Bioethical Principles of the Personal Domain E-Book

Michele Karaboue

• Herausgeber: Youcanprint
• Kategorie: Gesellschafts- und Liebesromane
• Sprache: Englisch

Veröffentlichungsjahr: 2025

Beschreibung

This work aims to analyse the thoughts of H.T. Engelhardt on some of the central themes of contemporary bioethical debate. The area in question includes the observation of the de facto existence of a highly plural society, i.e. one that is characterized from a moral point of view by an intrinsic pluralism. Central to this context is the concept of the person, which, contrary to any broad consensus on how this should be understood, requires extensive reflection to provide an appropriate definition. To speak of the "human person" also means necessarily addressing the rational capacity that characterises them, which is then strongly questioned from a theoretical point of view by the postmodern context of the plural society and Engelhardt himself. The importance of offering an adequate semanticization of the concept of the person is apparent when it becomes clear that this represents the key to addressing problems arising from a bioethical point of view. The main aim of this research will therefore be to understand (starting from an analysis of Engelhardt's thought, which provides much food for thought to this end) whether there is still room within contemporary debate for the use of the concept of the person which is capable of guaranteeing their protection in a well-founded manner, i.e. by leveraging capacity of reason to identify a non-arbitrary hierarchy of goods in a substantial way. This forms part of an overview of the fundamental features of the contemporary context, which is characterised by a crisis that affects each sector, cultural and otherwise, so undermining any possibility of achieving any degree of certainty.

Leseprobe

Contents

Titolo

Diritto d'autore

Table of Contents

Introduction

Chapter 1

1.1 Society and Ethics

1.2 Ethical Authority

1.3 Diversity of Ethical Perspectives

1.4 Identity as Individualization in Social Context and Ethical Estrangement

Chapter 2

2.1 Individuals as the Basis of Ethical Authority

2.2 Aspects and Interpretations of Ethical Authority

2.3 Ethical Landscape of Health

2.4 Medicalization as a Social Aspect of Personal Existence

Chapter 3

3.1 Practical Anthropology of Individuals

3.2 Basic Framework of Ethical Authority

3.3 The permission principle

3.4 The beneficence principle

3.5 The property principle

Conclusions

References

Guide

Copertina

Table of Contents

Start

Bioethical Principles of the Personal Domain

Michele Ahmed AntonioKaraboue

TITOLO | Bioethical Principles of the Personal Domain

AUTORE | Michele Ahmed Antonio Karaboue

ISBN | 9791222793030

Prima edizione digitale: 2024

© Tutti i diritti riservati all'Autore.

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TABLE OF CONTENTS

INTRODUCTION

Chapter 1

1.1 Society and Ethics

1.2 Ethical Authority

1.3 Diversity of Ethical Perspectives

1.4 Identity as Individualization in Social Context and Ethical Estrangement

Chapter 2

2.1 Individuals as the Basis of Ethical Authority

2.2 Aspects and Interpretations of Ethical Authority

2.3 Ethical Landscape of Health

2.4 Medicalization as a Social Aspect of Personal Existence

Chapter 3

3.1 Practical Anthropology of Individuals

3.2 Basic Framework of Ethical Authority

3.3 The permission principle

3.4 The beneficence principle

3.5 The property principle

CONCLUSIONS

REFERENCES

INTRODUCTION

This work aims to analyse the thoughts of H.T. Engelhardt on some of the central themes of contemporary bioethical debate. The area in question includes the observation of the de facto existence of a highly plural society, i.e. one that is characterized from a moral point of view by an intrinsic pluralism. Central to this context is the concept of the person, which, contrary to any broad consensus on how this should be understood, requires extensive reflection to provide an appropriate definition.

To speak of the “human person” also means necessarily addressing the rational capacity that characterises them, which is then strongly questioned from a theoretical point of view by the postmodern context of the plural society and Engelhardt himself. The importance of offering an adequate semanticization of the concept of the person is apparent when it becomes clear that this represents the key to addressing problems arising from a bioethical point of view.

