‘Bioethics: What? and why?’ : Revisited

Bioethics will publish articles on the ethical issues raised by medicine and the biological sciences. … The prefix ‘bio’ in our title, then, is used in a narrow sense to refer to the biological sciences, and especially, but not exclusively, the medical and health sciences. It is not being used in the wide sense in which we talk of ‘the biosphere’ to mean all living things, or anything which affects the ecology of our planet. ‘Ethics’ is at least a well-established term. We understand it to mean the study of what we ought to do, and by ‘ought’ in this context we mean not prudential ‘ought’ of self-interest, or even group interest, but rather reference to reason or considerations which can be defended from a universal or impartial perspective [emphasis added].1 Ruth Chadwick and I have been editors-in-chief of the journal for the last 25 years. We have tried to steward it to the best of our ability, and we have aimed to keep it true to its founders’ mission. That means, first and foremost, Bioethics is a journal that publishes primarily philosophical bioethics content. This scope limitation has—over the years—given rise to criticism from various quarters that didn't see themselves represented in the pages of the journal. Bioethics never claimed to represent every activity that goes under the label ‘bioethics’. I want to take the opportunity this Editorial affords me to address some of these criticisms. Some members of the bioethics community have criticized this—as well as other—journal(s) for being ‘too quiet’ when it comes to shocking human rights abuses, as is currently the case in the Gaza war, Yemen, Ukraine, etc. And it is true, we have not issued editorials condemning the activities of the Israel army in Gaza, or Russia's attacks on civilian infrastructure in the Ukraine. Like you, I have strong personal views on these conflicts, but these views are not significantly informed by my bioethics expertise. There are specific bioethics issues within the context of these conflicts that are worth addressing, such as the professional obligations of healthcare professionals to enemy combatants, terrorists with and without inverted commas, military attacks on healthcare facilities suspected of being used as shields by a group in the conflict, to name but a few. However, who the guilty party is in terms of what caused the Gaza conflict is not a bioethics issue. Accordingly, it is not a topic that will be litigated in the journal. This doesn't mean that we don't have views on these issues—like you, we are not intransigent to human suffering and injustice—but we don't have views on these issues in our role as editors of this journal. There are other academic journals that have a specialist focus on the ethical issues raised by these sorts of conflicts. Colleagues wishing to publish content on these topics should consider submitting their content to these kinds of publications, where their articles will be reviewed by academic peers with the relevant subject expertise. My good intentions and strong personal convictions do not make me an expert on war. Every now and then colleagues who are—rightly—concerned about our abuse of non-human animals, as well as our destruction of the environment, ask us to increase the scope of the journal to include such matters, too. As you will note from my own positioning, I concur with these colleagues that these issues are both extremely important, and also that they are—like the war and human rights issue—legitimate subjects of ethical inquiry. However, as far as human bioethics is concerned, they are clearly not within the scope of the journal that Kuhse and Singer envisaged. As it happens, and much like in the case of the topic I discussed above, there are subject-specific journals that cover these areas. There is no reason why Bioethics should aim to cover every topic that is vaguely related to bioethics. There is also no reason why a colleague who wishes to work on animal ethics issues should have to frame their engagement through a bioethics lens. Incidentally, where there is an overlap of bioethics and animal ethics issues, such as in the case of the ethics of xenotransplantation, we have encouraged and published such articles. The same holds true for environmental issues that have bioethical implications because of their health impacts. Every few years, the issue of religion and bioethics arises again. As regular readers of this journal will know, I have views on this subject matter.2 This Editorial is not the place to repeat at length what I have said elsewhere. However, a few comments may be in order. This journal is not the right publication for authors wishing to interpret religious scripture, precisely because that kind of content can't ‘be defended from a universal or impartial perspective’ as Kuhse and Singer would rightly point out to us if we decided to publish such articles. That doesn't mean that such content is irrelevant, if for no reason other than the existence of a large number of patients and healthcare professionals who hold such beliefs. Thankfully, a philosopher God (pun intended) has offered a solution: Plato rightly suggested that even Gods would need to have good ethical reasons for their actions, so we might as well aim to discern what those ethical reasons are. Mere deference to religious authority, and religious scripture credited to that authority, doesn't do that. There are other problems as well with such approaches, of course. We don't know whether the religious authority actually is an authority (has the writer chosen the right religious authority, if any, among many competing religious authorities?), and also, and not unimportantly, religious reasoning as a justification for public policy is incompatible with safeguarding religious freedom in diverse societies. Humanity has learned this the hard way during, among others, the religious wars in Europe and many human lives lost. It strikes me as unfortunate that those advocating for the legitimacy of religious reasoning in philosophical bioethics habitually gloss over this history as if there were no lessons to be learned from what happened. Incidentally, these lessons led to state neutrality when it comes to matters of religion in liberal democracies. They led to progress. However, as in the other areas mentioned, religion-specific bioethics journals have existed for many years, they also happen to be the right target for that sort of content. Their audiences typically share their—preferred—religious outlook, and certainly I can see no wrong with, for instance, Catholic bioethicists discussing bioethical issues through a sectarian Catholic lens in Catholic or Christian bioethics journals. Their findings may be of interest to other Catholics and Christians as well as those otherwise interested in Catholic outlooks on a particular bioethical question. But clearly, there is no universal appeal to that sort of output. If the Christian God isn't your God, for whatever reasons, Christian religious scripture and its textual interpretation by Christian bioethicists have no ethical lessons to teach you. The same holds true for interpretations of Islamic scripture and other religious documents. There is a colloquial saying in German, ‘Schuster bleib bei Deinen Leisten’, which roughly translates into ‘shoemaker stick to your last’, and that's what we plan to do with this journal. It matters to recognize the limits of one's expertise. It also matters to exercise caution when it comes to drawing boundaries and excluding content that isn't within the scope of the journal. We don't do that without giving due considerations to the views of those who disagree with us. That said, we are Editors of this journals, and we are human, we have made mistakes in our editorial judgment in the past, and at some point we will likely do so again, despite our best efforts. We appreciate that religious writers desire to see their religious content in the journal, but given its history and mission Bioethics isn't the right publication for their work. Not everything needs to be said and published in Bioethics, even if some bioethicists feel strongly about particular issues that are outside the remit of the journal. We will limit ourselves to what we—and our reviewers—are knowledgeable of. For everything else, there are other publications, other experts, and other audiences.

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