Biomedicine, Bioethics, and the Arts: Promises, Fears, & Fiction

Noorlinah Mohamed - Monday, July 07, 2014
By Prof. Paul Macneill

There is a fascination with science, biomedicine and promises of biomedical advances. The promises include a ‘cure’ for aging that banishes all the diseases and maladies that come with it.

The promises go beyond realistic expectations — far beyond science fiction — into hype. Even people within biomedical science, and within bioethics, take the fictions seriously. Some of them are harmful — causing people to destroy the fabric of their lives in chasing elusive dreams. The fascination with biomedical mythology is, of course, fuelled by fear: the fear of our own and our loved ones’ deaths.

There is another approach to these promises, fears, and fictions. They are quest myths —the stories of human vulnerabilities and desires. The antidote is in accepting that understanding and wisdom come from many sources. It is not only through science and rational debate that we gain knowledge, but also through music, painting, literature, dance, film, and theatre. In the arts, feeling, sensitivity, and awareness of beauty and pain are taken seriously as the stuff of our lives. It is not a quantitative measure — the length of a life — that matters, but the quality of the life we live.

Biomedicine and Bioethics

Biomedicine in defined simply as “the branch of medicine concerned with the application of the principles of biology, biochemistry, etc., to medical research or practice” [OED]. Bioethics is defined as “the discipline dealing with ethical issues relating to the practice of medicine and biology or arising from advances in these subjects” [OED]. I have taken a critical approach to bioethics, however. As stated in the Preface to Ethics and the Arts (Macneill 2014):

I have been teaching ‘bioethics’ in medical schools in Australia, and now Singapore, for the last 22 years. The major influences on bioethics — a sphere of applied ethics in medicine and other health professions — have been philosophy and law. The field is overly theoretical, philosophical, and legal — if not downright juridical. Even practising clinicians, who publish in bioethics, are obliged to pay respect to philosophy and the law, rather than found their views on clinical experience. For some time, I’ve been dissatisfied with this approach and prefer more practical methods of research — including watching what physicians actually do. These observations have led me to a conviction that medical practice is an art form. Whilst it is a truism that medicine is an art and a science, there is little substantive material on medicine as an art. It is not easy to research or write about. So much of this art is a synthesis of theory and practice, individual nous, and the experience of dealing compassionately (as most doctors do) with real patients in the midst of life’s crises. (p.viii)

And in the last chapter of Ethics and the Arts:

I... am dissatisfied with the predominant normative approaches, particularly because normative ethics does “little to promote an inner sense of mastery in acting well in relating to others”. I have turned to the arts to look for qualities that may have potential application in promoting acting well — or acting ethically in relation to others — and in ways that go beyond normative approaches. To this, I add: acting in ways that bring delight — and acting from a recognition that the most important change may be in the quality of affect rather than in achieving some instrumental purpose for an encounter. (p.259)

I concluded Ethics and the Arts with the statement:

Normative ethics is a necessity in many circumstances. Not all situations can be left to the moment and some prior considered agreement between participants, to cover what ought to happen, is often needed. Nevertheless, even within those constraints, there can be a fluidity and lightness, a crispness and delight in the performance. There is no music in dull, rigid following of the score with each player absorbed in getting it right. The arts can illustrate what it means to relate with pleasure and joy in full and cooperative engagement. (p.260)

Macneill, Paul. 2014. ed. Ethics and the Arts. Heidelberg, New York, and London: Springer.

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