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Jens Schlieter

Bioethics, Religion and Culture
from a Comparative Perspective

On the Meaning and Method of a New Inquiry

English
Summary

At a time when various Asian cultures are trying to debate the greatness of their own cultures in terms of Asian values and the freedom given to various kinds of genetic and biomedical research, it is necessary to look at the way bioethics can be made acceptable transculturally. It is arguable whether bioethics can become universally acclaimed like human rights. It will be difficult to come to an agreement on this point for both philosophers and scientists in different cultures. Such disagreement has also caused scientists to move to the countries and cultures where they experience more freedom in their research. A considerable drawback lies in the fact that bioethics has not become an established field of philosophy. To help articulate bioethics in different cultures, four methodological standpoints are offered. Though this could be done effectively at the theoretical level, it remains to be established concretely on the cultural and religious levels. This in turn depends a lot on the understanding of life people have in different cultures and religions. It is here that religion and culture provide answers to inexplicable questions, and where a dialogue on bioethics could be most fruitful.

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1. Gene-technology, Biomedicine and Bioethics in the Cultures

Can Bioethics, which is rooted in the Roman-Christian idea of the dignity of the human being, be formulated philosophically, so that it can find acceptance trans-culturally? Can the various cultural understandings be unified as to the ethical point of time of the beginning of life? 1 Is it justified when, during heated debates on »Asian values,« some Asians maintain that in the long run they have a better framework for biomedical research and practice, because in their tradition the welfare of the community is strongly taken into consideration? Or are these statements only the expression of a new political self-understanding which will consciously demarcate itself from the »West«? Can bioethics, which is rooted in the Roman-Christian idea of the dignity of the human being, be formulated philosophically, so that it can find acceptance trans-culturally? Or will a minimal consensus be found not in philosophically based principles, but, if at all, only in pragmatic compromises? Can the various cultural understandings be unified as to the ethical point of time of the beginning of life?
2 Questions of this kind are raised in the field of cross-cultural bioethical discussion. In what follows, no concrete answer can be given to these questions. Rather, as an introductory attempt, methodical approaches to these inquiries, which gain increasing significance with the globalization of biomedicine and gene technology, shall be identified.
3 Actually, the so-called »sciences of life« and their technological innovations have already served for long time as codes for the human expectation of the profoundest social transformations, revolutions of images of human beings, or »simply« the most effective medical therapies. In spite of the global significance of these, interculturally or comparatively working philosophers, and also religious scientists, have hardly taken part until now in the discussions about these technologies, although they can use their specific competencies in answering important questions. On the one hand, they could contribute to the clarification of the question of how leading concepts of other traditions concerning birth, life and death influence both the acceptance of biomedical-genetic research and its implementation, for example therapies based on it. Moreover, even culture-specific definitions of the individual, the family and the social system have a public effect on the discourse on biomedicine. The significance of these moments towards the positive acceptance of new technologies can likewise be analyzed. (For example, if the pressure or expectation on the individual to create one's own progeny is religiously loaded – thereby dominating perspectives, the meaning of the parents' lives is fulfilled in the children, or, the handing over of the religious tradition is of a higher value than the reproductive freedom of the individual, etc.)
4 On the other hand, particular perspectives could be articulated as objections against certain biomedical procedures and views. In these cases a critical potential is to them an inertia which they set against the technological development. Because of the specific European tension between the development of natural sciences, in the role of »enlightenment«, and the retreat of theology, often only the second objection has been taken note of – namely, the resistance and withdrawal of the traditional interpretations of meaning. How strongly the traditional ideas might lead to acceptance of certain biomedical practices in other cultures, on the contrary has been, until now, seldom emphasized.
»We stumble into very explicit and completely meta-technical questions, as soon as we venture to place a ›creative‹ hand on the physical constitution of the human being itself. They all culminate in a single question: According to which leading model?«

