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The Golden Rule and Bioethics The Golden Rule and Bioethics A Reflection upon the Foundation of Ethics By Mette Ebbesen (Student number 19960635 / 750810-P784 ) Master’s Thesis, Spring 2002. The Nordic Master’s Program in Applied Ethics, Centre for Bioethics, Faculty of Theology, University of Aarhus, Denmark in co-operation with Centre for Applied Ethics, Linköping University, Sweden. Avdelning, Institution Datum Division, Department Date 2002-06-07 Centrum för Tillämpad Etik 581 83 LINKÖPING Språk Rapporttyp ISBN Language Report category Svenska/Swedish Licentiatavhandling ISRN LIU-CTE-AE-EX--02/01--SE X Engelska/English Examensarbete C-uppsats Serietitel och serienummer ISSN D-uppsats Title of series, numbering Övrig rapport ____ URL för elektronisk version http://www.ep.liu.se/exjobb/cte/2002/001/ Titel The Golden Rule and Bioethics. A Reflection upon the Foundation of Ethics Title Författare Mette Ebbesen Author Sammanfattning The object of this thesis is the foundation of ethics. The question is whether there exists a universal core to ethics consisting of a fundamental ethical principle across cultures. This principle could for example be the so-called Golden Rule, which goes as follows: ‘You should do to others what you want them to do to you’. The Golden Rule is to be found in many of the world’s religions and is also reflected in secular society. The rule can for example be found in a political version in legal declarations e.g. the Humans Rights Declaration of 1948. There are philosophers and scientists who interpret the Golden Rule secularly. If one looks at the Golden Rule from a non-religious point of view, it can be understood for instance in the following ways: 1) As a rule which is followed to fulfil self-interest and 2) As a rule concerning role reversal. In this thesis we will go into detail on these two interpretations of the Golden Rule, because as we will see, they can be seen as two very different views of human nature. We will discuss which of the two interpretations of the Golden Rule is most adequate in connection with the description of human beings as moral agents having reason, motives, freedom and responsibility. Furthermore we will focus on the Golden Rule in a Nordic context, in this connection we will look at whether the Golden Rule corresponds to the four bioethical principles presented by the two American philosophers Tom L. Beauchamp and James F. Childress. These principles are the principle of respect for autonomy, the principle of nonmaleficence, the principle of beneficence and the principle of justice. According to the Danish physician Henrik R. Wulff one cannot use Beauchamp and Childress’ bioethical principles as a tool for solving ethical problems in the North, because they do not correspond to the Golden Rule. Wulff argues that the Golden Rule is a moral ideal within the health services in the Nordic countries. The purpose of the thesis is, among others, to analyse and discuss whether the four bioethical principles are implicitly contained within the Golden Rule and whether Beauchamp and Childress’ method can be used to analyse bioethical problems in a Nordic context. Finally, we will set forth an ethical assessment of a treatment within biomedicine. As an example of the application of the four bioethical principles, we will look at whether human somatic gene therapy is an ethical acceptable treatment. Thus my thesis is that the Golden Rule can be viewed as a fundamental ethical principle across cultures and that Beauchamp and Childress’ four bioethical principles correspond to the Golden Rule. That is, I think there is a reason to maintain, that the bioethical principles can be of use for solving bioethical problems across cultures. Nyckelord Keyword The Golden Rule, Beauchamp & Childress' Four Bioethical Principles, Ethical Assessment of Somatic Gene Therapy Contents ii Contents Chapter Page Preface................................................................................................................................... v About the Author...............................................................................................................vii 1. Introduction .......................................................................................................................... 1 2. The Golden Rule – a Rule for the Fulfilment of Self-interest........................................... 9 2. 1. The Golden Rule in Hobbes’ Philosophy............................................................. 9 2. 1. 1. Hobbes and His Age ............................................................................... 9 2. 1. 2. Hobbes’ Theory of Covenant................................................................ 10 2. 2. Sociobiology and the Golden Rule..................................................................... 14 2. 2. 1. Sociobiology is Based on Darwinian Theories ..................................... 14 2. 2. 2. Human Nature According to Sociobiology........................................... 17 2. 2. 3. Ethics is Genetically Based................................................................... 18 2. 2. 4. Altruism ................................................................................................ 19 2. 2. 5. Scientific-philosophical Problems in Connection with Wilson’s Theory ................................................................................................... 23 2. 2. 6. A Devaluation of Reason ...................................................................... 24 2. 2. 7. The Sphere of Morals............................................................................ 25 2. 3. The Deterministic View of Human Nature ........................................................ 28 2. 3. 1. The View of Human Nature in Hobbes’ Philosophy ............................ 28 2. 3. 2. Is the Human Being Able to Transcend Her/His Biological Nature? ... 29 2. 3. 3. Humans as Moral Agents...................................................................... 30 3. The Golden Rule - a Rule Concerning Role Reversal ..................................................... 32 3. 1. The Universalisability Thesis in Hare’s philosophy........................................... 32 3. 1. 1. The Tension Between Freedom and Reason......................................... 32 3. 1. 2. Moral Statements are Prescriptive ........................................................ 35 3. 1. 3. Moral Statements are Characterised by Universalisability ................... 36 3. 1. 4. An Ethical Conflict ............................................................................... 38 3. 1. 5. The Golden Rule................................................................................... 40 3. 2. Løgstrup’s View of the Golden Rule.................................................................. 41 3. 2. 1. Exaggeration of the Role of Principles in Ethical Argumentation........ 41 3. 2. 2. Intersubjective Relationships ................................................................ 43 3. 2. 3. The Ethical Demand ............................................................................. 45 3. 2. 4. Sovereign Expressions of Life .............................................................. 47 Contents iii Chapter Page 3. 2. 5. The Golden Rule................................................................................... 49 3. 2. 6. The Levels of Ethics ............................................................................. 51 3. 3. An Alternative to the Deterministic View of Human Nature............................. 52 3. 3. 1. The Logical Positivists.......................................................................... 52 3. 3. 2. Description of Humans as Moral Agents.............................................. 54 3. 3. 3. The Golden Rule in a Philosophy of Morality...................................... 57 4. The Golden Rule and the Four Bioethical Principles...................................................... 59 4. 1. Beauchamp and Childress’ Method.................................................................... 59 4. 1. 1. Ethical Reasoning ................................................................................. 60 4. 1. 2. Prima Facie Binding Principles............................................................. 61 4. 1. 3. The principles – a Part of a Common Morality .................................... 61 4. 2. General Criticism of Beauchamp and Childress’ Method.................................. 62 4. 2. 1. Beauchamp and Childress’ Method Stresses Theory in Relation to Practice.................................................................................................. 63 4. 2. 2. Balancing Principles ............................................................................. 64 4. 3. Beauchamp and Childress’ Method is More Than Principles............................ 65 4. 3. 1. An Application of Bioethical Principles Demands Practical Wisdom . 66 4. 3. 2. Dialectic Between Levels of Abstraction.............................................. 67 4. 4. The Revised Edition of Beauchamp and Childress’ Method ............................. 68 4. 4. 1. Practical Reason and Virtues ................................................................ 68 4. 4. 2. Balancing, Reflexive Equilibrium and Specification............................ 70 4. 5. Does a Universal Core of Ethics Exist? ............................................................. 71 4. 5. 1. Universalism Versus Pluralism............................................................. 71 4. 5. 2.
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