10.5294/pebi.2018.22.2.2
Artículo de reflexión

Reinventing Bioethics in a Post-humanist and Post-truth Society.
The Present and Future of Bioethics

Reinventar la bioética en una sociedad posthumanista y de posverdad.
El presente y futuro de la bioética

Reinventar a bioética em uma sociedade pós-humanista e pós-verdade.
O presente e o futuro da bioética

Luz María Pichardo

¹ orcid.org/0000-0002-5792-5181. Universidad Panamericana, México.
lpichard@up.edu.mx

Received: 2017-11-28
Sent to peer reviewers: 2018-01-29
Accepted by peers: 2018-06-18
Approved submission: 2018-06-18

To reference this article / Para citar este artículo / Para citar este artigo : Pichardo LM. Reinventing bioethics in a post-humanist and post-truth society. The present and future of bioethics. pers. bioét. 2018; 22(2): 212-222. DOI: 10.5294/pebi.2018.22.2.2.

Bioethics is about to celebrate its fiftieth anniversary. Is there any data to prove this new discipline is going through a rough patch in the midst of a society that seems to run away quickly from any human and veracity coordinates? As Dawson pointed out in 2010: "Bioethics has no future: at least not in its present form…we need to face up to the fact that, as a discipline, it is has become stale and tedious. It is time to ask some fundamental questions about what bioethics is and where it is going" ⁽¹⁾. Nothing could be closer to reality than this appreciation. For several decades, different authors in many countries around the world have raised these concerns ^(2-5) and put forth proposals. The multiplicity of opinions and the confusion between concepts and principles that are used in bioethical discourse and exist in numerous publications, congresses, symposiums and conferences are a reflection of what is going on in society. Unfortunately, it is not the enrichment of a pluralistic view. These dissimilarities reflect countless misrepresented academic perspectives, some of which belong to a post-truth or a post-humanistic era ⁽⁶⁾ in which the principal value may be rather unlike and a long ways from fact or reality and closer to a model presented by advanced science - biotechnology on the one hand - and economic interests managed by multinational companies or political entities, on the other. Concepts such as dignity, quality of life, respect for life, vulnerability, human identity, economic utility, human rights, radical autonomy, progress in techno-science and survival of the fittest, to name just a few bioethical concerns, are at stake. When it comes to decision-making on the so-called bioethical dilemmas in health sciences, the fact is that political and economic interests more often come before the real needs of the population. Therefore, it is urgent that bioethics find a new way of profound analysis and expression to overcome the consequences of a post-humanistic and post-truth society. As Dawson says, it ought to return to its original and broader concerns ⁽¹⁾ and interests on behalf of true values.

Proposals to straighten out bioethics in terms of the "concerns and reservations made in the face of science" did not come from a biased fraction of thinkers. They "do not proceed, contrary to what one might think, from believers or moralists of old stamp, but from a number of observers, intellectuals, jurists, physicians and psychoanalysts who practice agnosticism or militant atheism and who also have relativized, if not condemned, some of the supposed progress of science or medicine, not in the name of any religion, of course, but in the name of humanism. They include Bernard Edelamn, Monette Vacquin, Jacques Testar and Dominique Méel, to name but a few"⁽⁷⁾. Is it that the worries of these academics concerning proposals in biotechnology and science actually and in some way menace the core of human identity? On a broader scale, we are talking about the very foundation of human society. As Jonas accurately points out, "the apocalyptic potential of the technique and its ability to jeopardize the survival of the human species, to spoil its genetic integrity, modify it arbitrarily or even destroy the conditions of its higher life on earth raise a metaphysical question that ethics has never been confronted with before. Should there be humanity and why? Is there any reason why the human being is to be preserved as evolution has done so? Why must genetic inheritance be respected? Why is it that life must exist as it actually does?" ⁽⁸⁾.

Innovating as a main task

It is a constant that researchers work quite hard to promote the making of new innovative ideas and theories in biotechnology, medicine, neuroscience, pharmacology and genomic engineering, while lacking thoughts on their implications for human life and how they can affect moral values. It even gives one the impression that researchers only see one part of the full picture and do not want to see the other.

