As a bioethicist with a background in philosophy one thing aroused my curiosity. I have several friends and colleagues who think (almost arrogantly) that the term 'ethics' refers exclusively to a specifically philosophical discipline – that is, to moral philosophy. On one hand this is an understandable and strongly justifiable position: 'ethics' and 'moral philosophy' are usually used synonymously.

On the other hand, I find the notion slightly disturbing, partly due an observation I made by reading recent articles published in Journal of Medical Ethics. An increasing amount of articles published under the rubric of ethics - especially under bioethics - are more or less empirical in methodological background, as contrasted to more traditional analytical or philosophical. They use polls and questionnaires to probe into public opinion about ethical issues (usually within the clinical practice) and produce both quantitative and qualitative data about ethical opinions within the professions. According to a study made in 2006, the percentage of articles published in various medical and bioethics journals using an empirical design went from 5,4 % up to 15,4 % between 1990 and 2003.*

So if we are to draw any conclusions from this one quantitative study and make the initial choice of trusting its validity, there seems to be a clear trend towards empiricism in medical and bioethics. Anybody doing research in the field of bioethics might agree on this. Especially this way of bioethicising seems to be en vogue in European contexts, at least by a personal gut feeling.

I do feel that ethics as a discipline has not been the monopoly right of philosophers for a long time. The literary genre of 'Ethics of...' is filled with volumes written to growing degree by others than professional philosophers. True enough, there is often a short introduction to main ethical theories, but the main bulk is often short articles by field professionals tackling an ethical issue from a more or less empiric viewpoint. The moral lesson in these texts is usually based on so called "stable ethical norms"; that is, they are not intended so much as a challenge to our way of thinking about ethics as they are to pointing out (at least presumably) real ethical problems.

It seems to me that bioethics is gradually becoming, if not already is, a social science. The polls and the questionnaires provide us, when duly performed, with a glimpse of these more or less stable norms: what the professions find already either acceptable practices or troubling issues. They're not intended for solving the "big issues" of moral philosophy but pointing out the "small issues"; hence as a philosopher-bioethicist one should not dismiss this line of research too hastily as uninteresting.

As a scientifically-minded person, the "hard fact approach" does have a certain appeal to me. But what kind of moral wisdom does this kind of empirical research in ethics yield? Or to put it in more academic terms, what kind of normative conclusions we ought to draw from these descriptive accounts?

Based on a small survey on how these results are often used I believe we have ultimately two options how to react: to take them either as justification or as challenge to our existing intuitions, the former being the cognitively easier way.

Let's say we're provided with a plausible account of how, for instance, practicing pediatricians in a certain country react approvingly to testing a certain experimental drug with small children. Having an initial response of appreciating drug testing for a therapeutical orphan group such as small children and respecting pediatricians’ professional opinion, one might draw the justifying conclusion: OK, here the norms are stable. The way these professionals see it in the light of their knowledge, maybe it is not a problematic issue after all. Let's build our argumentative fortress around that intuition.

Or, one might have initial suspicions about the ethical competence of these physicians, and find some clues on how the pharmaceutical industry has one way or another biased their professional judgment; hence one may well find the result troubling that these pediatricians lack ethical sensitivity, especially for this particularly ethically vulnerable group. Here the initial moral intuition justified by the factual findings is the polar opposite of the previous example.

The hard way is to reverse these initial sets of beliefs and the drawn conclusions, i.e. interpret the findings as a challenge to our existing beliefs. Most often we don't see that happening, even though it would be the scientific thing to do. Empirically-minded bioethicists are potential victims of the so called confirmation bias** and other hobgoblins of the mind as any of us.

This is just to scrape the surface of the problematic beneath the issue. For a scientifically-minded person, combining descriptive accounts of how people in fact feel and think about moral issues with clearly normative conclusions how they ought to act and perform in their professional lives does have its glamour, I do agree. Hard facts are a precious thing to have. But they're no silver bullet for the impatient ethicist.

The way I see it, hard facts are not the point where our ethical and philosophical reasoning must stop, but to begin.

References

* Empirical research in bioethical journals. A quantitative analysis. P Borry, P Schotsmans, K Dierickx. J Med Ethics  2006;32:240-245.
** http://en.wikipedia.org/wiki/Confirmation_bias

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