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The problems of bioethics are embedded in people's lives and social worlds. They are shaped by individual biographies and relationships, by the ethos and institutions of health care, by economic and political pressures, by media depictions, and by the assumptions, beliefs, and values that permeate cultures and times. Yet these forces are largely ignored by a professional bioethics that concentrates on the theoretical justification of decisions.

The original essays in this volume use qualitative research methods to expose the multiple contexts within which the problems of bioethics arise, are defined and debated, and ultimately resolved. In a provocative concluding essay, one contributor asks his fellow ethnographers to reflect on the ethical problems of ethnography.

In 2006 anthropologists Paul Rabinow and Gaymon Bennett set out to rethink the role that human sciences play in biological research, creating the Human Practices division of the Synthetic Biology Engineering Research Center—a facility established to create design standards for the engineering of new enzymes, genetic circuits, cells, and other biological entities—to formulate a new approach to the ethical, security, and philosophical considerations of controversial biological work. They sought not simply to act as watchdogs but to integrate the biosciences with their own discipline in a more fundamentally interdependent way, inventing a new, dynamic, and experimental anthropology that they could bring to bear on the center’s biological research.

Designing Human Practices is a detailed account of this anthropological experiment and, ultimately, its rejection. It provides new insights into the possibilities and limitations of collaboration, and diagnoses the micro-politics which effectively constrained the potential for mutual scientific flourishing. Synthesizing multiple disciplines, including biology, genetics, anthropology, and philosophy, alongside a thorough examination of funding entities such as the National Science Foundation, Designing Human Practices pushes the social study of science into new and provocative territory, utilizing a real-world experience as a springboard for timely reflections on how the human and life sciences can and should transform each other.

Van Rensselaer Potter created and defined the term "bioethics" in 1970, to describe a new philosophy that sought to integrate biology, ecology, medicine, and human values. Bioethics is often linked to environmental ethics and stands in sharp contrast to biomedical ethics. Because of this confusion (and appropriation of the term in medicine), Potter chose to use the term "Global Bioethics" in 1988. Potter's definition of bioethics from Global Bioethics is, "Biology combined with diverse humanistic knowledge forging a science that sets a system of medical and environmental priorities for acceptable survival."

The National Institutes of Health and the National Science Foundation together fund more than $40 billon of research annually in the United States and around the globe. These large public expenditures come with strings, including a complex set of laws and guidelines that regulate how scientists may use NIH and NSF funds, how federally funded research may be conducted, and who may have access to or own the product of the research.

Until now, researchers have had little instruction on the nature of these laws and how they work. But now, with Robert P. Charrow’s Law in the Laboratory, they have a readable and entertaining introduction to the major ethical and legal considerations pertaining to research under the aegis of federal science funding. For any academic whose position is grant funded, or for any faculty involved in securing grants, this book will be an essential reference manual. And for those who want to learn how federal legislation and regulations affect laboratory research, Charrow’s primer will shed light on the often obscured intersection of government and science.

Embryo adoptions, stem cells capable of transforming into any cell in the human body, intra- and inter-species organ transplantation—these and other biomedical advances have unsettled ideas of what it means to be human, of when life begins and ends. In the first study to consider the cultural impact of the medical transformation of the entire human life span, Susan Merrill Squier argues that fiction—particularly science fiction—serves as a space where worries about ethically and socially charged scientific procedures are worked through. Indeed, she demonstrates that in many instances fiction has anticipated and paved the way for far-reaching biomedical changes. Squier uses the anthropological concept of liminality—the state of being on the threshold of change, no longer one thing yet not quite another—to explore how, from the early twentieth century forward, fiction and science together have altered not only the concept of the human being but the contours of human life.

Drawing on archival materials of twentieth-century biology; little-known works of fiction and science fiction; and twentieth- and twenty-first century U.S. and U.K. government reports by the National Institutes of Health, the Parliamentary Advisory Group on the Ethics of Xenotransplantation, and the President’s Council on Bioethics, she examines a number of biomedical changes as each was portrayed by scientists, social scientists, and authors of fiction and poetry. Among the scientific developments she considers are the cultured cell, the hybrid embryo, the engineered intrauterine fetus, the child treated with human growth hormone, the process of organ transplantation, and the elderly person rejuvenated by hormone replacement therapy or other artificial means. Squier shows that in the midst of new phenomena such as these, literature helps us imagine new ways of living. It allows us to reflect on the possibilities and perils of our liminal lives.

Over the past thirty years, the world’s patent systems have experienced pressure from civil society like never before. From farmers to patient advocates, new voices are arguing that patents impact public health, economic inequality, morality—and democracy. These challenges, to domains that we usually consider technical and legal, may seem surprising. But in Patent Politics, Shobita Parthasarathy argues that patent systems have always been deeply political and social.
 
To demonstrate this, Parthasarathy takes readers through a particularly fierce and prolonged set of controversies over patents on life forms linked to important advances in biology and agriculture and potentially life-saving medicines. Comparing battles over patents on animals, human embryonic stem cells, human genes, and plants in the United States and Europe, she shows how political culture, ideology, and history shape patent system politics. Clashes over whose voices and which values matter in the patent system, as well as what counts as knowledge and whose expertise is important, look quite different in these two places. And through these debates, the United States and Europe are developing very different approaches to patent and innovation governance. Not just the first comprehensive look at the controversies swirling around biotechnology patents, Patent Politics is also the first in-depth analysis of the political underpinnings and implications of modern patent systems, and provides a timely analysis of how we can reform these systems around the world to maximize the public interest.

Technology evolves at a dazzling speed, and nowhere more so than in the field of genetic engineering, where the possibility of directly changing the genes of one's children is quickly becoming a reality. The public is rightly concerned, but interestingly, they have not had much to say about the implications of recent advancements in human genetics.