The main aim of this research will therefore be to understand (starting from an analysis of Engelhardt's thought, which provides much food for thought to this end) whether there is still room within contemporary debate for the use of the concept of the person which is capable of guaranteeing their protection in a well-founded manner, i.e. by leveraging capacity of reason to identify a non-arbitrary hierarchy of goods in a substantial way. This forms part of an overview of the fundamental features of the contemporary context, which is characterised by a crisis that affects each sector, cultural and otherwise, so undermining any possibility of achieving any degree of certainty.

With this observation as starting point, a crisis of reason ends up rendering any attempt to ground knowledge futile, in particular moral knowledge. The concept of postmodernism encapsulates those traits that characterise this situation. The comparison with the modern era and the elements that have marked it, such as the myth of progress, the centrality of freedom and conscience, and man's domination over nature and trust in reason, help us understand the path that has aggravated these traits, showing them today in a distorted manner, emptied of those positive elements that allowed man to conduct a meaningful discourse on reality. Therefore, we provide a precise analysis of Engelhardt's reading of this path, which (using his terminology) led first to the crisis of the Enlightenment project and subsequently to proposing its minimalist morality. It will be interesting to understand whether this outcome is inevitable or can still acknowledge man's rational faculty to trace substantial morality.

The second part is entirely devoted to the concept of “the person” to ascertain how this is to be understood and consider exactly what the human person is, i.e. what can be identified as an adequate definition and therefore who can rightfully be defined as a “person”. We will therefore briefly address the history of this concept and subsequently observe how Engelhardt uses it: it is clear from the outset how he reduces this to a synonym for 'healthy adult'. Engelhardt makes the distinction between human beings and human persons his own, believing that the two terms do not have the same semantic extension. Thus he rightfully claims his place among those authors who in the field of bioethics recognise the rights only of those who are capable of exercising their self-awareness, rationality and freedom in an autonomous manner. In the light of the semanticization of the concept of person, we will then address the bioethical issues Engelhardt deals with, in particular those based on a single denominator: permission, which those involved can grant or refuse. Hence, the centrality of the concept of person for bioethical debate and the importance of its correct semanticization emerges, since the granting of rights (or not) and the extension of protection depend on it.

This view is characterised by specific keywords: charity, permission, property, moral friends and strangers, community and society. Therefore, the objective of is that of understanding the sustainability of the morality proposed by Engelhardt and the image of the person that derives from it. Through a critical analysis of Engelhardt's thought, therefore, this paper intends to address some of the central themes of contemporary bioethical debate on the premise that before delving into specific problems, it is first necessary to establish whether it is still possible for human reason to be intentionally opened up to reality in order to grasp its profound meaning and thus both demonstrate a substantial morality as well as establish what protection should be adopted for the human person.

Chapter 1

1.1 SOCIETY AND MORALITY

In addressing the impasse faced by humans in contemporary society, characterised by an undeniable pluralism of ideas and lifestyles, Engelhardt1 approaches the relationship between society and morality as a valuable point of comparison through which to address issues central to current bioethical debate. Since a philosophical thesis can be discussed either by taking into consideration its premises and examining their consistency or by verifying their internal coherence from a methodological point of view, in this overview an argumentative strategy interweaves both of these approaches. For example, Engelhardt's point of departure is similar to that of Jonas. However, in his principle of responsibility, Jonas proposes a morality that is anything but minimal since, by tracing the duty to be in being, he reopens metaphysical or, at least, ontological discourse. The effort Engelhardt makes in probing the possibilities of moral discourse stems from his awareness of the fact that it is the very process of post-modernity2 that has led to the weakening (if not yet the cancellation) of the need to trace criteria so as to guide the overwhelming power that technology places in the hands of humanity. Indeed, while humanity is experiencing an unprecedented expansion of its powers, its certainties at the level of duties and limits (if any) of human action are rapidly disappearing. Different communities have experienced a sense of vertigo over an unprecedented range of possibilities and the difficulties of attempting to trace a common language within a fragmented society. Attempts to provide a solution to this vertigo address the question: how can we sustain public morality amid post-modernity? The belief that it is possible to sustain a single substantive morality that can be accepted as valid by all is increasingly losing ground.

