely to be induced by a dearth of ethical positions rather than by a
plurality thereof.
A second concern is the rapid transformation of the field of bioethics from a discipline
focused on broad substantive questions into a largely technical field preoccupied with
fundamental principles and with procedural considerations rather than outcomes. The shift of
professional bioethics toward technical, narrowly defined questions also has legitimized many
hitherto controversial biomedical developments. The currently dominant bioethical perspective
16
17
Ralf Dahrendorf, Dopo La Democrazia. Intervista a Cura Di Antonio Polito (Roma: Laterza, 2001).
Tom L. Beauchamp, "Reply to Strong on Principlism and Casuistry," Journal of Medicine and Philosophy 25,
no. 3 (2000); Bernard Gert, Charles M. Culver, and K. Danner Clouser, "Common Morality Versus Specified
Principlism: Reply to Richardson," Journal of Medicine and Philosophy 25, no. 3 (2000); Albert R. Jonsen,
"Strong on Specification," Journal of Medicine and Philosophy 25, no. 3 (2000); Henry S. Richardson,
"Specifying, Balancing, and Interpreting Bioethical Principles," Journal of Medicine and Philosophy 25, no. 3
(2000); Ana Smith Iltis, "Bioethics as Methodological Case Resolution: Specification, Specified Principlism and
Casuistry," Journal of Medicine and Philosophy 25, no. 3 (2000); Carson Strong, "Specified Principlism: What
Is It, and Does It Really Resolve Cases Better Than Casuistry?," Journal of Medicine and Philosophy 25, no. 3
(2000).
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