Playing God? asks why and explores the social forces that have led to the thinning out of public debate over human genetic engineering. John H. Evans contends that the problem lies in the structure of the debate itself. Disputes over human genetic engineering concern the means for achieving assumed ends, rather than being a healthy discussion about the ends themselves. According to Evans, this change in focus occurred as the jurisdiction over the debate shifted from scientists to bioethicists, a change which itself was caused by the rise of the bureaucratic state as the authority in such matters. The implications of this timely study are twofold. Evans not only explores how decisions about the ethics of human genetic engineering are made, but also shows how the structure of the debate has led to the technological choices we now face.

Health care is ubiquitous in the industrialized world. Yet, every medical development, technique, and procedure impacts the environment. Green bioethics synthesizes environmental ethics and biomedical ethics, thus creating an interdisciplinary approach to sustainable health care. Notably, green bioethics addresses not the structure of environmental sustainability in health-care institutions but the sustainability of individual health-care offerings. It parallels traditional biomedical ethics by providing four principles for ethical guidance: distributive justice, resource conservation, simplicity, and ethical economics. Through these four principles, green bioethics presents a coherent framework for evaluating the sustainability of medical developments, techniques, and procedures. The future of our world may very well depend on how effectively we halt ecological destruction and conserve our resources in all areas of life. The principles of green bioethics, outlined in this book, will advance sustainability in health care.

The implicit questions that inevitably underlie German bioethics are the same ones that have pervaded all of German public life for decades: How could the Holocaust have happened? And how can Germans make sure that it will never happen again? In Reasons of Conscience, Stefan Sperling considers the bioethical debates surrounding embryonic stem cell research in Germany at the turn of the twenty-first century, highlighting how the country’s ongoing struggle to come to terms with its past informs the decisions it makes today.

           

Sperling brings the reader unmatched access to the offices of the German parliament to convey the role that morality and ethics play in contemporary Germany. He describes the separate and interactive workings of the two bodies assigned to shape German bioethics—the parliamentary Enquiry Commission on Law and Ethics in Modern Medicine and the executive branch’s National Ethics Council—tracing each institution’s genesis, projected image, and operations, and revealing that the content of bioethics cannot be separated from the workings of these institutions. Sperling then focuses his discussion around three core categories—transparency, conscience, and Germany itself—arguing that without fully considering these, we fail to understand German bioethics. He concludes with an assessment of German legislators and regulators’ attempts to incorporate criteria of ethical research into the German Stem Cell Law.

Slow Cures and Bad Philosophers uses insights from the philosophy of Ludwig Wittgenstein to rethink bioethics. Although Wittgenstein produced little formal writing on ethics, this volume shows that, in fact, ethical issues permeate the entirety of his work. The scholars whom Carl Elliott has assembled in this volume pay particular attention to Wittgenstein’s concern with the thick context of moral problems, his suspicion of theory, and his belief in description as the real aim of philosophy. Their aim is not to examine Wittgenstein’s personal moral convictions but rather to explore how a deep engagement with his work can illuminate some of the problems that medicine and biological science present.
As Elliott explains in his introduction, Wittgenstein’s philosophy runs against the grain of most contemporary bioethics scholarship, which all too often ignores the context in which moral problems are situated and pays little attention to narrative, ethnography, and clinical case studies in rendering bioethical judgments. Such anonymous, impersonal, rule-writing directives in which health care workers are advised how to behave is what this volume intends to counteract. Instead, contributors stress the value of focusing on the concrete particulars of moral problems and write in the spirit of Wittgenstein’s belief that philosophy should be useful. Specific topics include the concept of “good dying,” the nature of clinical decision making, the treatment of neurologically damaged patients, the moral treatment of animals, and the challenges of moral particularism.
Inspired by a philosopher who deplored “professional philosophy,” this work brings some startling insights and clarifications to contemporary ethical problems posed by the realities of modern medicine.

Contributors. Larry Churchill, David DeGrazia, Cora Diamond, James Edwards, Carl Elliott, Grant Gillett, Paul Johnston, Margaret Olivia Little, James Lindemann Nelson, Knut Erik Tranoy

In his provocative book The Next Social Contract, Wayne Gabardi rigorously considers the fate of animals in the twenty-first century. He claims that if we are to address the challenges raised by the Anthropocene—the period where nonhuman beings tend to be mere extras, often subsumed under the umbrella notion of “nature”—we need to radically rethink our basic ethical outlook and develop a new, “more-than-human” social contract.

Gabardi’s wide-ranging and multidisciplinary analysis focuses on four principal battlegrounds of animal biopolitics in the twenty first century: the extinction of wild animals, the crisis of oceanic animals, industrialized farm animals and the future of industrial agribusiness, and the situation of contact-zone animals moving into human-occupied habitats. 

In his recasting of the social contract, Gabardi envisions a culture shift in human-animal relations toward posthumanism that features the ethical and political prioritization of animal life so it is on par with that of human well-being.

The Origins of Bioethics argues that what we remember from the history of medicine and how we remember it are consequential for the identities of doctors, researchers, and patients in the present day. Remembering when medicine went wrong calls people to account for the injustices inflicted on vulnerable communities across the twentieth century in the name of medicine, but the very groups empowered to create memorials to these events often have a vested interest in minimizing their culpability for them. Sometimes these groups bury this past and forget events when medical research harmed those it was supposed to help. The call to bioethical memory then conflicts with a desire for “minimal remembrance” on the part of institutions and governments. The Origins of Bioethics charts this tension between bioethical memory and minimal remembrance across three cases—the Tuskegee Syphilis Study, the Willowbrook Hepatitis Study, and the Cincinnati Whole Body Radiation Study—that highlight the shift from robust bioethical memory to minimal remembrance to forgetting.