Medicine and Bioethics as a Democratic Moral Tradition

Abstract: In this presentation, I will consider the moral project underlying contemporary American medicine and bioethics to identify its key features and nature. My primary question is: do medicine and healthcare constitute a coherent and independent moral tradition? If so, what does this tradition look like, and how does it operate in the world? To explore these questions, I will consider discourse from the last century regarding the nature of moral traditions. I will ground my understanding of moral traditions in Alasdair MacIntyre’s presentation of traditions and their characteristics. From there, I will turn Jeffrey Stout’s understanding of American liberal democracy as a moral tradition. This tradition is more metaphysically austere and activity-dependent than MacIntyrian virtue ethics, making it a suitable counterpoint to MacIntyre’s traditions when considering the practical quality of medical ethics. By examining multiple interpretations of recent healthcare history, I will suggest that medicine’s moral project possesses some of the qualities of a moral tradition because it sustains a particular way of learning and knowing, of existing as a social entity, and of ethically evaluating the world. This moral tradition, I argue, looks most like Stout’s democratic tradition because it is based on professional activity and dialogue that maintain the reality of objective truth but seek practical moral goals over metaphysical ones. This, in turn, reveals the ways medicine fails to live up to Stout’s democratic vision and the ways that a democratic medical tradition is liable to significant concerns due to its pragmatic nature.

Keywords: moral tradition, democracy, American medicine