Expertise and citizenship: Public bioethics and the ethicist's role

This dissertation examines bioethics as an increasingly significant voice in public deliberation and debate. That voice is heard not only in ways that are obviously public, such as service on government commissions and appearances in the media, but also in bioethicists' publications, their work in hospitals and medical schools, and their participation in professional organizations.; Although most bioethicists complete terminal degrees, there is no core curriculum they are required to master, nor is a license requisite to practice. No laws have been promulgated by which they can be held accountable to society, and there is as yet no ethical code capturing the virtues or principles to which they should aspire. The claim to ethical expertise is grounded in the study and practice of moral inquiry and analysis. This is distinguishable from the claim that by virtue of such expertise the bioethicist possesses overriding moral authority. Confusion about this distinction creates a dual challenge. Some people want moral experts to exert moral authority for choices they are not empowered to make; while others are deeply skeptical that moral expertise can be acquired, or that it serves any meaningful purpose.; Since its emergence about forty years ago, bioethics has been deeply rooted in the humanities, but realization of a fully humanistic bioethics has yet to be achieved. The theological perspective that was a cornerstone of bioethics was marginalized while philosophy gained more prominence. Bioethics has also been heavily influenced by law, resulting in more of a focus on individual rights and self-fulfillment rather than public spiritedness and virtuous self-moderation. These developments have occurred in the larger social context of major discoveries and innovations in medicine and science, which have increased hope that application of the healing arts will correct and enhance the human condition.; Is bioethics a profession, a discipline, or something else altogether? What does it mean to have ethical expertise, and how does that differ from moral authority? How should a humanistic bioethics be understood and achieved? This dissertation grapples with these questions in order to clarify the possibilities and limitations of this new specialty.