(Bio)Ethics in a Pluralistic Society

Abstract

Traditional (bio) ethics relies to a large degree on the analysis of problems to determine the right course of action. In particular, in medicine, a dominant text declares that there is a “Common Morality” that applies to all people. This paper will argue that ethics is culture bound and that, in a pluralistic society, a common morality approach to the resolution of problems has significant limitations. I will argue that more attention needs to be paid to the process of agreeing to a way forward given that there is disagreement. I will illustrate how this applies not only at the clinical level but also at the level of national and international politics. A theoretical understanding of compromise and a look at ways of describing the way people make ethical decisions as opposed to seeking an ideal ethical code is presented as a way in which we can manage problems better in a pluralistic society.

Planetary Health Ethics: Beyond First Principles

“…Elements of the ethical underpinning we propose may require scaling back from current ambitions. It may require a greater exploration of how compromises might be reached [7], and may benefit from a greater understanding of the social choice theory than has previously been applied [32,33]. It may also require greater input from those in business, corporate law and finance, sectors that may not always sit comfortably alongside environmentalism and ecoprotectionism, but they are a useful source in understanding how to leverage action.…”

“…When compromises have to be made, ethics provide protection for the vulnerable as well as guidance to the powerful. As more compromises become necessary, there is likely to be an increasing need for us to learn how to manage compromise and disagreement [7]. Global pandemics, famines, refugee movements, failed states and climate change can only be addressed by the world as a whole [37], based on mutual trust as much as multilateralism, in which all partners feel valued and empowered to actively seek common ground, through formal deliberation if necessary.…”

“…Ethics do not provide incontrovertible answers. They can be highly controversial and politically loaded, and finding consensus on what they should be will not be easy, particularly in a pluralistic world [7]. However, they do provide a base for ethical reasoning, from which principles can be put into practice.…”

“…However, they do provide a base for ethical reasoning, from which principles can be put into practice. They can, therefore, provide a basis for negotiating actions in situations where decisions on whether or not to act, and how to act, is neither unanimous nor the preferred first choice of all actors [7]. In this sense, the notion of ethics carries with it something bigger than the sense of the individual, pushing us towards actions that are not (only) for self-interest [6].…”

“…Ethical judgements thus empower us to transcend our own likes and dislikes and to reason with others as to why they should do the same. Inherent in traditional ethics are concepts such as honesty, prudence, avoiding harm and concern for others [7]. If we can extend the notion of "others" to other species inhabiting the Earth and to the Earth itself, we can more easily ensure the "sustainable vitality of all systems" called for by the Canmore Declaration [3].…”