Hans Jonas:
Technik, Medizin und Ethik. Zur Praxis des Prinzips Verantwortung.
Frankfurt 1987, 170.
5 Precisely interculturally or comparatively working philosophers are challenged by the task of ethical foundations for modes of action which are developed in other traditions for the orientation in bioethical questions. However, researchers like ethnologists and anthropologists, who because of their intensive involvement with regional cultures are confronted with different value systems, also show a greater affinity for culturally relative standpoints when dealing with bioethics (cf. for example, the contributions in Tao 2002). Obviously, the standpoints of universalism and its gradual relativization up to radical relativism agree only with difficulty. However, searching for a compromise which takes cultural differences seriously without giving up the attempt to translate into action ethical orientations from one culture to another is the most preeminent goal here.
6 In view of the comprehensive discussion on the universality of human rights, it is understandable that the demand for its international recognition is to be carried over in the development of intercultural bioethical standards. Granting that the demand is justified: would the pursuit of comparative perspectives of philosophy and religious sciences be needed at all? Yes. As an example: The question about human gender ethics, as it stands behind the Habermasean formulation of a »future of human nature« (cf. Habermas 2001), presupposes as a principle of ethics that this is valid for the human being alone. It is not valid for all conscious beings, including animals, as it would be in the case of the principles of Buddhist ethics. So we must ask whether the question about human nature raised earlier is not included within in the – comparatively placed – question about the human cultivation of »human nature.«
7 Moreover, the new face of the biomedical research landscape comes into play here also. The fight over biotechnological research and biomedical procedures involves not only the classical technological centers of the USA, Europe and Japan, but also countries where foundational research, i.e., the development of new technologies, has hardly played a great role until recently. For example, China, Korea, Singapore and India have developed centers which – at least – have catched up with biotechnological research. These developments are also to be observed in other key technologies.
8 A specific problem exists in this development with reference to biomedicine, especially if observed from a European perspective. On the one hand, more than a few relevant biotechnical companies and scientists from the classic European technology countries have recently migrated out of those countries. In newly-developing countries they find – in the ethical-legal as well as economic sense – greater freedom for their research, for example, on embryonic stem cells. On the other hand, we can see that in some of the aspiring countries of Asia, biotechnology is considered to be the last phase of an emancipation from the West, whose comprehensive ethical reflections (for example, regarding the permission of research on embryos) are considered to be an exaggeratedly narrow interpretation of the dignity of the beginning of life.
The dilemma is that, with the development of biotechnology, for the first time a technologies is developed whose results and, perhaps still more, whose research praxis immediately impacts the self-understanding of human beings in countries which stand in another cultural, religious and philosophical stream of tradition than that of the West. 9 Certainly, these are hardly more than one-sided arguments which present a greatly simplified view of the plurality of global debate. In Asian countries there is a lively discussion too and there are very different positions, and in Europe, up to now, there are differing feelings and various legal norms. The above one-sided sketch serves here to introduce, above all, the dilemma that it has opened up for traditional Western morality. This dilemma carries economic, scientific and moral aspects, which all influence one another.
