Bioethics, a humble servant to the queen?

Image taken from page 25 of 'The Men in the Moon: or, the 'Devil to pay.' With thirteen cuts [by George Cruikshank], etc. [A satirical poem-chiefly in reference to the proceedings of Messrs Cobbett, Hunt, and others.]'

The role of bioethics has been questioned in an op-ed by the silver-maned experimental psychologist Steven Pinker. Pinker’s piece has generated some heated online responses. While some commentators call for context and nuance in reading Pinker’s piece, others read it in the context of the turf wars over the role of science and the humanities in the modern production of knowledge. Pinker has held a lead role with #TeamScience in these disputes. Until recently, bioethics has been able to negotiate these wars by trying to get along with everyone. However, Pinker’s recent call for bioethics to “Get out of the way” and allow medical science to do its life-saving thing has publicly questioned whether bioethics is helping or hindering medical science.

A questionable lineage

In the not so distant past, theology and philosophy both laid claim to the title “queen of the sciences” – a claim that not many today would grant either. In terms of institutional and financial support, both are in the descent (see, see). This is not to say that we should smooth the pillow and send them off into the quiet night. Both will continue their important work, but many of the hangers-on will continue to retreat to other parties. Vice-Chancellors and politicians won’t be launching books or holding soirees to celebrate a new breakthrough in Hegelian scholarship, for instance.

While the social and economic capital of theology and philosophy declines, their child, Bioethics, is perhaps in a more opportunistic optimistic position. Since the 1970s bioethics has found a role in service of the new queen – medicine. Medicine fulfills the role once held by theology and philosophy in ordering the human sciences.* The importance of medicine and medical research in the modern university is unquestioned. In the same way theology was once essential to Oxford University; medical research has become essential for a major research institution to be taken seriously. Its role is more than this however. Medicine is not only greatly valued, but determines the value of other human sciences. The closer a discipline’s proximity to medicine and the goal of securing human health and preventing curing disease (see), then the greater the value of that discipline.

Bioethics has been placed, or placed itself, within and alongside medical research.

In the 1970s, philosophers and theologians offered initial responses to public scandals in research and clinical practice. For example, Tuskegee syphilis experiments in the US, the experiments on women with cervical cancer at New Zealand’s National Women’s Hospital, or the death of Jesse Gelsinger; who died while participating in a clinical trial at the University of Pennsylvania. Events such as these led to acceptance that ethical oversight of medical research and practice is essential. Ethics committees were established, and ethics education became standard for medical students and researchers. The success of these interventions has led Pinker to conclude that medical researchers have learned to behave and appropriate checks are now in place. Therefore the shackles of bioethics can be loosened.

Keeping medical research “in check” is only part of the story.

A role also opened up for bioethics centres and bioethicists to calmly communicate breakthrough medical research to anxious publics. In Australia, Monash University established the Monash Centre of Human Bioethics in 1980 with Peter Singer as Director. The initial role of the centre was to promote the rapidly advancing research in artificial reproductive technologies at Monash University. Alan Trounson, the former director of the Monash Centre for Early Human Development, recalls:

I had to sort myself out in the early days just like anyone who works in a new area involving something like human embryos. If we hadn’t had Peter Singer around in those days I think we might not have pursued some things to the extent that we have.

Singer, among others, helped further the research of Trouson and his colleagues by communicating to the public that the moral status of an embryo is not something to be concerned about and that so called “test-tube” babies are just fine.

Pinker believes that it is time for bioethics to “get out of the way”. However, rather than saying “stop”, a lot bioethicists have arguably greased the wheels of medical science and widened societal ethical boundaries to allow more and more research to be done. So perhaps in this case, what Pinker meant to say was not “get out of the way”, but “get in your place! Tell the public that editing genomes is not to be worried about because biomedical research is progressing and soon disease will be regressing”.

*This is not to suggest a neat linear progression from theology to philosophy to medicine. The effects of theology, for instances, are still very present in philosophy and medicine (and bioethics).

Bioethics, obesity and the harm principle

Fat people should pay more to fly, because they weigh more and hence use more fuel.
Fat people can’t make good food choices so they should be coerced and stigmatized into making the right choice.
These and other spurious ideas are permitted to float around opinion pages of leading newspapers and journals because a) we think we have a fat people problem; b) shocking, blunt and simplistic solutions to complex problems are key ingredients to “click-bait”; and c) if we can reduce complex problems to economic calculations then we can pretend moralistic interventions into peoples lives are “neutral” because, hey it’s the raw numbers talking.
Anyway, in the below paper published this week I argue against Peter Singer and Dan Callahan’s attempts to justify direct interventions into the lives of fat people based on a simplistic use of the harm principle and a deep ignorance of empirical and public health research on obesity. Or as H.L. Mencken quipped, “For every human problem, there is a solution that is simple, neat, and wrong.”
If you can’t get beyond the paywall send me an email or message.

The Harm of Bioethics: A Critique of Singer and Callahan on Obesity


Debate concerning the social impact of obesity has been ongoing since at least the 1980s. Bioethicists, however, have been relatively silent. If obesity is addressed it tends to be in the context of resource allocation or clinical procedures such as bariatric surgery. However, prominent bioethicists Peter Singer and Dan Callahan have recently entered the obesity debate to argue that obesity is not simply a clinical or personal issue but an ethical issue with social and political consequences.

This article critically examines two problematic aspects of Singer and Callahan’s respective approaches. First, there is an uncritical assumption that individuals are autonomous agents responsible for health-related effects associated with food choices. In their view, individuals are obese because they choose certain foods or refrain from physical activity. However, this view alone does not justify intervention. Both Singer and Callahan recognize that individuals are free to make foolish choices so long as they do not harm others. It is at this point that the second problematic aspect arises. To interfere legitimately in the liberty of individuals, they invoke the harm principle. I contend, however, that in making this move both Singer and Callahan rely on superficial readings of public health research to amplify the harm caused by obese individuals and ignore pertinent epidemiological research on the social determinants of obesity. I argue that the mobilization of the harm principle and corresponding focus on individual behaviours without careful consideration of the empirical research is itself a form of harm that needs to be taken seriously.

Keywords: obesity; Peter Singer; Dan Callahan; harm principle; public health

Mayes, C. (2015), The Harm of Bioethics: A Critique of Singer and Callahan on Obesity. Bioethics, 29: 217–221. doi: 10.1111/bioe.12089