Nevertheless, it is worthwhile providing an understanding of how post-modernity is portrayed. According to Engelhardt the term post-modernity is both a sociological and epistemological condition: the loss of a universal narrative whose terms interpret human experience and at the same time the loss of an ability to justify or clarify the content of that narrative in generally secular terms. There are, in fact, a number of ethical visions in the current era that seem to re-propose the myth of Babel and its disruptive consequences for the human family. For Engelhardt this condition is a result of the failure of the so-called Enlightenment project, i.e. an attempt to establish in secular terms a substantial canonical morality which can be justified to people in general. The failure of this project is one outcome of the long journey represented by the entire history of Western thought3, a reconstruction of which Engelhardt provides on several occasions in his writings. The idea that humans can understand reality (both their own and that of the world) through reason has ancient roots: philosophy itself can be seen as stemming from a love of wisdom that is certain to enhance the object of its desire. The idea of a canonical viewpoint transcending cultures and open to all was already present among the pre-Socratics.

As is already well-known, at the dawn of philosophy the first thinkers4 went in search of a principle that would allow for a single understanding of all reality that in their eyes presented itself as a clearly ordered phenomenon. This conviction later deepened and was to find its highest point in the ancient world thanks to Plato and Aristotle and later with the Stoics, who further developed the aim of articulating a rational vision of being and morality. However, the decisive point in the history of Western thought was, according to Engelhardt, the advent of Christianity, or rather the cultural hegemony that Roman Catholicism played for centuries5. It took up the legacy of Greek thought and thanks to a marriage of faith and reason strengthened trust in reason by anchoring it to a solid foundation: the ultimate reference to a God creator who gave order to reality, making it intelligible to man. As a metaphysical explanation, the Judeo-Christian view offered a single foundation for the existence of reality, the origins and justification of morality, and the motivation for choosing to be moral. Western Christianity6 implied, in particular, the presumption that morality could be known and mainly understood by reason alone, without the support of faith. Faith and reason were thus closely intertwined for a long time and formed the strong premise from which philosophy developed, up to the threshold of the modern era. Before analysing Engelhardt's reconstruction7, however, it should be pointed out that although it includes abundant elements of truth, it also contains one major limitation: that of presenting the history of thought from such a long and complex period as that of the West in a monolithic and schematic manner.

Christianity and, therefore, the influence it had on philosophy. Indeed, Engelhardt speaks of the Judeo-Christian vision as if it were a whole: this is true since Christianity receives the Judeo-Christian tradition in the light of the Incarnation, but in truth, the ways that have produced a more extraordinary echo in philosophy are Judeo-Christian8. This suggests to us that Engelhardt should perhaps have distinguished between what explicitly belongs to faith and is mistakenly assumed as such in a philosophical perspective and what, on the other hand, is suggested, so to speak, by faith to philosophical reflection but in reality has a rational character and content. One should not underestimate that faith has imposed problems and perspectives on the philosophy that it would otherwise never have tackled, thus providing a fruitful stimulus for philosophy itself. This is probably how it was with the doctrine of creation: at a certain point in history, it did nothing but promote in a new light the deepening of the thesis which, moreover, gives ground to everyday experience, according to which it is possible to trace the order and a goal in nature, a thesis already developed in detail by Aristotle, among others, even if he considered the world eternal, and present in an embryonic way in the Platonic theory of the Demiurge. Engelhardt's analysis is premised on the conviction that something new is happening in modernity: He believes that Christian faith has gradually lost ground, literally collapsed, since the 16th century and that the West has nevertheless entered modernity with robust expectations of reason. The synthesis elaborated by Christianity entered a crisis and broke down due to particular historical and cultural events. First, the Protestant Reformation, i.e., when Martin Luther slammed his Ninety-Five Theses on the door of the Church of All Saints in Wittenberg in 1517, marking the beginning of a new era in the West and the collapse of hopes for a possible uniformity of religious and moral views. What happened was the point of no return, unhinging the monolithic approach that Christianity had given to Western culture.

