THE PARADIGMS AND “TURNS” OF BIOETHICS: THE POTENTIAL FOR DIALOGUE
DOI: 10.23951/2312-7899-2024-1-62-81
The article provides an analysis of the use of the terms “paradigm” and “turns” in bioethics research. Various paradigms in bioethics serve as its images – each paradigm reveals a certain aspect of bioethics. Bioethics can be considered, in the sense of a paradigm, as a disciplinary matrix (Thomas Kuhn), since the transition from traditional medical ethics to bioethics marked a true scientific revolution, and it can rightfully be called a paradigmatic science. More often, bioethical paradigms represent its models, varieties. This is explained by the fact that bioethics is an interdisciplinary activity, and it does not correspond to the idea of “normal science”, as no single discipline can claim an exclusive representation of bioethical research. Among the vast array of bioethics paradigms, the most discussed are the liberal, conservative, American ones, and the paradigm of the principles-based system. All of them are grounded in the principles of bioethics but examine them in different contexts, combinations, and approaches to understanding individuality, autonomy, and human dignity. The presence of turns indicates a different nature of bioethical paradigms. They began to emerge in the mid-1990s to the early 2000s, revealing shortcomings in existing paradigms and directing researchers toward aspects of bioethics that were either not considered at all or received no adequate attention from bioethics researchers. Anthropological, cultural, and relational turns share a sensitivity to cultural diversity, consideration of socio-cultural context, and dissatisfaction with the analytical methods of traditional bioethics. This has led to bioethics adopting methodological tools from empirical disciplines, particularly sociology, giving rise to an empirical turn. Today, the empirical turn continues to evolve (as evidenced by the emergence of "digital bioethics"), introducing into bioethics the methods of increasingly new disciplines while simultaneously giving rise to new challenges. The turns visualized the necessity of interdisciplinary dialogue because, as a scientific discipline, bioethics needed to rely on a specific method, and this became the interdisciplinary method. In this method, contributions from various specialized disciplines are integrated into a synthesis capable of guiding researchers in the search for ethically correct solutions. Bioethics organizes dialogue within the scientific community, involving experts from various scientific fields in addressing current ethical issues in medical science, practice, and healthcare. An example of such a dialogue is interdisciplinary research conducted at Siberian State Medical University (Tomsk, Russia), in which scientists from different disciplines and specialties participated: sociologists, doctors with experience in clinical trials of pharmaceuticals, historians, and bioethics specialists.
Keywords: paradigm, empirical turn, digital bioethics, dialogue, clinical trials
References:
Agazzi, E. (2015). Bioethics as a paradigm of an ethics for a technological society. Bioethics Update, 1(1), 3–21.
Almeida, J. L. T., & Schramm, F. R. (1999). Paradigm shift, metamorphosis of medical ethics, and the rise of bioethics. Cadernos de Saúde Pública, 15, S15–S25.
Arras, J. D. (2001). Freestanding pragmatism in law and bioethics. Theoretical Medicine and Bioethics, 22, 69–85.
Azétsop, J., & Rennie S. (2010). Principlism, medical individualism, and health promotion in resource-poor countries: can autonomy-based bioethics promote social justice and population health? Philosophy, Ethics, and Humanities in Medicine, 5, 1–10. https://doi.org/10.1186/1747-5341-5-1
Beauchamp, T. L. (1993). Principles and other emerging paradigms in bioethics. Ind. LJ, 69, 955.
Borry, P., Schotsmans, P., & Dierickx, K. (2004). Empirical ethics: A challenge to bioethics. Med., Health Care & Phil, 7, 1–3.
Borry, P., Schotsmans, P., & Dierickx, K. (2005). The birth of the empirical turn in bioethics. Bioethics, 19(1), 49–71.
Bryzgalina, E. V. (2023). Digital Bioethics: Disciplinary Status between Tradition and Computation. Voprosy Filosofii,, 1, 94–103. (In Russian).
Channick, S. A. (1999). The myth of autonomy at the end-of-life: Questioning the paradigm of rights. Vill. L. Rev., 44, 577–642.
Cooke, E. F. (2003). On the possibility of a pragmatic discourse bioethics: Putnam, Habermas, and the normative logic of bioethical inquiry. The Journal of medicine and philosophy, 28(5-6), 635–653.
Ehrlich, P. R. (2003). Bioethics: are our priorities right? Bioscience, 53(12), 1207-1216.
Frith, L. (2012). Symbiotic empirical ethics: a practical methodology. Bioethics, 26(4), 198–206.