10 The dilemma is that, with the development of biotechnology, for the first time a highly significant technology is developed in countries which stand in another cultural, religious and philosophical stream of tradition than that of the West – a technology, whose results and, perhaps still more, whose research praxis immediately impacts the self-understanding of the human being. A technology which is born and developed to a considerable extent in the West is accepted and further developed in other regions, without receiving an ethical reflection about the moral boundaries, equally developed in the Western tradition, as usually being transmitted in the case of other technology imports so far. This is also not surprising, since the reflection about the conditions of usage of new technologies presents often an answer to border crossings.
11 Does it follow that members of other cultures 1 will be influenced by their respective views, which depart completely from the European framework, with regard to the development of biotechnological research and its use? In any case there arises – probably for the first time – a situation in which even the traditionally oriented Western philosophers must also consider the ethical reflections of other cultural regions, at least if they are interested in the formation of international ethical standards. Ethical reflection on the most recent biotechnological courses of action meanwhile also takes place in other traditions, where it has direct consequences on the regional »bio-politics.« Certainly, many philosophers will hang ethical standards on the unconditional and universally accepted tenets of rationality, human dignity and freedom. In relation to the international recognition of human rights, agreement is much more forthcoming than in regards to the complicated mesh of biomedical options for action, about which until recently no agreement had been reached even in the West.
12 According to Foucault, in modern societies a new concept has arisen which can be described as ›bio-power‹ or ›bio-politics.‹ Foucault describes the changing face of a state politics of health (wherein also other medical institutions, health insurance companies, industries, etc. gain influence); that is, to feel responsible for the health of the citizens that ›bio-politics‹ enters decisively into life from birth until death. In any case, it is certain that these regulations extend, in turn, far-reaching changes of view; for instance, if certain mental illnesses have a genetic cause and can be diagnosed before birth, they can be increasingly interpreted as »avoidable suffering.« But bio-politics also protects a just distribution of medical goods and health resources.
In any case there arises a situation in which even the traditionally oriented Western philosophers must also consider the ethical reflections of other cultural regions, at least if they are interested in the formation of international ethical standards. 13 If Foucault had in mind the process of state-regulated birth control and of a eugenic program, the »biopolitical« question today arises furthermore as to how options on research and therapies compare with those of other countries. In the face of the worldwide distribution of biomedical products and service resources, it no longer affects only permission for individual actions (for example, those of the physician), since interventions always affect the people as a whole, if not on a global scale. For example, the fluctuating proportion of men and women in some Asian countries is a result of prenatal sex selection (that is, the prevention of female children).
14 It is this political dimension which poses the greatest challenge to the discourse on biomedicine. It is additionally made difficult because the discussion is held under the continuing pressure of liberalization on the side through economics (and of politics in favor of national advantages). By the immediate interest in the result of a discussion, which ultimately is reflected in legal norms, the danger grows that the dealing with culturally weighted views in other countries is being instrumentalized. »Instrumentalized,« because the actors, guided by their ostensibly content-wise interest, adopt only such views of other traditions as their own which they could use for their demands according to the relaxation of the local valid laws (or morality). Precisely here, as corrective the competency of the comparative disciplines is necessary, whose methodic entries I would to sketch in the following.

