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A Cultural Giant HEIKKI SAXÉN HEIKKI SAXÉN Acta Universitatis Tamperensis 2308 A Cultural Giant A HEIKKI SAXÉN A Cultural Giant An interpretation of bioethics in light of its intellectual and cultural history AUT 2308 AUT HEIKKI SAXÉN A Cultural Giant An interpretation of bioethics in light of its intellectual and cultural history ACADEMIC DISSERTATION To be presented, with the permission of the Faculty Council of Social Sciences of the University of Tampere, for public discussion in the auditorium Pinni B 1096, Kanslerinrinne 1, Tampere, on 6 October 2017, at 12 o’clock. UNIVERSITY OF TAMPERE HEIKKI SAXÉN A Cultural Giant An interpretation of bioethics in light of its intellectual and cultural history Acta Universitatis Tamperensis 2308 Tampere University Press Tampere 2017 ACADEMIC DISSERTATION University of Tampere Faculty of Social Sciences Finland The originality of this thesis has been checked using the Turnitin OriginalityCheck service in accordance with the quality management system of the University of Tampere. Copyright ©2017 Tampere University Press and the author Cover design by Mikko Reinikka Acta Universitatis Tamperensis 2308 Acta Electronica Universitatis Tamperensis 1812 ISBN 978-952-03-0522-2 (print) ISBN 978-952-03-0523-9 (pdf) ISSN-L 1455-1616 ISSN 1456-954X ISSN 1455-1616 http://tampub.uta.fi Suomen Yliopistopaino Oy – Juvenes Print 441 729 Tampere 2017 Painotuote For Salla ABSTRACT The field of bioethics was established in the United States during the sixties and early seventies. The field addresses the ethical challenges of life sciences—the science of living organisms, from plants to humans—and tries to incorporate various perspec- tives in doing this. It mostly came into being as a radical challenge to the medical profession and its age-old tradition of ethics, which were seen as exclusivist and elit- ist. A lot has changed since the early days. Today, bioethics is a broad and somewhat established field in its country of origin and in many places throughout the world. However, despite its past successes, bioethics now appears to be undergoing a middle age crisis in which people in the field, along with others, are asking perplexing questions about its meaning, essence, and even its reason for being. Bioethics has clearly arrived at some kind of turning point. As the dust has settled from the early days, many are asking whether bioethics was, after all, a welcome addition to prevailing intellectual vocabulary and what pre- cise purpose it serves in academia and in society today. Much criticism has been raised: to some, bioethics has never been a real thing, at least in any positive sense. Rather, for them bioethics is only a nuisance that gets in life sciences’ and their ap- plication’s way, especially in health care. Others strongly disagree with this. And then there are other views. All in all, everyone seems to have her own conception of the way things are. However, what is certain is that the outcome of this debate will have a significant impact on determining the future of the field. The stakes are high. This study seeks to offer fresh answers to the ongoing debate about the nature of bioethics by exploring bioethics’ past and current state from the perspective of intellectual and cultural history. Under this umbrella, a range of theories from polit- ical decay to political philosophy to social capital are applied to unearth the deeper nature of the field, especially its cultural essence. A central argument revolves around two identified core characteristics of bioeth- ics: its aspirations to be intellectually open-ended and to be socially inclusive. This observation leads to further identification of the field’s features such as the “delib- erative shallowness of bioethics.” The study argues that by appreciating these aspects of bioethics, a clear challenge to embrace and support them emerges. At the same time, this offers a potential way for bioethics to move forward from its early and present schemes and for it to flourish in the future. Eventually, the study argues that bioethics could, and should, be seen as a “cul- tural giant,” an important part of at least Western culture—a cultural force that could help, for its part, to renew political and social institutions according to present needs. Besides this, bioethics is also argued to have an intrinsic cultural value, in other words, bioethics should not only be judged by its merits; rather, it should be accepted as a matter of fact of the current cultural landscape. Moreover, to assist bioethics to move forward, the study sketches a few more precise suggestions of how this could be done. Particular emphasis is placed on de- veloping a genuinely new kind of body of thought to support this endeavor. To this end, preliminarily, the study coins a new term, “organic bioethics,” to help in better conceptualizing