What Would John Dewey Do? The Promises and Perils of Pragmatic Bioethics

Abstract

Recent work done at the intersection of classical American pragmatism and bioethics promises much: a clarified self-understanding for bioethics, a modus vivendi for progress, and liberation from misguided and misguiding theories and principles. The revival of pragmatism outside bioethics in the past twenty years, however, has been of a distinctly anti-realist orientation. Richard Rorty, for example, has urged that there is no objective truth or good for philosophy to be concerned with. I ask whether the work in Pragmatic Bioethics follows this perilous Rortyan trend. It will move towards anti-realism if its account of the good abandons any notion of truth or objectivity, and if, in its discussion of specific problems, it divides these problems into public and the private, urging consensus as the goal of the one, and an unconstrained notion of happiness as the goal of the other. In a final section, I suggest that bioethics done in the spirit of Royce's Philosophy of Loyalty might have much to offer to those dissatisfied with anti-realism.

Reductionism, Eclecticism, and Pragmatism in Psychiatry: The Dialectic of Clinical Explanation

“…Although they need not assume a distinct metaphysical position to perform clinical work, psychiatrists do not thereby commit themselves to denying objective reality. They avoid the danger of anti-realism discussed by philosophers interested in pragmatic bioethics (Tollefsen, 2000) by rooting themselves not in ontological theory but in empirical evidence derived from clinical research and treatment experience.…”

A pragmatist approach to clinical ethics support: overcoming the perils of ethical pluralism

“…Interestingly, some critiques argue that bioethics is inherently pragmatist (Tollefsen 2000; Arras 2002, p. 33; Schmidt-Felzmann 2003; Moreno 2003). Among others Arras claims that American bioethics has always tried to avoid the reference to “ground philosophical schemas in favour of pragmatic policy making and democratic consensus” (Arras 2002, p. 29).…”

“…Various authors have proposed a pragmatist approach to bioethics (Arras 2002; Cooke 2003; Fins et al 1997, 1998; Hester 2003; Keulartz et al 2002; McGee 2003; Tollefsen 2000; Mallia and ten Have 2005). As Wolf (1994) argues, pragmatism corresponds with the agenda of a (at that time) new approach to bioethics arising at the end of the twentieth century, abandoning the traditional “principle or rule-driven” (ivi, p. 399) approach in favour of a more empirical, bottom-up approach, focusing on the actual needs and characteristics of patients and stakeholders, also paying more attention to gender-, race-, ethnicity-, and religion-related issues.…”

Can Patients and Psychiatrists be Friends?

“…These 4 p's of clinical pragmatism were rooted in the thinking of classical American pragmatists, including Charles Sanders Peirce (1904), William James (1909), and John Dewey (1929. They are also strongly influenced by the work of more contemporary pragmatic philosophers and bioethicists, such as Christopher Tollefsen (2000) and Glenn McGee (2003). For example, the falliblism of Peirce, the pluralism of James, and the participatory democratic attitude of Dewey all combine with their privileging of good practical results in many forms of life -and help to define a structure for the 4 p's.…”