It is an obvious fact that humans "share the same hereditary patrimony of species and the same brain unit, as a remarkable distinctive feature, as well as the aptitude to speak a language of double articulation. In short, as Morin ⁽⁹⁾ concludes, all humans have in common the traits that make for the humanity of humanity: an individuality and intelligence of a new kind, a cerebral quality that allows for the appearance of the mind, which permits the appearance of consciousness" ⁽¹⁰⁾. There is a threat that is beginning to grow in biotechnological and experimental science of which we must be aware. Urgent reflection is required concerning the possible dangers and side effects of what post-humanist science is trying to achieve. Here is where bioethics has its part. Specifically, "both cybernetics and biotechnologies are basic to post-humanist thinking because their discoveries have allowed philosophers and scientists to imagine a world built beyond humanistic postulates, with beings that transcend the biological limits that are proper to our ordinary human nature. They radically affirm the end of the human being as it has been known up to now, to propose a being that directs its own genetic evolution" ⁽¹⁰⁾. Is bioethics capable of a serious and profound understanding of the limits of these postulates?

It is a one hundred and eighty degree turn to say "the discoveries and applications of cybernetics allowed stripping the "human identity" (individualized in that rational and autonomous subject) of singularity and exclusivity, within a world whose center became the flow of information, the theory of systems and not the subject" ⁽¹⁾. These are thrilling conclusions, indeed. These researchers are a long ways from having clear trains of thought as far as bioethical principles go for centuries. They do not have a sense of reality in terms of the person being the central focus of bioethics; rather, they place bio-techno-science at the center of every form of progress. One cannot allow their judgement and principles to be concealed when the core essence of human life is at stake!

Researchers’ priorities

Actual trends in scientific research relate to being published in journals with a major impact, unfortunately sometimes without a thorough ethical and humanistic framework. Most of these papers are not in accord with scientific, medical, psychological or social health priorities. They give more weight to technological advances and the innovations mention before, motivated by advantages and economic profit. Autonomy affords a principal reference to make decisions on bioethical dilemmas over many other equal or more important principles. These tendencies fail to bring to light the real needs of human populations, global ecology and other forms of main interests in life, which must be at the heart of research objectives, with a direct focus on what is genuinely good for the greater part of the population and in terms of world needs. The lack of strong philosophical references to back up their scientific claims must be remedied by returning to the primary goals of bioethics, which was born to reunite the experimental and human sciences. Is it true that this is no longer happening? Publications, courses, degrees and events on bioethics abound, but are they still in accord with their original aims?

Foremost contributions in bioethics

Undoubtedly, bioethics has made relevant contributions to life and to the philosophical sciences. The following are but a few of them.

a. The first contribution made by the founding father of bioethics, Van Rensselaer Potter, was to point out the need to draw a bridge between these two worlds: "the world of ethical values and the world of biological facts"⁽¹¹⁾.

b. Another contribution is the endorsement of an interdisciplinary approach to decision-making, one that involves philosophy, law, medicine, biology, informatics and economics, among other sciences. Combining these disciplines to work together in the realm of today’s complex thinking and in the increasingly accelerated world of scientific and biotechnological development is the main goal.

c. Bioethics also has favored overcoming radical paternalism, to give way to the patient’s legitimate voice. Through the exercise of informed autonomy, the patient now can be a protagonist in decisions about his or her health, or that of their loved ones.

d. There also has been the development of hospital committees on bioethics and research ethics, which provide key ethical guidelines on a range of issues, from how to deliberate and study bioethical problems to clinical practice and the development of research. These guidelines help to ensure respect for the dignity of those who participate in the protocols.

We must appreciate the appearance of this new science. Nevertheless, should we be worrying about its identity, and what the future holds for bioethics? Is it true that bioethics in many countries is an instrument in the hands of technicians who are willing to justify their findings?

Neutrality and worthless arguments

Numerous forums, commissions and committees in recent years have sought out neutrality as being essential when reflecting on bioethical problems in order to come to acceptable conclusions. In DOIng so, they have tried to avoid the bias of popular beliefs – be they cultural, religious or ideological differences, etc. – that jeopardize the objectivity of what is being discussed.

This false idea is nonsense, given the enormous danger posed by the lack of solid fundamentals to support the arguments. Consider the fact that a solid foundation or firm basement is necessary when constructing a high building. Not having a solid humanistic and ethical foundation and putting aside reliable resources that sustain the object of a study –in order to keep peace in the discussion– is absurd and not logical, especially in the fields of ethics, anthropology and philosophy, if one is to be able to achieve a good level of thinking and to delve deeper and arrive at solid considerations. Previous publications, well-known resources, earlier information from decades and centuries of thinking, and confronting ideas with practical experience make for what we accurately refer to as the state of the art. These elements imply a sound academic posture and represent a delicate and essential question in any serious discussion, if one is to argue successfully with appropriate premises. "Writers seem reluctant to ask fundamental questions about the topics they choose to address, the methods they use or the theoretical positions they advocate. This is where the dogmas lie, and why medical ethics (and, in turn, bioethics) can be thought of as currently little more than an ideology" ⁽¹⁾.