Gorbuleva, M. S., Melik-Gaykazyan, I. V., & Meshcheryakova, T. V. (2013). Mech i skal’pel’: semioticheskaya diagnostika transformatsii vlastnykh vzaimootnosheniy kak kul’turnykh determinatsiy osnovnykh printsipov bioetiki [The sword and the scalpel: semiotic diagnosis of the transformation of power relationships as cultural determinations of the basic principles of bioethics]. TSPU.
Gorbuleva, M. S., Melik-Gaykazyan, I. V., & Pervushina, N. A. (2020). Initiatives of pedagogical bioethics. Vysshee obrazovanie v Rossii, 29(6), 122–128. (In Russian).
Greaves, D. (2002). Reflections on a new medical cosmology. Journal of medical ethics, 28(2), 81–85.
Hanson, M. J., DeVries, R., & Subedi, J. (1999). Bioethics and society: Constructing the ethical enterprise. Journal of Value Inquiry, 33(33), 423–428.
Hester, D. M. (2003). Is pragmatism well-suited to bioethics? The Journal of medicine and philosophy, 28(5-6), 545–561.
Hurst, S. (2010). What ‘empirical turn in bioethics’? Bioethics, 24(8), 439–444.
Jennings, B. (2016). Reconceptualizing autonomy: A relational turn in bioethics. Hastings Center Report, 46(3), 11–16.
Jennings, B., Callahan, D., & Caplan, A. L. (1988). Special supplement: Ethical challenges of chronic illness. The Hastings Center Report, 18(1), 1–16.
Koch, T. (2004). The difference that difference makes: bioethics and the challenge of “disability”. The Journal of Medicine and Philosophy, 29(6), 697–716.
Kuhn, T. S. (2012). The structure of scientific revolutions. University of Chicago Press.
Kurlenkova, A. S. (2013). Bioethics and Anthropology. Ethnographic Review, 1. 89–103. (In Russian).
Martín-Badia, J., Obregón-Gutiérrez, N., & Goberna-Tricas, J. (2021). Obstetric violence as an infringement on basic bioethical principles. Reflections inspired by focus groups with midwives. International Journal of Environmental Research and Public Health, 18(23), 12553. https://doi.org/10.3390/ijerph182312553
Mbugua, K. (2012). Respect for cultural diversity and the empirical turn in bioethics: a plea for caution. Journal of Medical Ethics and History of Medicine, 5. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3713942/
Melik-Gaykazyan, I. V. (2012). Memory-turn: the architecture of bioethics as a diagnosis of a new turn in philosophy. Tomsk State University Journal of Philosophy, Sociology and Political Science, 4, 165–179. (In Russian).
Melik-Gaykazyan, I. V. (2018). Diagnostics of bioethics models. Tomsk State University Journal of Philosophy, Sociology and Political Science, 45, pp. 75–82. (In Russian).
Melik-Gaykazyan, I. V., Smyshlyaeva, L. G., & Pervushina, N. A. (2019). The research program of pedagogical bioethics in the conditions of uncertainty of social scenarios. Tomsk State University Journal, 448, 83–90. (In Russian).
Meshcheryakova, T. V. (2009). Bioethics as a form of protecting individuality in modern culture. Vysshee obrazovanie v Rossii, 10, 108–112. (In Russian).
Meyers, C. (2004). Cruel choices: autonomy and critical care decision‐making. Bioethics, 18(2), 104–119.
Po-Wah J. T. L. (2002). Is just caring possible? Challenge to bioethics in the new century. In Cross-cultural perspectives on the (Im) possibility of global bioethics (pp. 41–58). Springer Netherlands.
Reimer, M. V. (2016). “Cultural Turn” in Contemporary Bioethics: Dissertation for the Degree of Candidate of Cultural Studies: 24.00.01. Volgograd. (In Russian).
Salloch, S., & Ursin, F. (2023). The birth of the “digital turn” in bioethics? Bioethics, 37(3), 285-291.
Schneider, C. E. (1993). Bioethics with a human face. Ind. LJ, 69, 1075-1104.
Schneider, M., Vayena, E., & Blasimme, A. (2021). Digital bioethics: introducing new methods for the study of bioethical issues. Journal of Medical Ethics. 49. https://jme.bmj.com/content/medethics/49/11/783.full.pdf
Turner, L. (2009). Anthropological and sociological critiques of bioethics. Journal of Bioethical Inquiry, 6, 83–98.
Wolf, S. M. (2018). Shifting paradigms in bioethics and health law: the rise of a new pragmatism. In F. H. miller (Ed.), Rights and Resources (pp. 3–24). Routledge.
( 373.11 kB ) 
( 357.73 kB )
Issue: 1, 2024
Series of issue: Issue 1
Rubric: ARTICLES
Pages: 62 — 81
Downloads: 289