From then on, it was no longer possible to hope for life in a society that could aspire to a unified moral code dictated by a supreme moral authority. The so-called religious wars that made the following century bloody are a real confirmation that the horizon was no longer unified, or at least that it could no longer find a synthesis on God. From the methodological point of view, there is a gap here: The author claims that the historical reconstructions he proposes in a way that corresponds to the most recognised historiographical reconstructions function as arguments and, as a method, almost fall into this type of philosophy of history. He moves inappropriately from descriptive statements to evaluative statements, violating Hume's law9 that prevents the transition from facts to values. He proposes historical facts as evidence for his theses, which are not historiographical but theoretical. Sixteenth-century Christianity was internally divided into different denominations, a fact that does not detract from the hope of living in a society that could aspire to a unified moral vision. On this point, it seems contradictory to claim that Christianity, in its Roman Catholic version, lost its cultural hegemony from the 16th century onward and argue that it is futile to understand what is good and what is evil objectively. On closer examination, Grotius's oft-quoted claim that one should argue Etsi Deus non daretur, i.e., even if God did not exist, is based, on the one hand, on the difficulty of invoking God to settle moral controversies, but, on the other hand, precisely on the firm conviction that it was possible to argue truthfully in any case, despite the absence of this assumption. Therefore, it is a logical leap to blame the loss of a common faith for the dissolution of a fertile ground on which the search for the truth could continue. The publication of Copernicus' De revolutionibus orbium coelestium10 is another striking moment on this path, which gradually undermined the certainties guaranteed by the Christian faith. As is well known, Copernicus introduced the heliocentric theory, which after centuries undermined the geocentric theory of Ptolemy, which saw the Earth and man at the centre of the universe, a theory consistent with the biblical account of creation. The Copernican Revolution was one of many changes in ideas that took away our sense of an absolute or final perspective: Man was no longer the centre of the universe. Undoubtedly, this revolution caused no slight confusion in the consciences and a violent reaction from the Church hierarchy. However, it cannot yet be said that this really undermined the Church's conception of man and his value, which was certainly not based on geographical or astronomical considerations11, but on anthropology that was indeed rooted in the creation account, even if not taken literally from the Bible and in the event of the Incarnation. For Engelhardt, another disorientation occurred in 1859 with the publication of Darwin's The Origin of Species. After that, the human species no longer seemed to enjoy any privilege in the evolution of life, contradicting the biblical assertion of the value of a man created in the image and likeness of God and opposing this view with the authority and force of a scientific theory, evolution, which would show that man was instead the result of chance. In the Darwinian view, man does not embody an eternal image but is part of universal becoming, especially biological becoming. His existence is ultimately the unintended product of neutral forces whose continuing interaction with circumstances leads to evolution but is not directed toward any particular end. Here lie the roots of those theories, which today hope that man will finally take the reins of his evolution into his own hands, as technology makes such a scenario possible12. Charles Darwin was clear that he was more than a scientific theory: a long series of reflections undermined the providential worldview in its foundations and included man definitively in the laws of nature. Just as after the Copernican Revolution, it was claimed that an astronomical discourse was downgrading the value of a man, so too about Darwin's discoveries on the evolution of species; there is a tendency to downgrade the concept of human dignity by considerations based on scientific data which, as such, can say nothing about it. Once again, there is a danger of violating Hume's Law by pretending to move from the modern scientific theory of evolution to evolutionism, which is also explicitly called philosophical Darwinism. The former is the theory founded by Darwin and then confirmed by the discoveries of genetics and is among the most scientifically accepted to explain how the different species have evolved from a biological point of view, and among them, therefore, the human one. However, when we speak of evolutionism13, we mean a philosophical theory that, as such, goes one step further than what scientific theory can tell us. However, when such a theory claims to reach conclusions that are not scientific but purely metaphysical, if not theological, it becomes something more than a scientific theory. Evolutionism represents a further and essential step in the dissolution of the finalists' ideas about the cosmos and nature, which discredit the idea that man is a unique creature that came into being by deliberate design. That the theory of evolution can disprove the finalists' conception of reality, however, raises many doubts if one only thinks that every becoming entity, which is all entities of which we have experience, has within itself what it is supposed to be. The predictive capacity available to all experimental science confirms this. Thus, the analysis of the binomial society and morality continues with the confirmation of one of his central theses: 'While the synthesis of the Christian West was losing ground, the Enlightenment and the progressive hope that reason (through philosophy or, more generally, rational reflection) could shed light on the nature of the morally good life and the general criteria of moral rectitude outside a particular moral narrative were gaining ground.' In other words, he believed that the certainties in the moral realm supported by religion could be taken over by philosophy and outlined in a different language that would not appeal to revelation but could be accepted and shared by all. After faith in belief disappeared, faith in reason remained, becoming one of the main factors of secularisation.14 According to Engelhardt, the culmination of this attempt is represented by Kant, who affirmed traditional Christian morality without any reference to Christ and assumed that it was based on reason. Kant continued the project developed in the mid-thirteenth century, representing the last great scholastic. To call Kant 'scholastic' borders on an oxymoron, for Kant's morality is notoriously deontological, that is, at its centre is the primacy of duty rather than that of final value, as is the case, on the other hand, with scholastic morality, which is precisely teleological.

