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Will Bioethics Take the Life of Philosophy?

Stephen Toulmin asked whether the challenges of medicine present either a special case for the utility of philosophical methods in professional practice or an essential test of whether the role of the philosopher could return to an earlier, central place in the discourse of literate society. His oft-cited essay “How Medicine Saved the Life of Ethics” was one part of a broad but short-lived emphasis in the literature of philosophical ethics to craft a special institutionalized activity, largely in philosophy departments, that aimed at returning ethics as a theoretical pursuit to the American social agenda.

There exist a few clever exceptions, such as the presence of perhaps a dozen fully credentialed, “practicing” philosophers, e.g., Ph.D.s working as sheriff’s deputies, therapists, or elected officials, but one can point to a general failure of the discipline of philosophy to adjust its modes of training or scholarship in response to the experiences of or opportunities for philosophers who are “applying ethics” to modify social institutions. We do not teach philosophers to or solve the ethical problems of individuals in any way that places the philosopher in a direct, Socratic interaction, apart from classroom teaching.

One need not point to the fact that the young philosopher who writes popular books or articles in non-philosophical journals, or who pursues a non-standard research agenda clearly marginalizes him or herself. This would have been viewed with incredulity only a century or so ago by, e.g., the Harvard philosophy department of William James’ era, and indeed by philosophy across much of the history of western philosophy. Utilitarianism was published first in a womens' magazine in Britain.

Today, if you want tenure as a philosopher, the wrong path is public engagement.

One need not point to the almost mandatory hyperspecialization of the most successful graduate students in philosophy, programmed into the arcane style of philosophical dissertations or the general resistance of faculty in the most prominent philosophical institutions to mentor their students in bridging the gap between philosophical rigor and the idiom of the general public and its media. Just no- tice where philosophers are not. In bookstores, “self-help” replaced philosophy by 1985. Philosophy courses are no longer mandatory in most universities. Philosophers comprise only a tiny and shrinking number of columnists and essayists in mainstream literature. And where philosophers are present they are often selling something: the validation of the current mode of teaching the discipline.

So it is not surprising that philosophers both seem, often, to be the most qualified to make a valuable, timely and historically informed contribution to public debate and education yet least likely to make it.

I will not pause, as have some historians of philosophy, to amplify the observation made by Toulmin himself that the rarification of contemporary philosophy has lessened the possibility that a philosopher trained at, e.g., New York University, Princeton or Harvard might ever play the kind of social role of Socrates, Aristotle or even Nietzsche, not even while holding a post in a philosophy department that ranks among the top “applied ethics” departments in Brian Leiter’s “Philosophical Gourmet Report,” a now oft-cited ranking of the key departments in the field.

Instead I want to identify why disciplinary philosophy’s attempts to create a new area of specialization, training and publication, which Toulmin believed could save the discipline from the irrelevance that Dewey predicted would otherwise come for philosophy in American political and moral discourse, have failed.

Only the briefest review of applied ethics’ most successful inroads over that past twenty years is required to see the scope of this failure and its significance.

In the application of philosophical work to medicine, Stephen Toulmin, Al Jonsen, Arthur Caplan, Tom Beauchamp and James Childress, Norman Daniels, Donald Light, William Winslade, Mark Siegler, among others [and not all of whom are philosophers], have authored canonical textbooks that attempted in part to make philosophical material more accessible by reducing complex moral problems to formulae and/or principles that can be applied in the course of ordinary medical practice in a coherent way. These writers and others stress those elements of moral philosophy that are most compat- ible with allopathic medicine. Each principle seems chosen, or at least translated, for the purpose of maintaining its relative ubiquity, for its relevance to the law, policy, and practice of such diverse medical endeavors as trans- plantation, genetic engineering and euthanasia, and for its simplicity.

This spread of “cook books” in bioethics has been, of course, much criticized and viciously by philosophers, and today books of this sort are almost never reviewed in philosophical journals, but neither have they been considered.

Toulmin suggested that if philosophers were not able to solve such problems as were encountered in professional clinical practice of the early 1980s, they “might as well close up shop.” ...