Bioethics

The discipline of bioethics emerged in the United States in the 1960s as a response to several prominent controversies in medical research and practice, including the aftermath of the Tuskegee syphilis experiments and the development of kidney dialysis and associated concerns about resource allocation. Anthropology and bioethics have had a contentious relationship since the field’s inception. Anthropologists have viewed bioethics as ethnocentric, universalizing, and inattentive to the social, cultural, and political contexts of bioethical dilemmas. Anthropologists have challenged foundational bioethical concepts such as autonomy, showing that decision making, in many cases, unfolds in a relational context that is poorly matched to individualized models of informed consent, which lodge decisional authority within a single autonomous patient or research subject. At the same time, anthropology has much to offer the discipline of bioethics. Empirical data can help to address or resolve normative questions, bring unrecognized factors to light, and open up new avenues for further exploration. Anthropology’s characteristic use of cases grounds bioethical debates in contextual details that may change the stakes of discussion. And anthropology can enrich bioethics scholarship with its use of ethnography and social theory to illuminate power structures and relations of inequality, its characteristic dual focus on the micro and the macro, and its capacity for reflexivity. In exchange, bioethics may beckon anthropologists to go outside their comfort zone and develop prescriptive solutions to ethical challenges. On the other hand, debate is ongoing about whether anthropologists should revitalize bioethics and infuse it with more attention to cultural and historical contexts, or, instead, leave bioethics behind entirely and develop their own ethical projects. Moving forward, it may be useful to distinguish between anthropology in bioethics and anthropology of bioethics. The former category of research and scholarship encompasses anthropological studies of bioethically relevant topics, such as end-of-life decision making, organ transplantation, genetic screening, stem cell research, and the globalization of clinical trials. Anthropology of bioethics performs a critical analysis of bioethics as a sphere of knowledge production and professional expertise. This approach acknowledges that bioethics, as an ideology and a practice, may best serve certain kinds of social actors and obscure its limits for other actors and conditions. While these two approaches are by no means mutually exclusive, they can help to structure an understanding of anthropology’s potential contributions to the field.