Proposing an alternative framework for bioethics

Bioethics in the Age of New Media

Joanna Zylinska

The MIT Press; 2009.

As a scholarly discipline, bioethics has focused typically on ethical and philosophical issues encountered in the biological and health sciences that place the status and concerns of humans as central: when life begins and ends; how we define health and what resources we should allocate to its pursuit; the technologies we should allow in health care and how they should be used — to name just a few. Within these debates, there is considerable discussion about how to define “life” and “quality of life,” but the definition of “human” is assumed.

Some technological developments and advances in new media (such as radical cosmetic surgery and computer-assisted communication) have raised questions about the implied distinctions bioethics draws between what is human and what is nonhuman.

This is the territory explored by Joanna Zylinska, Reader in New Media and Communications at Goldsmiths, University of London, England. She raises thought-provoking questions, such as whether people who have undergone extensive and radical cosmetic plastic surgery are “21st century neo-cyborgs?” If so, what does traditional bioethics have to say about their moral status?

Zylinksa argues that the current theoretical basis of bioethics is too rigid and human-centric to respond to these kinds of conceptual challenges. In response, she embarks on the significant project of rethinking the philosophical basis of contemporary Western bioethics. She sets herself several tasks: to provide an alternative theoretical approach to bioethics grounded in continental philosophy and cultural theory rather than analytic philosophy; to explore and develop an ‘ethics of life’ that is not prescriptive, yet still attends to the idea that we may have moral obligations to others; to interrogate the human-centric stance of bioethics; and to situate all of this within the contemporary social context of rapid developments in digital media and other technologies.

Any of these alone would be sufficient for a book of this length, yet Zylinska adds an additional layer of complexity, if not confusion, by oscillating between her stated goal of developing an alternative theoretical basis to bioethics and completely re-envisioning the field of bioethics itself including what its central preoccupations should be. She writes that her “understanding of [bioethics] here is much broader. Bioethics for me stands for an ‘ethics of life,’ whereby life names both the physical material existence of singular organisms and their political organization into populations.” This is useful to know, but makes unclear to what Zylinska is referring when she provides her analysis of “bioethics” — is she talking about how bioethics defines itself as a field, or how she thinks it should be defined?

The book begins with a critical overview of the philosophical basis of contemporary bioethics, followed by Zylinska’s theoretical position, which draws heavily upon the work of Giorgio Agamben, Michel Foucault, Emmanuel Levinas, Jacques Derrida and Gilles Deleuze. This section makes for dense and complex reading, that will be inaccessible to readers who are not familiar with these scholars and their place in philosophy.

Zylinska then brings her theoretical position to bear upon three examples of where therapeutic technologies have been put to nonhealing purposes: television makeover programs and the culture and discourse that surrounds them; the conceptualization of the discovery of the structure of DNA and the mapping of the human genome; and the interdisciplinary practice known as bioart (art that utilizes biomaterial such as tissue or blood as its medium). Situated within these cultural tropes, the author’s earlier theorizing becomes somewhat more transparent. Zylinska’s use and play with commonly used bioethics terms or roots such as “respons-ible” (to evoke the notion of deserving a response) and “hospitality” (to emphasize the centrality of the clinical within bioethics) was particularly clever and thought-provoking.

Ultimately, however, the book’s multiplicity of aims complicates things for the reader and undermines Zylinska’s principal goal of presenting an alternative framework to contemporary bioethics. Zylinska focuses primarily on understanding “life itself” and thus seems more concerned with ontological questions than ethical ones. This is a legitimate line of inquiry, but instead of offering an alternative framework to bioethics, she seems to be offering an alternative to bioethics altogether.

Furthermore, Zylinska tends to position her work against a bioethics she characterizes as rigid and rule-driven. I think this does not fairly represent the theoretical plurality of North American academic bioethics, nor the respect for ambiguity that characterizes clinical bioethics. I have heard other UK-based scholars describe bioethics similarly and I wonder if the particular way in which disciplinary bioethics operates in that country influenced her depiction of bioethics as a whole. At the same time, however, the author aptly critiques the human-centric position of Western bioethics, which she rightfully identifies as central to even the best work in that tradition.

A significant issue is Zylinska’s claim that her alternative framework is nonnormative. She does avoid inferring specific rules from her overall analysis and thus can legitimately claim to be nonprescriptive. However, her claim that she has developed a “content-free obligation towards other beings and forms of life…” cannot be viewed as nonnormative. Surely if we are “already indebted to the other” as she states, then there is a norm that we ought to fulfill this obligation, even if the specifics of fulfillment can only be ascertained in a given situation. There may be no algorithmic way of explicating these specifics, but doing so will necessarily involve a normative, ethical response — for that situation — even if it is not universalizable.

If she wants to show how her approach really is an alternative to bioethics, the reader would benefit from greater contrast between her proposal and current, dominant approaches using the specific case examples she explores or others. By the end of the book, I was clearer as to how Zylinska’s approach reframes debates in bioethics, but left uncertain as to its potential for advancing these debates.