Phenomenological Bioethics: Medical Technologies, Human Suffering, and the Meaning of Being Alive

176 Pages·2017·2.09 MB·English

by  Fredrik Svenaeus

PHENOMENOLOGICAL BIOETHICS
Emerging medical technologies are changing our views on human nature and what
it means to be alive, healthy, and leading a good life. Reproductive technologies,
genetic diagnosis, organ transplantation, and psychopharmacological drugs all raise
existential questions that need to be tackled by way of philosophical analysis. Yet
questions regarding the meaning of life have been strangely absent from medical
ethics so far. This book brings phenomenology, the main player in the continental
tradition of philosophy, to bioethics, and it does so in a comprehensive and clear
manner.
Starting out by analysing illness as an embodied, contextualized, and narrated
experience, the book addresses the role of empathy, dialogue, and interpretation in
the encounter between health-care professional and patient. Medical science and
emerging technologies are then brought to scrutiny as endeavours that bring
enormous possibilities in relieving human suffering but also great risks in
transforming our fundamental life views. How are we to understand and deal with
attempts to change the predicaments of coming to life and the possibilities of
becoming better than well or even, eventually, surviving death?
This is the first book to bring the phenomenological tradition, including
philosophers such as Martin Heidegger, Edith Stein, Maurice Merleau-Ponty,
Jean-Paul Sartre, Hans-Georg Gadamer, Paul Ricoeur, Hans Jonas, and Charles
Taylor, to answer such burning questions.
Fredrik Svenaeus is Professor of Philosophy at Södertörn University in
Stockholm, Sweden.
‘Drawing on the insights and methodologies of existentialism, phenomenology,
and hermeneutics to deepen our understanding of health and illness, Phenomenological
Bioethics is a timely and path-breaking work. With his signature clarity and
accessibility, Fredrik Svenaeus illuminates the situated and experiential aspects of
suffering, embodiment, empathy, and death that are all too often neglected in
current bioethical debates.’
— Kevin Aho, Professor of Philosophy, Florida Gulf Coast University
‘A ground-breaking development in medical bioethics, this book is the first to use
phenomenology to analyse and understand contemporary bioethical issues, such as
organ transplantation and assisted reproduction. This book announces the birth of
a new field – phenomenological biomedical ethics – and is an important
development for both philosophy of medicine and for phenomenology.’
— Havi Carel, Professor of Philosophy, University of Bristol
‘Hitherto, few Anglo-American bioethicists have benefitted from the riches to be
found in philosophical phenomenology. This can perhaps be traced to the
phenomenologists’ inhospitable language. Fortunately, in invitingly clear language,
Svenaeus now offers a wonderfully thoughtful and accessible introduction to
phenomenology – and shows how it can illuminate questions of bioethics.’
— Erik Parens, Senior Research Scholar, The Hastings Center, Garrison, NY
PHENOMENOLOGICAL
BIOETHICS
Medical Technologies, Human
Suffering, and the Meaning of
Being Alive
Fredrik Svenaeus
First published 2018
by Routledge
2 Park Square, Milton Park, Abingdon, Oxon, OX14 4RN
and by Routledge
711 Third Avenue, New York, NY 10017
Routledge is an imprint of the Taylor & Francis Group, an informa business
© 2018 Fredrik Svenaeus
The right of Fredrik Svenaeus to be identified as author of this work has been
asserted by him in accordance with sections 77 and 78 of the Copyright, Designs
and Patents Act 1988.
All rights reserved. No part of this book may be reprinted or reproduced or
utilized in any form or by any electronic, mechanical, or other means, now
known or hereafter invented, including photocopying and recording, or in any
information storage or retrieval system, without permission in writing from the
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Trademark notice: Product or corporate names may be trademarks or registered
trademarks, and are used only for identification and explanation without intent
to infringe.
British Library Cataloguing-in-Publication Data
A catalogue record for this book is available from the British Library
Library of Congress Cataloging-in-Publication Data
Names: Svenaeus, Fredrik, author.
Title: Phenomenological bioethics : medical technologies, human suffering, and
the meaning of being alive / Fredrik Svenaeus.
Description: Milton Park, Abingdon, Oxon ; New York, NY : Routledge,
2018. | Includes bibliographical references and index.
Identifiers: LCCN 2017010129| ISBN 9781138629950 (hbk) | ISBN
9781138629967 (pbk) | ISBN 9781315210131 (ebk)
Subjects: LCSH: Medicine--Philosophy. | Medical ethics. | Bioethics.
Classification: LCC R723 .S85 2018 | DDC 174.2--dc23
LC record available at https://lccn.loc.gov/2017010129
ISBN: 978-1-138-62995-0 (hbk)
ISBN: 978-1-138-62996-7 (pbk)
ISBN: 978-1-315-21013-1 (ebk)
Typeset in Bembo
by Saxon Graphics Ltd, Derby
CONTENTS
Preface ix
Acknowledgements xiii
1 Phenomenological bioethics 1
Phenomenology of medicine and health care 1
Phenomenology of illness 3
Phenomenological bioethics 6
Different understandings of phenomenology in medicine and health care 6
Phenomenology and the application of principles 8
Phenomenology as a critique of principle-based bioethics 9
Some examples of major phenomenological moral philosophers 10
Phenomenological bioethics as philosophical anthropology 14
Phenomenological bioethics and wide reflective equilibrium 15
Summary 16
2 The suffering person 18
Suffering and bioethics 18
Suffering as an attuned being-in-the-world 20
The suffering person 22
Developing a phenomenology of suffering 24
The meaning of suffering 26
The moods of suffering 30
What makes a life worth living? 33
Summary 36
vi Contents
3 The body uncanny 37
Phenomenological explorations of the body as alien 37
Sartre on falling ill 40
Suffering illness and having a disease 42
Anorexia nervosa 44
The uncanny body of anorexia 47
The body uncanny and bioethics 51
Summary 53
4 Empathy and the hermeneutics of medicine 55
Empathy and moral philosophy 55
Aristotelian ethics 57
The phenomenology of empathy 58
Empathy and the virtues 59
Empathy and bioethics 61
Medical hermeneutics 62
Gadamer and the hermeneutics of medicine 64
Hermeneutics and bioethics 66
Empathy with the dying 69
Summary 74
5 Medical technologies and the life world 75
Phenomenology and medical technology 75
Heidegger’s philosophy of technology 76
Heidegger and medical technologies 78
Heidegger among the doctors 80
Implications of phenomenology of technology for bioethics 83
Psychopharmacology and medicalization 87
The phenomenology of health and human flourishing 89
DSM and the Gestell 92
Summary 95
6 The beginning of life 97
Medical science and human reproduction 97
Phenomenology and early forms of human life 99
Are embryos potential persons? 100
Embryo ethics and the instrumentalization argument 104
The ethics of abortion 108
Choosing children 113
Designing babies 117
Summary 119
Contents vii
7 Surviving death 121
The concept of death 121
The body as gift, resource, or commodity 124
The paradox of organ-transplantation ethics 126
Persons and their organs 127
The experience of undergoing kidney transplantation 129
The heart transplant 131
Sharing organs in an embodied community 134
Very early, early, and narrative persons 136
Late, very late, and post-persons 140
Summary 144
References 146
Index 157

