September 24, 2022

The Optimist: I have lived in a golden age, says US bioethicist

Arthur Caplan’s brisk summary of the history of bioethics in the latest issue of the Journal of Medical Ethics is decidedly upbeat.

Arthur Caplan’s canter through the history of bioethics in a special 40th anniversary issue of the Journal of Medical Ethics is decidedly upbeat. “Bioethics today is riding high in the saddle; shaping public health policy, exercising oversight of biomedical research, consulted by powerful organisations for ethical help and setting normative rules for the diagnosis and treatment of patients. It has spread worldwide, from a few small think tanks and medical school programmes located in the USA.”

How did this happen?

Caplan, who launched his career in the 70s and now teaches at New York University’s Langone Medical Center, is probably the most quoted bioethicist on the planet. He attributes the good fortune of his vision of bioethics to public engagement. Bioethicists provided answers to unsettling questions raised by novel technology at the exact time when the public needed them.

“It was a field whose timing was impeccable—new problems and challenges emerged one after another in rapid succession fuelled by technological advances creating a demand for somebody, anybody, to provide thoughtful input into their management. It was a field that, notably, attracted few, but among the thin ranks were many intellectual giants.”

Many reasons have been put forward to explain the glamour of bioethics, including the “intellectual bamboozlement” of the medical profession, the chaotic state of philosophy departments, and the abdication of moral authority by the medical establishment. But Caplan has a different explanation: bioethicists like himself were not afraid of the media. “Bioethics gained social legitimacy by not following the British analytical philosophy tradition into the ivory tower, but, rather, the Socratic tradition of engaging the public in the ‘marketplace’.”

He worked hard to engage journalists, by teaching at Columbia University’ journalism school and then by serving on the board of a journalism think tank, the Poynter Institute. He has always tried to teach the media that “bioethics [is] not simply an after-dinner mint but often the core subject of interest to those following stories about healthcare and the biomedical sciences”.

Later on he began to write a syndicated newspaper column. “By the time social media burst on to the scene in the mid-2000s, opening a new world of blogs and websites and somewhat diminishing the authority and impact of the mainstream media, bioethics’ responsibility to engage in public discourse was taken for granted and even extolled by national commissions and panels.”

Other academics were not always impressed and grizzled about celebrity bioethicists and oversimplification. But, for Caplan, the proof is in the pudding. “By using the media to move into the public arena, the field engaged the public imagination, provoked dialogue and debate, and contributed to policy changes that benefitted patients and healthcare providers.” Bioethics did well by doing good. 

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