and embracing the nature of the field and its best qualities. TIIVISTELMÄ Bioetiikan tieteenala syntyi 1960- ja 1970-luvuilla Yhdysvalloissa. Bioetiikka käsitte- lee lääke-, terveys- ja biotieteiden eettisiä, moraalisia ja yhteiskunnallisia kysymyksiä. Keskeistä alalle on pyrkimys näiden teemojen moniääniseen ja -arvoiseen pohtimi- seen. Bioetiikan syntyyn johti erityisesti radikaali pyrkimys haastaa lääketiedettä ja sen ikiaikaista etiikkaa, jotka koettiin aikanaan yksiäänisiksi ja elitistisiksi. Sitten bioetiikan alkuaikojen paljon on muuttunut. Nykyisin bioetiikka on laaja ja varsin vakiintunut ala synnyinmaassaan ja monin paikoin ympäri maailmaa. Suomessa bioetiikka on to- sin yhä suhteellisen tuntemattomassa ja vähäisessä roolissa niin akateemisesti kuin yhteiskunnallisestikin. Menneestä menestyksestään huolimatta bioetiikka käy parhaillaan läpi keski-iän kriisiä, jonka myötä monet tahot alalla ja sen ulkopuolella kysyvät keskeisiä kysymyk- siä bioetiikan merkityksestä ja olemuksesta, jopa sen olemassaolon oikeutuksesta. Bioetiikka on selvästi saapunut eräänlaiseen kehityksensä taitekohtaan. Pölyn laskeuduttua bioetiikan alkuaikojen jäljiltä monet kysyvät nykyisin, oliko bioetiikka loppujen lopuksi tervetullut lisä vallitsevaan henkiseen ilmastoon ja mitä tarkoitusta ala tarkalleen ottaen palvelee sekä akateemisessa maailmassa että tämän ulkopuolella. Paljon kritiikkiä on esitetty: joillekin bioetiikka ei ole ikinä ollut mitään todellista, ainakaan myönteisessä mielessä. Pikemmin näille kriitikoille bioetiikka on näyttäytynyt lähinnä rasitteena, joka on ollut lääke-, terveys- ja biotieteiden ja niiden soveltamisen tiellä, varsinkin terveydenhuollon piirissä. Toiset keskustelijat taas ovat vahvasti eri mieltä. Kaikkineen ilmassa on paljon erilaisia näkemyksiä eikä yhteistä maaperää ole paljon. Joka tapauksessa on varmaa, että tämän keskustelun lopputulos tulee keskeisesti vaikuttamaan alan tulevaisuuden kehitykseen, joten panokset ovat korkeat. Tämä tutkimus pyrkii tarjoamaan tuoreita vastauksia käynnissä olevaan keskuste- luun bioetiikan luonteesta valottamalla alan menneisyyttä ja nykyistä tilaa aate- ja op- pihistorian sekä kulttuurihistorian näkökulmasta. Tämän viitekehyksen puitteissa so- velletaan yhä kattavaa teoreettista kirjoa, johon ammennetaan muun muassa poliit- tisten instituutioiden rappion, poliittisen filosofian sekä sosiaalisen pääoman tutki- muksen parista. Tarkoituksena on kaivaa esille syvempi bioetiikan luonne, erityisesti alan kulttuurillinen ydinolemus. Tutkimuksen keskeinen argumentti tiivistyy kahteen havainnoituun bioetiikan ydinpiirteeseen: alan pyrkimykseen olla avoin erilaisille henkisille lähestymistavoille sekä sosiaalisesti uusille osanottajille: siis toisin sanoen alan pyrkimykseen olla moni- ääninen ja -arvoinen. Nämä havainnot johtavat tutkimuksessa yhä uusien bioetiikan alan puolien valottamiseen, joista mainittakoon esimerkiksi bioetiikan pyrkimys py- sytellä tarkoituksellisesti tietyssä mielessä henkisesti pinnalla, menemättä liian syvälle mihinkään tiettyihin eettisiin, moraalisiin ja yhteiskunnallisiin näkemyksiin. Tutki- muksessa argumentoidaan, että tällaisten bioetiikan piirteiden kokonaisvaltaisempi ymmärtäminen auttaa samalla hahmottamaan selvän haasteen näiden ominaisuuk- sien kattavammaksi hyväksymiseksi ja tukemiseksi. Samalla tässä haasteessa muotou- tuu eräs mahdollinen tie bioetiikalle siirtyä pois sen alun ja nykyisten ajatusmallien parista ja kukoistaa paremmin tulevaisuudessa. Syvimmiltään tutkimuksessa puolustetaan näkemystä, jonka mukaan bioetiikka voidaan – ja se pitäisi – nähdä kulttuurillisena jättiläisenä, joka on tärkeä osa ainakin länsimaista kulttuuripiiriä. Toisin sanoen bioetiikka nähdään kulttuurillisena voi- mana, joka voi osaltaan auttaa poliittisia ja sosiaalisia instituutioita uudistumaan ny- kyisin vallitsevien yhteiskunnallisten tarpeiden mukaan. Tämän ohella tutkimuksessa argumentoidaan, että bioetiikka on kulttuurillisesti itseisarvoinen asia, jota ei tulisi arvioida ainoastaan sen hyötyjen kautta vaan pikemmin hyväksyä vallitsevana kult- tuurin osana. Lisäksi tutkimuksessa pyritään auttamaan bioetiikkaa kehittymään tulevaisuu- dessa hahmottelemalla joitakin konkreettisempia ehdotuksia etenemiselle. Erityinen painoarvo asetetaan aidosti uuden ajatusjärjestelmän kehittämiselle tämän pyrkimyk- sen tukemiseksi. Tässä hengessä tutkimuksessa luodaan alustavasti ”orgaanisen bio- etiikan” käsite, jonka tarkoitus on auttaa paremmin käsitteellistämään ja omaksu- maan bioetiikan luonnetta ja alan parhaita puolia. Table of Contents Acknowledgements ........................................................................................................................... xi Introduction ........................................................................................................................................
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