However, Kant is comparable to Thomas in that he represents a continuum between the moral doctrine of scholasticism, which derives the ends of the law from man's natural inclinations, and the former's attempt to base morality absolutely on reason, whose imperatives apply to all men as rational beings. Kant proposes a sound philosophical system that, by examining and delimiting the limits of reason, which has no access to the noumenon, i.e., the thing-in-itself, makes unobjectionable what reason is entitled to say15. To Kant, we owe the most succinct formulation of the respect due to the human person, represented by the categorical imperative, which commands that we act in such a way that man, both in his person and in the person of everyone else, is always treated simultaneously as an end and never merely as a means.

From Kant’s perspective, ethics and morality are central to determining the actions and decisions of individuals within society. In his work 'Groundwork of the Metaphysics of Morals', Kant emphasizes the importance of acting ethically, respecting the dignity and intrinsic value of every individual. His famous aphorism, "Act only according to that maxim whereby you can at the same time will that it should become a universal law,"16 underscores the need to consider others not just as means to achieve our own goals, but as beings endowed with value and dignity regardless of their roles in our lives17.

Continuing on the concept of personhood and the possibility of a foundation for ethical-bioethical values, one can observe how the recognition of intrinsic dignity and the value of every individual can serve as a solid base for the development of universal ethical principles. This approach allows for transcending cultural, religious, and ideological divisions, proposing an inclusive and respectful vision of human diversity.

The centrality of the person, understood as an entity endowed with reason, will, emotions, and dignity, enables the identification of rights and duties that transcend the particularities of the social and cultural context. These rights and duties arise directly from human nature, regardless of any other consideration18.

If one aims to analyze ethics without relying on the necessity of a divine being, affirming the centrality of the concept of person as a shared foundation for ethical and bioethical values, it is possible to construct a robust and meaningful ethical system, recognizing and respecting the dignity and intrinsic value of every individual, without depending on theistic assumptions19. This not only strengthens the argument in favor of a principled approach to ethical dilemmas but also provides a secular and accessible perspective that resonates with Kantian imperative to always treat humanity as an end in itself.

However, Kant is comparable to Thomas in that he represents a continuum between the moral doctrine of scholasticism, which derives the ends of the law from man's natural inclinations, and his attempt to base morality absolutely on reason, whose imperatives apply to all men as rational beings. In this way, the concept of personhood becomes an indispensable point of reference for bioethics and ethics in general, capable of providing objective criteria for the evaluation of actions and choices.

Kant proposes a sound philosophical system that, by examining and delimiting the limits of reason, which has no access to the noumenon, i.e., the thing-in-itself, makes unobjectionable what reason is entitled to say. To Kant, we owe the most succinct formulation of the respect due to the human person, represented by the categorical imperative, which commands that we act in such a way that man, both in his person and in the person of everyone else, is always treated simultaneously as an end and never merely as a means.

From the perspective of secular bioethics, the foundation of ethical-bioethical values is not sought in religious doctrines or metaphysical assumptions, but rather in the shared experience of humanity, in the rational and critical analysis of ethical issues, and in open and inclusive dialogue between different viewpoints. This approach values the autonomy of the person, while also promoting individual and collective responsibility towards ethical issues related to life, health, and the environment.

As a moral subject, the person is called to exercise their freedom responsibly, taking into account the consequences of their actions on others and on the environment. In this sense, secular bioethics proposes an ethics of responsibility, which requires considering the long-term implications of ethical choices and acting in a manner that promotes the common good and respects every individual.