2. Bioethics in the Cultures – Methodic Approaches

15 What is bioethics? Historically defined, bioethics arose from traditional medical ethics, as 1970s American Protestant theologians took up ethical reflection on new technologies (prevention of conception, artificial insemination, gene diagnostics, the rights of patients to be informed, and so on).
16 Today, the concept serves as a description of three different areas (cf. Schicktanz 2003, 264 f.):
a) On one hand it designates the academic discipline which simply searches for the ethical foundations of actions, i.e., for the orientation of action in the area of biomedicine and also in connection with the living being.
b) Secondly, bioethics characterizes the entire process of controlling biotechnologies, which includes the respective political and legal norms in individual countries.
c) Thirdly, it includes the bioethics of public discourse (by patients, doctors, scientists, the media and so on).
At least four different methodological standpoints could be differentiated:

1) cross-cultural bioethics (normative);

2) bioethics from the perspective of intercultural philosophizing (hermeneutical);

3) comparative bioethics (as part of comparative philosophy; history of ideas);

4) bioethics in culture (descriptive; science of culture).
17 How bioethics is articulated in different cultural contexts is of special significance in ascertaining in which realm it is spoken of. For example, the fact that in a country certain biomedical research is allowed cannot be seen as evidence of a permissive attitude of the majority religion in that country. For this attitude may merely be the result of a situation in which certain biomedical research does not fall under legal regulation and control. Or it could be the expression of the view that the state must distance itself concerning goals, like long-term competitive competence of those in the life sciences, from the respective influences of religious groups, non-governmental organizations (NGOs) and ethical meta-reflection. In both cases, the legal position does not reflect back on the academic and public bioethical discourse ([a] and [c] above). It is therefore incorrect to view the lack of regulations as reflecting the views of certain religious traditions.
18 What does this possible differentiation of three areas of bioethics signify now for the comparative approach? For one, it must be established that in many non-European contexts bioethics is barely institutionalized as a philosophical or academic discipline, and the discussions until recently have connected strongly with the juridical, political or religious discourses.
19 It becomes easier, first of all, to more precisely define one's own interests when searching for knowledge. At least four different methodological standpoints could be differentiated:
1) cross-cultural bioethics (normative);
2) bioethics from the perspective of intercultural philosophizing (hermeneutical);
3) comparative bioethics (as part of comparative philosophy; history of ideas);
4) bioethics in culture (descriptive; science of culture).
20 If bioethics is studied in order to formulate cross-cultural or transcultural maxims, then it deals with philosophical bioethics in a narrow, that is, a normative sense. For the schematic definition suggested here, cross-cultural bioethics essentially follows normative views, that is, it is reflected by the verifiable criterion, intentions and maxims or ways of acting, which should be transculturally connected. It is obvious that cross-cultural bioethics in this sense is differentiated only by the geographical extension of its area of application from »domestic« bioethics.
21 Many philosophers also consider the field of cross-cultural bioethics to include a universalistic, transcendental philosophical foundation of morality. However, the applied criteria of rationality, if they disapprove of other foundation models, should be modifiable, what they precisely are not by definition. Approaches with a richer outlook are thus above all such which like a new Aristotelian project of Martha Nussbaum proceed from specific incultured virtues which can enter in a fruitful competitive struggle of interpretations. A presupposition for this is that the virtues of a culture are translatable in the other cultures, without being traced back to all-common a priori necessarily available principles.
In contrast to an intercultural perspective, comparative ethics does not necessarily arise from one's own standpoint in the discourse. So considered, the comparative interest is to be characterized as meta-ethical. 22 From the perspective of interculturality towards bioethics, which I would like to differentiate from bioethics undertaken from comparative perspective, it is, above all, to be de-located in the hermeneutic situation, in which in the actual dia- or polylogical process, the traditions of thought of various cultures, are mutually understood (cf. the approach of Franz M. Wimmer).
23 Comparative ethics, on the contrary, gains knowledge about ethical actions by the comparison of positively available ethics, i.e., moral theories. In contrast to an intercultural perspective, comparative ethics does not necessarily arise from one's own standpoint in the discourse. So considered, the comparative interest is to be characterized as meta-ethical. 2 Comparatively working ethicists analyze the history of ideas, which leads to their respectively held positions. In addition, the attempt to reconstruct different ethical positions systematically, as for example Max Weber undertook in his typology of ethics, can be described as comparative ethics.
24 Finally, bioethics can be studied within the interest of the science of culture. Here, descriptive methodics also stand on the front lines, as they are developed by medical ethnology, theology, or cultural anthropology. The advantage of using as a starting point the science of culture consists in the fact that not only the academic discourse of bioethics, but also the process of controlling (above [b]) and public discourse (above [c]) can be integrated in the research. Advancements using such a view can also meet with difficulty if certain ethical concepts are superimposed too quickly onto other traditions. The Kantian separation of ethics and morality brings with it difficulties according to which ethics enters as foundational discourse for moral behavior, briefly: as reflection theory of morality (cf. Luhmann 1993), in the comparative context. It can be carried further if ethical statements of other traditions are considered, first of all, either as »moral lines of action,« 3 or, as Nussbaum suggests, understood in the virtue-ethical sense, and as such are »translated« in one's own language.
25 The conceptual separation of ethics and morality presupposes on the contrary, among other things, that the criterion of rationality put forward maintains in its turn an autonomous status against religiously founded morality, the ethos, the teaching of virtue, etc. A presupposition of this separation is that of a post-enlightenment society – a presupposition which is not met everywhere.
26 Which of the approaches is chosen finally lies in the specific interest with which one devotes himself to bioethics. It is naturally possible to follow one of the mentioned methods. The analysis can, first of all, begin descriptively with a presentation of the conflicting positions, the description of the discourse of participants and their religious and philosophical backgrounds, the legal regulations, etc., in order to improve the meta-ethical or normative reflections.

(Re-)Birth – Life – Death: On the Actuality of Incultured Interpretation of Meaning in the Bioethics Debate

Vier Prinzipien der Medizinethik nach Tom L. Beauchamp und James F. Childress:

(patient) autonomy
(Autonomie [des Patienten])

beneficence
(Wohltun)

non-maleficence
(Nicht-Schädigen)

