The Future of Bioethics » (New Edition)

Bioethics, born in the 1960s and 1970s, has achieved great success, but also has experienced recent growing pains, as illustrated by the case of Terri Schiavo. In The Future of Bioethics, Howard Brody, a physician and scholar who dates his entry into the field in 1972, sifts through the various issues that bioethics is now addressing—and some that it is largely ignoring—to chart a course for the future. Traditional bioethical concerns such as medical care at the end of life and research on human subjects will continue to demand attention. Brody chooses to focus instead on less obvious issues that will promise to stimulate new ways of thinking. He argues for a bioethics grounded in interdisciplinary medical humanities, including literature, history, religion, and the social sciences.

Drawing on his previous work, Brody argues that most of the issues concerned involve power disparities. Bioethics' response ought to combine new concepts that take power relationships seriously, with new practical activities that give those now lacking power a greater voice. A chapter on community dialogue outlines a role for the general public in bioethics deliberations. Lessons about power initially learned from feminist bioethics need to be expanded into new areas—cross cultural, racial and ethnic, and global and environmental issues, as well as the concerns of persons with disabilities. Bioethics has neglected important ethical controversies that are most often discussed in primary care, such as patient-centered care, evidence-based medicine, and pay-for-performance.

Brody concludes by considering the tension between bioethics as contemplative scholarship and bioethics as activism. He urges a more activist approach, insisting that activism need not cause a premature end to ongoing conversations among bioethicists defending widely divergent views and thcories.

Doody Review Services

Reviewer:Rebecca L Volpe, B.A.(Saint Louis University)
Description:In this engaging and insightful book, the author covers topics he believes to be crucial for the future of bioethics. He considers a topic worthy of inclusion only if it promises a shift toward Kuhnian "revolutionary science." Essentially, the topics require bioethics to develop new intellectual approaches rather than relying on "normal science.
Purpose:The author identifies two purposes: first, to point out how each topic area might enhance the work of future bioethicists and, second, to help move bioethics ahead in important, intellectually novel ways by stimulating the development of new conceptual tools to address these topics adequately.
Audience:Although it is aimed primarily at people familiar with general bioethics, the book is clear and accessible, so those new to the field should also find it an educational and persuasive read.
Features:The first chapter begins by quoting Sherlock Holmes: "'Is there any point to which you would wish to draw my attention?' 'To the curious incident of the dog in the night-time.' 'The dog did nothing in the night-time.' 'That was the curious incident.'" From here, the author notes that the impetus for his book was the nighttime activities of bioethics, or those issues that were making no commotion and thus receiving no, or very little, attention. The topics that fit the author's two criteria for inclusion, receiving less attention than deserved and requiring the use of "revolutionary science," turn in large part around power disparities in medicine and society. Other topics include patient-centered care, paradigms for healthcare delivery, and community dialogue.
Assessment:The author has managed to balance scholarly inquiry, accessibility, and thought-provoking argumentation in one work. He clearly lays out his premises, his logic is easy to follow, and his conclusions are compelling. It is difficult to imagine what might be missing from this new addition to the bioethics canon.