The Logic and Legitimacy of American Bioethics By Mary R. Leinho ...

In Evans’ view, the President’s Commission’s deliberations on human genetic engineering exhibited a Weberian rationalization, in which the logic of the deliberations became more systematized and less substantive (Evans, 1998). This rationalization was accompanied not only by procurement of state resources by bioethicists for reproducing the rationalized ethical system, but also by the development of a jurisdictional alliance between scientists and bioethicists, both of which advanced the interests of institutionalized biomedicine. Kelly (1994) found that the deliberations of federal ethics bodies have become less representative and more technocratic as biomedicine and bioethics engaged in an ongoing power struggle over resource allocation, with the consequences of discrediting opposing viewpoints, legitimizing the biomedical establishment, and deterring institutional change. Given “the problematic role of formal bioethical evaluation in affecting the technological imperative driving medical innovation” found by both these scholars, Kelly called for “further examination of the boundaries of medical science and bioethics” (p. 315).

Bioethics has been roundly criticized for neglecting to grasp its own social context, raising questions about the field’s ability to foster more socially responsible biomedicine. Sociological scrutiny of bioethics will aid bioethicists in reflecting on their own work and its implications, and will also advance our understanding of science and technology by revealing, in more detail, the relationships among ethics, science, technology, and society. Kelly (1994) argued that bioethics has provided a moral imperative for the technological imperative of biomedicine, calling for further study of the ethical work that is done in the legitimation of science and technology more broadly.

In this book I seek to (1) enhance the findings and analysis provided by prior sociological studies of bioethics and (2) examine how bioethics balances the need for institutional legitimacy with the commitment to make the biomedical enterprise ethically accountable. What follows is an account of the coproduction of legitimacy and knowledge content in recent academic bioethics, which examines the jurisdictional contests waged by bioethicists to sustain their academic departments, establish their expertise in the judicial forum, and guide the activities and recom-mendations of a recent national advisory body.