Theoretical bioethics as moral activism (?)

This is a draft of a paper that I gave at the Postgraduate Bioethics Conference, University of Bristol, UK, that was held between August 31 – September 1, 2016.


I

As empirical approaches are gaining a firmer foothold in bioethics, it is essential to reflect on the role philosophical theory might, or might not, hold in the future. If theoretical ethical reflection is still useful, what does a practical moral theory look like? In this paper I explore one possible way of understanding what practical moral theory means, what makes it particularly ‘moral’, and how we might think differently about its place in bioethical research.

II

I believe we can agree that we often have certain expectations for a practical moral theory: it needs to perhaps tell us something useful about the right way to live and the right thing to do, it needs to be directly applicable to real clinical situations, and it needs to give us clear guidance and concrete tools that help us to navigate the messy terrain of moral life. Criteria such as these arise from a mode of thinking that in continental philosophy and sociology is called instrumental reason. Instrumental reason understands the practicality of a moral theory as directly equivalent to some systematic tool, such as a set of universal rules and principles or some other framework that we can effectively – even cost-effectively – apply and utilise in bioethical problem-solving.

Instrumental reason is problematic, as theorists from Max Weber to the Frankfurt school have argued. We can find similar critiques also in ethics of care. One of the problems of instrumental reason is its tendency to reduce everything to mere utility. This reduction excludes everything that doesn’t fit its criteria, such as affectivity, complexity of moral life, etc. Despite the problems, it can also be thought to be useful: for example, when the best possible moral care may require more time and resources that are available, and if we can’t immediately change these material and ideological conditions that restrict moral action, then having easy and clear tools may be essential for the minimal standard of moral care.

However, despite this possible, although questionable advantage, we need to resist utility as the criterion of practicality. When the validity of a theory is measured against its immediate applicability, and it is thus reduced to a tool, instrumental reason disvalues theory and gives primacy to practice. This limits our understanding of what theory is and what it can do. To resist utility as the criterion means that instead of asking whether we can use this or that theory in practice – as if the theory would be an unchanging, ossified authority entirely external to us, and not a creation of human action – we could ask, for example, that can we learn something about ourselves and others, or about the society, by engaging with theory?

Simply by changing the question, I think we already take a step closer to a more practical theory. As the German critical theorist Theodor Adorno argues, when theoretical research resists this simple primacy of practice, or the principle of utility, it already (although paradoxically) contains a practical element. What this means is that when an idea is followed though ruthlessly to see where it leads, and the impatient demand of immediate application is disregarded, theory is taken to its full potential as a critique with practical, transformative potential.

III

Before I recast the meaning of a practical moral theory and argue for its continuing value in bioethics, I need to make my position clear: I’m not defending theory for theory’s sake. Neither do I think all theories are utterly unpractical merely because they are theories. Rather, for anything theoretical to prove its practicality, we need to expand our very understanding of what theory means.

First and foremost, theory doesn’t mean simply the list of theories that we find in many textbooks, such as the moral systems developed specifically for bioethics or the trinity of classical moral theories – virtue ethics, deontology, and utilitarianism. It is not the act of choosing and applying a methodology or a theoretical approach in our research either. Although these are all examples of ‘theories’, the idea of theory I’m trying to outline here includes the way we actively engage with these theories. If we expand the concept of theory further, it can also be taken to mean the way we practice thinking that uses theoretical elements.

This idea of theory can perhaps be better explained by contrasting the instrumental application of a theory against something that can be called the critical practice of a theory. By making this difference clear, I mean to say that theory can’t prove its practical worth if it is simply applied uncritically as some outside authority. It can prove its practical worth only through the practice of the theory; namely, through the idea of a theory as a form of practice.

Practicing a theory in bioethics can mean at least two things. Firstly, it refers to the critical, rigorous, and continuous engagement with the chosen theory in our research. In this sense, there can be no closed or finished philosophical systems, no ossified frameworks or tools, in this category of practical moral theory outlined in this paper. Rather, practicing a theory through critique keeps the theory fluid.

Secondly, and importantly, the practice of a theory requires that we think about its relevance to making better the actual material, ideological, historical, economic, political, and social conditions in which we do research and care for patients. This act of thinking is a form of practice, not merely because thinking itself is an active ‘doing’ but also because critiquing wrongs has a power to change the world, however minute or remote the changes may be at first.

For example, directing our critique towards the material and ideological conditions for morality allows us to stop accepting the world, with all its problems and obstacles for moral action, as given. In other words, we can stop accepting the role of theory as the external authority that helps us to make the best of the wrong conditions of moral life. Instead, the purpose of moral philosophy today is to point out the wrongs to start to make them right, even if we didn’t yet have a ready alternative to offer. This connection to the actual material and ideological conditions is also what makes a critique, or theory as a form of practice, as particularly moral. It could even be called moral or politico-moral activism.

In sum, by practical moral theory I don’t mean the moral theories themselves. It is rather the practice of continued critical thinking on the level of theory, directed towards theory, in relation to the actual material and ideological conditions we inhabit.

IV

In conclusion, the idea that theory can be a form of practice, challenges the way we think about theory’s place in bioethics. Theory becomes something that is not outside ourselves: it is rather our own action and our power of imaginative thinking. By rethinking the meaning of theory as internal instead of external, we assign a new task for it; one that shifts the moral agency from the external ethical tools and frameworks to the frontline professionals and researchers themselves. This task is to see (theorein, thea, theatro) and face the contradictions and discomforts of moral life, and create an awareness of them. Here lies the transformative potential of theory as a form of practice, of theory as moral activism.

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