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Rapid Response

Comment on Alastair Campbell's'Public Policy and the Future of Bioethics'

Received from Mairi Levitt, CESAGen, Lancaster University, and Nina Hallowell, Public Health Sciences, University of Edinburgh and School of Nursing, Midwifery and Postgraduate Medicine, Edith Cowan University, Perth, WA.

Campbell raises some very interesting points concerning the relationship between bioethics and public policy, some of which we wholeheartedly agree with - such as the need for "blue skies" research in bioethics, the social sciences and many other disciplines and the danger of commercialising of bioethical expertise- and others that we disagree with - for example, his dismissal of public involvement in the ethical debate and the nature of "interdisciplinary" research, the latter constitute the focus of our commentary.

Campbell wishes to eliminate the'naïve use of surveys of public opinion to establish ethical norms' and we agree that opinion surveys should not replace reasoned argument. However, this is surely a point about the methods used in much of this research, with its focus fixed choice responses (usually Yes/No answers) to complex and nuanced moral dilemmas; we believe that surveying the views of ethicists in a similar way would be open to the same criticism. Not all attempts to gather publics' views on moral issues necessarily produce such "naïve" data. Taking the HFEA sex selection consultation as an example, the public responses demonstrated that these non-experts were easily able to distinguish between individual cases and moral right. Indeed, it was the public responses rather than those of the ethicists that raised the'wider questions' Campbell refers to. Campbell is enthusiastic about'the fresh world of young people's moral perceptions' but we would suggest that it is the methods that are used to engage the public in the debate rather than the age of the debaters that is important.

Moreover, regarding his comments on the need to avoid confusing ethical analysis with public opinion, we would have liked to have seen more discussion of the basis for the bioethicists' expertise. One reason for the relative lack of political critique and concern with wider social issues (referred to by Campbell) within the debate is surely due to ethicists' focus on normative ethics with its associated asocial and acultural'oughts'.

We also remain unconvinced by Campbell's arguments about "interdisciplinary" research. First, we would argue that much of the research that passes as "interdisciplinary" is actually multidisciplinary , for example, having an empirical element led by social scientists, consideration of legal frameworks by the lawyers and a philosophical analysis undertaken by bioethicists. Second, in whatever way the disciplines work together, we do not see that this necessarily involves a'dumbing down' because of the need for cross-disciplinary communication. Different disciplines can communicate with as much rigor and complexity as they wish among their peers, but must also be able to communicate with those outside, if, as Campbell states, it is the task of bioethics'to guide the policy makers' and, for that matter, anyone else who will listen.

In conclusion, whilst we applaud Campbell's call for bioethics to move out of the ivory towers and the committee rooms of Whitehall, we believe that this is not an educational challenge, as he suggests, but involves us making more effort to tap into the alternative forms of bioethical expertise that is already out there. Like Campbell, we believe that as far as bioethics is concerned, the future is now, but that we can appreciate that if we stop and listen to what the world is saying.

Mairi Levitt and Nina Hallowell

Published online April 2005

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