When historical references cease to exist, especially when it comes to ethics, the mistakes of the past and the best and worst ideas end up being devoid of meaning. Bioethics cannot begin from nowhere. It must take into account pre-established limits. It always responds to a certain worldview, which implies a solid base. Plural debates must be founded on honest and realistic opinions with reliable resources to back up their arguments on a specific subject and to ensure a more balanced discussion. In these kinds of debates, one must be open to other points of view and portray a consequent attitude of humility, honesty and respect. One should be able to recognize when one’s views are wrong and those of others are right. "In addition to the explicit or implicit beliefs of the interlocutors in a discussion, there is also a particular logic, a grammar of thought that operates as an assumption" ⁽¹²⁾. If bioethics aims to overcome the rising crisis it is facing, it must consider "there are, in turn, moral attitudes that do not arise from dialogue but make it possible: listening ability, respect for the opponent, willingness to value their arguments and embrace the alternative proposal if it’s validity, etc. becomes evident in the development of dialogue. In every dialogue, there are elements that cannot be discussed. If everything were debatable, nothing would be in the end" ⁽¹²⁾. This is how bioethical analysis will find a trustworthy path to keep the reference is supposed to give.

Unfortunately, theoretical or academic bioethics is sometimes biased and disconnected from clinical and scientific practice. "Bioethics has long since become a self-referential discourse, precisely because it has blurred the reference to limits, to the point of the ethical substance of the argument being seriously compromised. And, according to Robert Spaemann, the notion of limits (grenzen) is decisive in ethics" ⁽¹³⁾.

The reconfiguration of human nature?

Many post-humanist scientists in several countries around the world are offering up the idea of a new step in the evolutionary chain for human beings. It is the core of "post humanism, as an intellectual movement, which aims to surpass current humanism by using advanced scientific research and technologies ⁽¹⁴⁾". Fiction is nothing when compared to what these researchers aim to achieve. On the contrary, bioethics has not been called on to provide an opinion, nor a philosophy.

For instance, Nick Bostrom speaks of the "aim mainly to improve the performance of the brain, to control procreation, to control behavior, to slow down aging and to achieve immortality. Neurosciences, genetics, cybernetics, computer technology, biotechnology, cognitive sciences and nanotechnology represent the main means of achieving these ends" ⁽¹⁵⁾. Yet, philosophy, anthropology and humanistic sciences are beyond these outrageous challenges. Research in these fields has been ongoing since the end of the twentieth century. Nevertheless, the first successful results have yet to materialize. In the short term, there are no trustworthy guaranties to achieve them without compromising essential parts of the nature of things.

A new human identity?

The post-humanists propose a big step in the evolutionary chain; namely, the "notion of a biological, autonomous, rational and essentialist subject as representative of human identity will undergo important changes in its conception, based on the discoveries with respect to: (a) cybernetics and (b) biotechnologies. Both cybernetics and biotechnologies are basic to post-humanist thinking, because their discoveries have allowed philosophers and scientists to imagine a world built beyond humanistic postulates, with beings that transcend the biological limits that are proper to our human nature. It is they who want to radically affirm the end of the human, as it has been known up to now, to propose a being that directs its own genetic evolution" ⁽¹²⁾. All of a sudden, what appears on the post-humanist horizon is definitively a quasi-machine built on what is left of the human being. In other words, "humans were to be seen primarily as information processing entities that are essentially similar to intelligent machines" ⁽¹⁵⁾.

Movable limits or no limits at all?

Consequently, for many researchers and bioethicists, science has no fixed limits and, therefore, is amoral. As some technologists put it, their boundaries are "movable". Ali Brivanlou, a developmental biologist at Rockefeller University, asked in the Hastings Center Newsletter in June 2017: Is it time to move the moral line in research in the human embryo? He affirms that the line moved when it was accepted, in many countries, that the embryo is not considered a human being until the fourteenth "day of life", as opposed to when fertilization takes place and during the first two weeks of gestation. The author’s approach is scientifically convenient when it comes to moving the line. This allows the manufacturing of artificial embryos to provide organs and tissue for regenerative medicine ⁽¹⁶⁾. This healing purpose is a noble goal. Improving humanity also seems to be worth trying. However, are the means justified? Here, the main question is: Are ethics movable or removable?