The emphasis placed on the dignity and intrinsic value of the person allows for the development of universal ethical principles, such as respect for autonomy, justice, beneficence, and non-maleficence, which can guide ethical decisions in a variety of contexts, from clinical practice to biomedical research, from health policies to environmental issues.

Indeed the Kantian perspective enhances the discourse on personhood and provides valuable insights into the respect and dignity that should be accorded to every individual, it also reveals the limitations of reason and the challenges faced when attempting to establish a universal morality without the postulation of God. The concept of personhood, understood in its fullness and complexity, offers a solid and shareable foundation for ethical-bioethical values, promoting a vision of bioethics as an open, inclusive discipline rooted in the daily reality of human experience. This approach not only contributes to addressing the ethical challenges posed by medicine and biotechnology but also promotes a way of living that recognizes and respects the dignity and value of every individual, whether through the lenses of secular bioethics or the philosophical depth provided by Kant's insights.

This ontological view of the essence of humanity implies that every person has intrinsic value and that our actions and decisions should reflect this recognition. In this context, social and ethical responsibility becomes a crucial component of living in society, requiring active engagement in treating others with respect and dignity, acknowledging their intrinsic value.

Neverthless, even this titanic effort is futile, for philosophical reflection cannot substitute for the perspective of the divine eye, which can give morality a canonical unity. The inability of reason to reason decisively in the realm of morality necessitates the perspective of God's eye -a perspective that is by definition inaccessible to man and of which he can, at best, discern signs in nature. Without this perspective, ensuring the proper primacy of morality over prudence becomes challenging.

It becomes difficult to answer the question, 'Why should one act morally if acting immorally would be of great benefit to oneself and to those with whom one is closely associated while acting morally would be of great harm to oneself and that one loves?' For Engelhardt, the point is that once the necessary connection (guaranteed by God) between acting morally right and achieving happiness is removed, the motivation for moral action no longer exists. Indeed, there is a difference between invoking God to establish reason's ability to identify excellent and evil and instead identifying the motivations that lead the acting subject to follow what reason identifies as good. In the first case, it is a matter of deriving moral philosophy from metaphysics; in the second case, on the other hand, it is a matter of positing God as the guarantor of the attainment of happiness by the subject who obeys his commandments. Despite his attempt to make the argument from reason rigorous in its pure and practical applications, Kant had to refer to God and the immortality of the soul to justify the primacy of morality over prudence. Indeed, Kant asserts that: "God and the future life are two presuppositions which, according to the principles of pure reason, are inseparable from the obligation which reason itself imposes on us20." Therefore, Kant introduces God as a postulate in his system for three reasons: First, to guarantee to proceed as if reality were always intelligible, coherent, and unified in its particulars. Second, as a necessary condition for morality, we must affirm the existence of God in order to act coherently, believing that morality must always overcome the concerns of prudence. Third, he also invokes God in a way that allows him to treat morality as unitary (i.e., to reject the possibility of moral pluralism). Thus, since Kant believes that it is impossible to obtain theoretical knowledge about the existence or nonexistence of God, he postulates his existence as a postulate. Kant thus represents the supreme moment of the attempt to establish a universal morality valid for all human beings, an attempt which, however, falters in the face of the inability of reason to accomplish this goal alone, so recourse must be had to a God who is the guarantor of the order of the world and the attainment of happiness. Such a God, presented as absolutely transcendent, becomes that 'other' whose existence can no longer be preached. For the Thomist21 tradition, the reference to God is ultimately necessary for the justification of moral philosophy. Nevertheless, even without this reference, it is possible to reach intermediate stages of justification by finding clues in man's natural inclinations based on the experience of daily life, which make it possible to distinguish what best contributes to the realisation of human goods from what deviates from this goal. Based on such considerations, Hegel marks the end of modernity and the beginning of postmodernity in the line of interpretation proposed by Engelhardt. This transition from modernity to postmodernity can be traced to feeling, of which he is the spokesman, anticipating Nietzsche. A sentiment on which the religion of modern times is based: “God himself is dead22”. Kant failed to revive the positive form of religion by ascribing to it a meaning derived from his philosophy. Hegel concludes precisely because he considers Kant's attempt a failure23. Hegel thus represents the final abandonment of a certain way that Western thought has cultivated for centuries, namely, to give credence to reason.