justice
(Gerechtigkeit / Fairness)
27 How do we now play culturally imprinted views into bioethical decisions and ways of action? In contrast to the above, the bio-political views of the entire people, in which, naturally, culturally imprinted views are also manifest, are to be considered above all with the individual attitudes of patients, doctors, researchers and so on. Since most bioethical decisions deal with questions on the meaning of life, religious interpretations always play a great role, even in a few strongly secularized cultures. Certainly, traditional interpretations struggle with the difficulty of evaluating biomedical practices; they can do it only through a basic approach to the biomedical-genetic interpretation. Naturally, judgments can be made without even reference to bioethics. Still, it is to be understood that this can hardly lead to differentiated statements. In any case, it remains a challenge which already contains within itself the step to a cross-cultural realm – namely, with reference to the globally spreading biomedicine and its »ontology,« if individual biomedical actions are judged ethically from a traditional cultural context.
28 However, the influence of incultured viewpoints in relation to decisions which deal with the meaning of suffering and sickness, dying, death, brain-damage, donation of organs, etc., is important in many places. Even in secular societies, even in a purely philosophical universal understanding of bioethics, as of the »four-principles-approach« by Childress / Beauchamp, 4 an influence of religious impact can be perceived. The increasing sensitivity towards cultural and religious contexts is seen, for example, in the respect given to the individual backgrounds of patients, in the USA and Canada, but also in Europe (cf. the guide of Ilkilic 2002).
29 Religion survives, above all, where it accomplishes contingency, as it provides death, suffering, loss and other events which resist rational explanation with meaning (cf. Lübbe 1979, especially 172 ff.). Religions specialize in the areas in which limits on the day-to-day interpretations of meaning are proposed – obviously those in which many bioethical positions are also established today.
Eubios Journal for Asian and International Bioethics.
external linkJournal
30 The cross-cultural discourse on bioethics has only begun, on the whole. There are international fora like the Eubios Journal for Asian and International Bioethics; but it were primarily recent developments like the cloning of the sheep »Dolly«(1997), the decoding of the human-genome(2000), human-animal hybrid experimentations (2003), and the first successful gain of stem-cells from a cloned human embryo (2004), that have marked the beginning of the discussion at a global scale.
31 It remains to be hoped that in this discussion about the future of human self-understanding, not only representatives of life sciences and of institutionalized bioethics participate, but also those who, from their own cultural backgrounds, search to find answers to questions about the ethics of biomedicine.
Translation from the German by Anand Amaladass.

polylog: Forum for Intercultural Philosophy 6 (2005).
Online: http://them.polylog.org/6/fsj-en.htm
ISSN 1616-2943
Source:
external linkSatya Nilayam: Chennai Journal for Intercultural Philosophy 7 (2005), 93-104.
© 2005 Author & polylog e.V.

Bibliography

Notes

1
Even if the talk is of cultures in the following, however must it be referred to the problematic of the usage of this concept. If one defines cultures in the meaning of general, action-oriented and action-motivating horizons, the decisive element remains hidden: namely, the individuals, however, (can) actualize in the individual way »their culture« – until the refusal to acknowledge. Thus it is to be considered that cultural impacts certainly suggest certain perspectives but present no argument in the ethical sense. On the other hand, ethical foundation discourses have in their turn again an influence on the culture, in which they take place, so that it is to be seen from a mutual process. go back
2
The volumes by Elberfeld / Wohlfart 2002 and Elm / Takayama 2004 offer a glimpse in actual discussions of intercultural and comparative ethics. go back
3
Im Kontext vergleichender Ethik hat sich der Begriff »moral action-guides« bewährt, eingeführt von Little / Twiss 1978, 25–28. go back
4
In 1976 appeared the foundation work, frecuently new edited, by Tom L. Beauchamp and James F. Childress (2001), whose medical ethics suggested the following four principles: (patient) autonomy, beneficence, non-maleficence, justice. About the transcultural implementation – especially of the principles of autonomy and justice – is since then much debated. go back

Author

Jens Schlieter (*1966 in Garatshausen, Germany) studied philosophy, comparative religion, tibetology and Buddhist studies at the universities of Bonn and Vienna. In 1999, he received his PhD from Bonn University with a thesis on the philosophical significance of language in European and Buddhist thought. He was a Scientific Officer in Bonn and Munich. Since 2005, he is Assistant Professor at the Institute for Religious Studies of the University of Bern. His research areas are bioethics of the religions, especially Buddhism, history of Indo-Tibetan Buddhism, the interface of religion and philosophy in comparative perspective, and theory of religious language. Among his publications are Buddhismus zur Einführung (1997) and Versprachlichung – Entsprachlichung. Untersuchungen zum philosophischen Stellenwert der Sprache im europäischen und buddhistischen Denken (2000).
Prof. Dr. Jens Schlieter
Universität Bern
Institut für Religionswissenschaft
Länggassstrasse 8
CH-3000 Bern 9
Switzerland
Fax +41 (31) 631 35 51
emailjens.schlieter@relwi.unibe.ch
external linkhttp://www.relwi.unibe.ch/homeJens.html
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