Albert W Dzur | PubMed Health

PubMed2004

The "nation's conscience:" assessing bioethics commissions as public forums.

As the fifth national bioethics commission has concluded its work and a sixth is currently underway, it is time to step back and consider appropriate measures of success. This paper argues that standard measures of commissions' influence fail to fully assess their role as public forums. From the perspective of democratic theory, a critical dimension of this role is public engagement: the ability of a commission to address the concerns of the general public, to learn how average citizens resolve moral issues in healthcare, and to monitor public opinion on the topics addressed in the commission. Such a public forum role is supported by the critical literature within bioethics, which has deemed some commissions successful, supported more generally by the history of bioethics as a reform discourse that has brought socially important values into the medical domain, and supported more generally still by the example of the great social issues commissions of the 1960s.

Advisory Committees↗

PubMed2002

Democratizing the hospital: deliberative-democratic bioethics.

The increased presence of moral consultants, or bioethicists, within hospitals and clinics in the last two decades has begun to raise questions about their sources of authority and norms of practice. Under pressure from critics in the social sciences, a number of bioethicists have recently raised the ideal of democratic deliberation to defend and reconstruct their place in the medical field. This article sheds light on these developments by placing bioethics in a historical context that shows an early tension between bioethicists as whistle-blowers and bioethicists as incremental reformers of medical practice. This article also develops a conceptual framework for analysis that indicates how such tensions have grown more complicated for contemporary bioethicists because they occupy a fluid and structurally ambiguous role in which there are multiple sources of normative expectations and little guidance for meeting these expectations. The liminality of the role and the overload of expectations have made bioethics vulnerable to methodological criticisms from social scientists. This article concludes that such methodological criticisms cannot address the more systemic problems of liminality and overload. The ideal of democratic deliberation, though imperfect, does address these systemic problems because it shows bioethicists how to gain guidance and share responsibility for moral consultation.

Anthropology, Cultural↗