PREFACE
My aim in this book is to show how the tradition of phenomenology, including
philosophers such as Martin Heidegger, Edith Stein, Maurice Merleau-Ponty,
Jean-Paul Sartre, Hans-Georg Gadamer, Paul Ricoeur, Hans Jonas, and Charles
Taylor, can be brought to the field of biomedical ethics. The continental tradition
of philosophy, including the neighbouring fields of phenomenology, existentialism,
hermeneutics, and post-structuralism, has been strangely absent in bioethics so far.
There are probably several reasons for this, but two main ones are undoubtedly
differences in philosophical style and disciplinary context; continental philosophy
has migrated to several fields of the humanities and social sciences but has rarely
teamed up with the natural sciences, which have been rather the companions of
analytical philosophy.
This book is an attempt to close these gaps of style and disciplinary context in
introducing phenomenology in the field of bioethics. It is not a book primarily
aimed at philosophers who are already familiar with the phenomenological tradition
– although I hope it will prove interesting to some of them, too – but written
rather for scholars and laypersons professionally involved or interested in bioethical
themes and without prior knowledge in the field of phenomenology. The
explorations and analyses found in the book are inspired by some of the main
philosophers in the phenomenological tradition, but they are systematic in manner
and meant to be accessible in style, proceeding from main problems and themes of
contemporary bioethics, including questions regarding human nature, suffering,
empathy, and how we are to deal with medical technologies in our present situation
and the future to come. The problems and themes addressed involve questions
discussed in association with, for instance, new reproductive technologies, embryo
ethics, genetic diagnosis, brain death, organ transplantation, and human
enhancement, and also questions found in clinical ethics dealing with patient
autonomy, euthanasia, abortion, medicalization, and the goals of medicine. In the