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Biomedical Research and BeyondReview - Biomedical Research and Beyond
Expanding the Ethics of Inquiry
by Christopher Tollefsen
Routledge, 2007
Review by Nathan Emmerich
Aug 11th 2009 (Volume 13, Issue 33)

Biomedical Research and Beyond is, for the most part, a virtue based examination of what the author calls an ethics of inquiry. The first two chapters introduce the concept and subsequent chapters examine some stand issues in biomedical research ethics, these being: Consent; Fairness; Truth-Telling; Human Embryological Research; and Animal Research. The final two chapters continue the virtue based account of the ethics of inquiry but with a greater focus on inquiry as vocation and practice.

So far so good yet is has to be said this is a strange book. Given the title we might expect the book to explore the ethics of psychology, anthropology or sociology, either on their own terms as inquiry's or in relation to consent, fairness and truth-telling. These subjects go unmentioned apart from a brief paragraph on page 41.  It is difficult to see how the author is to go beyond biomedical research in his exploration of the ethics of inquiry. The chapters entitled 'Coercion, Torture, Enhancement and the Inviolability of the Person' (Chapter 7) and 'Humanistic and Journalistic Inquiry' (Chapter 10) are presumably this expansion however they form part of a four chapter tangent that the second half of this book takes.

Chapters 7 and 10 bookend two intervening chapters which concern the relationship between the state and, for the main part, biomedical science. Perhaps it is this exploration which is the 'beyond' referred to in the title. The author is, one presumes, trying to use a discussion of coercion, torture and enhancement in chapter 7 as a lead in to discussing the relationship between the state and what and how science is permitted to inquire. This is, of course, a legitimate area of inquiry however it employs some rather dubious tactics. First the title indicates that enhancement (whatever that may or may not be) is somehow related to coercion and to torture. The author also suggests that the aim of research into in vitro fertilization and cloning "is to remove from the sphere of sex, marriage and the family the act of creation of children, and indeed, to remove it from any necessarily interpersonal context at all." The suggestion that research into human reproduction is aimed at such a thing is, I think, a startling claim. One can certainly entertain the notion that it may result in such a thing but it is quite another to suggest that someone (Scientists? Science itself? Politicians?) actually has such an aim. On the same page the author continues that "[c]loning is akin to masturbating for children, a lonely and solipsistic business" (104) which is, at best, a rather unusual simile.

To round this section on reproduction he suggests that the depersonalised human relationship "is especially apparent in the relationship to the created children that are the fruit of a technical process, rather than of a loving human relationship. Children created through such technical means are ultimately in the eyes of their creators, artifacts, products of their will and design, rather than persons." (104) This is an argument that was raised prior to the birth of Louise Brown in 1978. It is not clear but the author seems to be suggesting that such 'created children' do already exist and so he is not just advancing an argument about reproductive cloning. If this is the case then it seems strange to maintain such a position given the lack of empirical evidence to back up such a claim. Children born through reproductive technologies certainly seem to be considered persons by their parents and, furthermore, seem to be perfectly fine biologically and socially.

One could continue to document the rhetoric which characterizes this chapter however as it is merely aimed at leading us to a discussion of the relationship between science and state it is perhaps time to move on. In chapter's 8 and 9 the author consider science as a profession and public good, he then considers the state's responsibility for promoting that public good and the sovereignty of the state and how it might be exercised. Important subjects worthy of discussion however Tollefsen finds himself advancing some questionable arguments in order to support his previous conclusions regarding human embryological research and animal experimentation. Despite there being disagreement regarding the ethical nature of embryological research it is, apparently, to be distained on the grounds of political legitimacy; pro research scientists and others should bow to the logic and honestly expressed concerns of those against the research because to carry out "such research buy the state would fail as regards the criterion of reciprocity and would thus destroy the bonds and the possibility of civic friendship." (146) The same is not true of animal experimentation as "the number of animal rights activists seems considerably smaller than  the number of supports of embryo rights… the ideological bonds that tie together those who believe in  and practice animal rights are typically desperate and lack unity… the supporters of animal rights range widely from rights theorists to utilitarian's, to deep environmentalists, to those who believe the domination of animals is linked to gender domination… it is not clear that there is a definite class of animals that all animal rights activists believe deserve protection." (146)

This may all indeed be true but it is not clear why animal rights are not to be legally protected by the state when it is the argued case that embryo rights should. The first point raises a question of precisely how much of a moral minority any group must be before the bonds of civic friendship are threatened by not having ones views enacted legally. In response to the second we might point out that the ideological bonds which tie together Christian's are not free from uncertainly, variation or change either in overarching theological terms or in the specifics of embryological research. There remains a question regarding precisely how different ones reasons for a view must be before it is the case that you are to be considered disparate. The final point merely reiterates the central question at stake in the debate about embryo research. It may be that the biological boundary between plant and animal is uncertain and whilst the author has argued that such uncertainty does not exist between the concepts fetus, human being and person there are a great number who disagree.

There then follows a chapter on 'Humanistic and Journalistic Inquiry'. As noted above it would seem more sensible to consider the social sciences before moving into the humanities or into journalism and this chapter does stick out. The author discusses the relationship the state has with the humanities and journalism but the ground has shifted so much from previous discussion it does not feel like a natural progression of a thesis or of the book. The concluding chapters return to the human virtues and to a generalized notion of inquiry and it is here that the most interesting ideas and arguments are advanced. The chapters demonstrate that there is merit in the central concern of the book but the diversion at its heart means that it is flawed in its presentation.

 

© 2009 Nathan Emmerich

 

Nathan Emmerich, nemmerich01@qub.ac.uk, School Of Sociology, Social Policy and Social Work, Queens University Belfast.  Nathan Emmerich is completing a PhD which concerns the teaching and learning of medical ethics on the UK undergraduate medical degree.


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