Against Bioethics

Basic Bioethics

by Jonathan Baron

Governments, health professionals, patients, research institutions, and researchsubjects look to bioethicists for guidance in making important decisions about medical treatment andresearch. And yet, argues Jonathan Baron in Against Bioethics, applied bioethics lacks the authorityof a coherent guiding theory and is based largely on intuitive judgments. Baron proposes analternative, arguing that bioethics could have a coherent theory based on utilitarianism anddecision analysis. Utilitarianism holds that the best option is the one that does the most expectedgood. Decision analysis provides a way of thinking about the risks and trade-offs of specificoptions. Like economics, utilitarian decision analysis makes predictions of expected good in complexsituations, using data when possible, and focusing human judgment on the issues relevant toconsequences. With such a guiding theory, bioethics would never yield decisions that clearly goagainst the expected good of those involved, as some do now.Baron discusses issues in bioethics thatcan be illuminated by such analysis, including "enhancements" to nature in the form of genetics,drugs, and mind control; reproduction; death and end-of-life issues, including advance directives,euthanasia, and organ donation; coercion and consent; conflict of interest and the reform ofinternal review boards; and drug research. Although Baron opposes current practice in bioethics, heargues that by combining utilitarianism and decision analysis, bioethics can achieve its aims ofproviding authoritative guidance in resolving thorny medical and ethical issues.

Genres: Philosophy

248 pages, Hardcover

First published January 1, 2006

About the author

Jonathan Baron is professor of psychology at the University of Pennsylvania. He studies intuitions and judgment biases that impede maximization of utility (good) by democratic government. These include parochialism, the act-omission distinction, moralistic values, and the isolation effect. Relevant rubrics are Behavioral Public Finance, Behavioral Public Economics, and Behavioral Law and Economics. He is also interested in experimentation and data analysis.

Reviews

[gaby · Rating 2 out of 5]

I want to give baron the benefit of the doubt and say that my impoverished understanding of economics stunted my appreciation for this work. That may be so. But I do not have an impoverished understanding of either theoretical or applied bioethics. And my knowledge and his ideas rarely crossed. I was frustrated by his overly academic attitude towards situations that arise in the world outside of the ivory tower -- decisions made at the bedside or operating room, or at a higher level, decisions that yield admittedly incoherent public policy on healthcare and biomedical research. As a lawyer who practices applied bioethics, I was frustrated by his dismissal (or, worse, incorrect restatements) of the federal and state laws and regulations governing the topics he discusses. Perhaps this book would be a better match for an economist interested in these issues -- I'd be interested to know how the book was received in that circle.