Erase rather than move

During the last few decades, the lines of morality have not only been "moved", they also have been erased from various fields of experimental science, leading to "a bioethics that has long lost its way," as Barrio-Maestre argues ⁽¹³⁾. A relativist form of bioethics is one that allows expressions and solutions to be multi-diverse and multicultural, depending on context, time, and circumstances, based exclusively on political, social and economic interests and utilitarian concerns linked to the dominant form of capitalism. As a result, bioethics has lost its way and is increasingly predictable, sterile and unquestioning. It has become little more than an ideology. It needs to embrace, once again, its true philosophical origins "⁽¹⁾. As Dawson so precisely says, bioethics "might be different if it focuses on public health ethics that can help step away from three dogmas: 1) autonomy as the greatest thing; ⁽²⁾ voluntary contractual obligations, and ⁽³⁾ law and regulation as central to ethics" ⁽¹⁾.

In the context of our pluralistic and globalized society, it is essential and urgent to "rediscover an ethical rationality that can be invoked to justify certain decisions desirous of respecting diversity within a common political framework. It should be a priority objective of contemporary (ethical) practice in philosophy, and if there is a field where this need is especially noticeable, it is in the field of bioethics" ⁽¹²⁾. The main challenge that bioethics now faces is to re-establish its up and down turnabout, through an ethical rationality in relation to the purposes of the life sciences in light of today’s post-modern aims and circumstances.

The challenge of rediscovering an ethical rationality for bioethics

The first step toward acquiring this ethical rationality implies understanding that human behavior has a universal basis. The main problem is that this has been neither convenient nor obvious to most contemporary thinkers and scientists in the last few centuries. They have taken a more materialist, sociological, constructivist, relativistic and pragmatic stance on the human condition as opposed to an objective view of facts.

As González sums it up, the main problem is the lack of reference to human nature. Without it, ethics is reduced to a series of private experiences disconnected from responsibilities that have to do with others and with society. Each individual attends to their own moral standards or values and uses them for their own particular good, without caring about the problems and well-being of others who surround them, as long as they respect their rights in a multi-moral context ⁽¹⁾. It is not in the interest of society, but rather in an individual interest, specifically that of those intellectuals and scientists who hold power. "For the Greeks, who thought it through more carefully, politeia is the rule of reason, a regime based on the word that is convincing and not misleading. A regime is political and not despotic when law replaces the right of the strongest by the force of law. In other words, it is when the law of the jungle yields to the force of reason and argument opens the way, thanks to a just logical articulation and a persuasive, convincing presentation that uses the word and not the whip" ⁽¹³⁾.

The position of current bioethical dialogue is far from recognizing this force of logic and word; namely, the necessary frame of rationale that lies in the very deep nature of things and their laws. Inasmuch as "there are certain actions that are unworthy, that can never be in line with the human or cosmic order, however much they become "normal" (with statistical, unethical normality)…a moral life is impossible without a certain moral reflection. You cannot act morally without rational deliberation ⁽¹²⁾". In the case of bioethics, it is a matter of extrapolating ordinary moral life in the field of health and life in an even broader sense. It is untenable to act in a bioethical way when bio-technological and genetic engineering achievements pretend to create a more evolved man, a robotic man. In this case, without a prior philosophical, ethical and anthropological understanding of the possible consequences, there certainly will be huge surprises that will not necessarily be for the good. If we do not rigorously rethink this subject in light of "ethical wisdom," as Potter notes, or from the standpoint of biological humanism, we will repeat the abuses the human being unfortunately experienced in the preceding century. "For bioethics to have a future, it ought to return to its original and broader concerns" ⁽¹⁾.

Reinventing bioethics

To put it unpretentiously and in a simple way, bioethics, as mentioned already, can be understood as ethics applied to life. According to the book by Potter ⁽¹¹⁾, who coined the term and outlined the axis of this new discipline, "there are two cultures –sciences and humanities– that seem unable to speak to each other. This is part of the reason why the future is uncertain. He proposes the idea of building a bridge between the two in the future, so as to create the discipline of bioethics. Ethical values cannot be separated from biological facts". Potter ⁽¹⁷⁾ believes humanity is in urgent need of a new wisdom that will provide "the knowledge of how to use knowledge." This is the core of bioethics, the most essential nucleus; namely, to know the limits of knowledge and how to apply it. A recent example is provided by Güell Pelayo, whose profound analysis indicates that "when current knowledge of genetic and epigenetic processes and evidence of the risks of assisted reproductive technologies are taken into account, we find sufficient reason to abstain from the use of current techniques of genetic manipulation and embryonic selection" ⁽¹⁸⁾.

