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7 Med., Health Care & Phil. 1 (2004-2005)

handle is hein.journals/medhcph7 and id is 1 raw text is: Medicine, Health Care and Philosophy 7: 1-3, 2004. Editorial Empirical ethics: A challenge to bioethics In medicine the metaphor of an earthquake is often used to denote spectacular, earthshaking developments in the field of diagnosis, prognosis or treatment of diseases. Bioethics is often challenged by such evol- utions and forced to take on the role traditionally expected from bioethics, by either consenting to or rejecting such developments through a method of rational argumentation. At this moment, the discip- line of bioethics itself is confronted with a sudden shaking at its core and a questioning of its actual iden- tity and methodology. Bioethics began as a dialogue between people from many different disciplines (such as medicine, law, theology, biological sciences, social sciences, philosophy, humanities) about moral ques- tions in the field of medicine and biology. However, through a process of professionalisation and institu- tionalisation, bioethics crystallized into a discipline that became anchored in the fields of theology and philosophy. Despite the fact that other disciplines such as law, medicine, and biology latched onto the bioethical field, the goal of bioethics became primarily a philosophical inquiry (with the aim of logical reasoning, conceptual clarity, coherence, and rational justification) (Borry et al., 2005). This identity has come under pressure from empi- rical ethics. Empirical ethics is a broad category, grasping different interpretations of combining or trying to integrate ethics and empirical research. In spite of the interdisciplinary operating base of bio- ethics, in the past the field remained rather reluctant towards collaboration with social sciences. Most bio- ethicists depicted sociological studies as irrelevant to their discipline because they feared being too strongly influenced by historical and sociological contextualisation, which could bog them down in cultural and ethical relativism. Such a strong bifurc- ation between normative and empirical perspectives to bioethical issues was partly rooted in the fundamental metaethical distinction between is and ought. Although there are various ways of combining empi- rical research and ethical reflection (and of doing empirical ethics), they all have some basic assump- tions in common: firstly, empirical ethics states that the study of people's actual moral beliefs, intuitions, behaviour and reasoning yields information that is meaningful for ethics and should be the starting point of ethics; secondly, empirical ethics acknowledges that the methodology of the social sciences (with quantita- tive and qualitative methods such as case studies, surveys, experiments, interviews, and participatory observation) is a way (and probably the best way) to map this reality; thirdly, empirical ethics states that the crucial distinction between descriptive and prescriptive aspects should be more flexible. Empirical ethics denies the structural incompatibility of empirical and normative approaches, and believes in their funda- mental complementarity; fourthly, empirical ethics is a heuristic term which argues for an integration of empirical methodology or empirical research evidence in the process of ethical reflection. In its overarching meaning empirical ethics is not a methodology of doing ethics, but a basic methodological attitude to use the findings from empirical research in ethical reflec- tion and decision making; finally, empirical ethics cannot be considered to be an anti-theorist approach, in which the context and only the context would dictate what is morally good or evil, because then it would cease to be ethics. Is empirical ethics a new approach? On the one hand one can argue no because empirical research on bioethical issues (Fox, 1989) and combining ethics and empirical research (Edel, 1955) has been under- taken for many years. Yet on the other hand, for the first time more and more empirical studies focusing on bioethical issues are being published. Some authors label this a novel form of scholarship in bioethics (Brody, 1990) or a new form of ethics paper (Arnold and Forrow, 1993, p. 195). This new empirical work is being done not only by sociologists or anthropolo- gists, but also by researchers in medicine and public health, epidemiologists, health economists, physicians and even ethicists. In addition, for the first time theo- logians, philosophers, health care scientists, social scientists and medical scientists are being challenged in an interdisciplinary debate to clarify what value they attribute to empirical evidence in ethical reflection. A reflection on the possibilities and impossibilities of the use of empirical ethical research or ethics-

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