We will argue here that after more than 30 years of talk, theory, and
clinical practice, we bioethicists still know far too little about what
patients, subjects, and healthcare professionals are up to, morally.
Bioethics is still near the beginning in grasping what it means to
understand, much less to honor fully, the moral power and perspicacity of
those bioethics is designed to serve. This is, of course, a serious
charge, but one we will endeavor to show has merit. However, we want to be
clear from the start that we do not gainsay the important work that has
been done in and through the influence of bioethics, both as a field of
practical engagement and as a cultural movement, in improving how
healthcare is delivered and how human subjects are treated. Thirty or 40
years—depending on how one marks the beginning point—is a very
short time, and it is hard to imagine that wholesale changes, all of them
in the right direction, could be the outcome for a field this young.
Hence, we do not intend the title, “One Cheer for Bioethics,”
as a wholesale indictment, but as an indication that there is a great deal
of work yet to be done, and that following the currently dominant
direction of the field is not likely to get us there. Our aim is to
indicate just where future work should be focused, and to do so we will
need to be critical of some of the preoccupations of the last three
decades.The authors thank Lida Anestidou,
Mark Bliton, Ellen Clayton, Stuart Finder, Elizabeth Heitman, Joshua
Perry, Annabeth Schenck, and Lucia Tanassi for helpful comments on earlier
presentations and drafts of the ideas in this paper.