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

The SHHV’s original statement of purpose suggested the goals of the new bioethics movement: “This Society sees its task as identifying these [bioethical] problems, in forming groups that will develop methods to clarify and assist in solving them, and in developing change in both professional attitudes and public awareness in relation to them” (Fox, 1985, p. 338). But what impact has bioethics made over the last 3 decades? A 1997 Nature article describes the growth and current prominence of bioethics, but asks “whether U.S. bioethicists have substantially shaped either the culture of science or the political decisions of recent years” (Wadman, 1997, p. 658). Bioethicist Arthur Caplan admitted, “Bioethics has a lot of authority but no real power” (Wadman, 1997, p. 658).

In this book, I examine the ways in which the legitimacy and intellectual content and organization of academic bioethics are coproduced in the United States (Jasanoff, 1996). To succeed as an academic enterprise, bioethics needs to legitimate its moral authority within the institutional structures of biomedicine and the state, and to develop the intellectual tools and content to grapple with the ethical aspects of biomedicine and biotechnology. The potency of bioethics is particularly critical today, in an era featuring a completed Human Genome Project, a thriving biotechnology industry, and daily reports of new biomedical discoveries—and new biomedical quandaries, as well as increasingly frequent litigation against clinical investigators and universities. It is hoped that this research will provide useful insight to the bioethics enterprise as it works to balance its need for institutional legitimacy with its commitment to make the biomedical enterprise accountable to all of society.

The central question of this book is the following: How are the legitimacy and logic of bioethics jointly constructed? By logic, I mean the epistemic content, approach, and social structure of the field of bioethics (its knowledge content, and the organization of the field in terms of its interdisciplinary professional work, self-described identity, and its relationships to the constituencies it purports to advise); the logic of the field is the system of expertise it provides, and the basis for that expertise.