"Some authors, after a thorough study, think it seems that embryo genetic manipulation, despite being effective in the treatment of diseases, has many challenges, especially in the field of bioethics. Some of these challenges are unavoidable now" ⁽¹⁹⁾.

Wisdom and bioethics

For some authors, wisdom "is the necessary consequence of following a practical point of view; that is, the point of view of the human agent who is living and acting" ⁽¹²⁾. It begins with the actions and experience of the one who acts. "In the biography of every human being, elements are articulated that intervene on their own initiative. This can occur in a planned manner, with unforeseen events and ones that often are expected. Each of them implies an important ethical load…what happens to me, because even though I have not planned it, asks me for an answer… It is a challenge that forces me to put into play the resources of my own moral identity" ⁽¹²⁾.

This refers to the need to recover a sense of responsibility, which the philosopher Hans Jonas prophetically alluded to in the late seventies, when he warned of the dangers of technological advancements and how they would affect society. He thought about the future of bioethics in various ways, one being as a new categorical imperative to technological advances, one that works " in such a way that the effects of your actions are compatible with the permanence of an authentic human life on earth, including in your present election, as an object also of your will, the future integrity of man"⁽²⁰⁾. This implies thinking, with scrutiny, about future generations and how the consequences of our actions in the world will affect them profoundly.

Reference to life and a culture of humanistic values

In conclusion, we have reflected briefly on how, in many instances, bioethics has broken away from reality and the laws given by none other than life itself, both in a practical and speculative sense. We cannot even begin to imagine the consequences these types of actions could bring and have caused already. In many cases, the indiscriminate application of biotechnologies has resulted in a moral vacuum where everything is possible; there are no limits to draw the line on unwanted consequences, nor is there any intrinsic human value. Something imperative to consider is what Fukuyama says in the sense that "the most significant threat posed by contemporary biotechnology is the possibility that it will alter human nature and thereby move us into a ‘post-human’ stage of history. This is important, I argue, because human nature exists, is a meaningful concept, and has provided a stable continuity to our experience as a species" ⁽²¹⁾.

It is not a matter of blocking science and progress; it is a matter of directing them accordingly towards authentic benefits, which are universal and respect variety in the context of each culture. Indeed, there exists a personal search for the moral habits that lead towards these benefits. They do not change in their essence, but rather their execution in each particular case seeks greater moral virtue and greater perfection of knowledge. Heidegger points out two ethical attitudes that oblige us to live in the world in a rather different way. They promise us a new solid ground and a solid base to keep on going and to live out our lives in a technical world, but safe from its threat. Heidegger characterized "gentleness as an ethical attitude that provides for respectful treatment, with attention to differences ... the mood of serenity towards things and openness to mystery: two attitudes that ... make it possible for us to reside in the world in a very different way. They offer us a new ground and foundation on which to maintain ourselves and subsist, while being in the technical world but sheltered from its threat. Serenity towards things and openness to mystery expose our perspective to a new rootedness ... they do not fall from the sky. They do not happen fortuitously. Both grow solely from incessant and vigorous thinking" ⁽²²⁾. This new grasp can come only through necessary metaphysical meditation on the position of man in a technological world ⁽¹²⁾.

"If people cannot see that their lives are interwoven with those of others in myriad ways and that this fact is morally relevant, and the only way to stimulate them to perform the right action is by force of law, then we live in an impoverished society: one where social relations are apparently stripped of much of their value… Dependency is not a weakness but a fact of human life. Much of what we value in our lives arises from what we share together as social creatures. This fact is morally relevant and ought to be the foundation for the way we see bioethics" ⁽¹⁾. Morality is a personal code of conduct that points to the goals of universal moral principles, which will never cease to be so and are inherent in life itself. A valuable lesson for the scientist and the technologist would be to consider that "it is for the good of the individual to learn to see the common good as his own" ⁽¹²⁾. Bioethics has universal ideals that need to be rediscovered and reinvented.

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