James Dwyer suggests why and how we should bring environmental concerns back into bioethics.
In an article published in 1970, Van Rensselaer Potter coined the English word “bioethics”. The next year, he used this article as the first chapter of a book entitled Bioethics: Bridge to the Future. Potter coined the term “bioethics” because he saw the need to bring together biological knowledge and ethical values. He hoped this new field would address our relationship to the natural world, threats to population health, and what he called “acceptable survival”.
But a field of study that developed at the Hastings Center, Georgetown University, and elsewhere came to appropriate the term bioethics. It focused most of its attention on emerging biotechnologies, research ethics, and the doctor-patient relationship. The book that came to dominate this field was Principles of Biomedical Ethics by Beauchamp and Childress, now in its eighth edition. In retrospect, it looks as if these two fields of bioethics had different accounts of the “bio” in “bioethics”. For Potter, “bio” included the biosphere, ecology, and evolutionary biology. For many others, “bio” referred to biomedicine and biotechnology.
Now, more than fifty years after Potter coined the term “bioethics”, the environmental problems are more urgent and serious than ever. Since these problems have a profound impact on people’s health, well-being, and livelihoods, there is a great need to bring environmental concerns back into bioethics. To cultivate this broader view of bioethics, we can utilize Potter’s vision. Of course, we can also consider antecedents, both those that Potter acknowledged – like Aldo Leopold’s articulation of a land ethic – and those he seemed unaware of – like Fritz Jahr’s account of a Bioethik. We should also consider indigenous ways of thinking that antecede Leopold and Jahr by thousands of years.
Although I admire Potter’s vision, I cannot recommend his sense of the problems we face or his way of thinking about these problems. In both Bioethics (1971) and Global Bioethics (1988), he emphasized the problem of population growth and the individual responsibility to limit reproduction. It seems clear to me now that patterns of high emissions and consumption are more of a problem. Greenhouse gas emissions in the United States are fifty times higher than in Bangladesh. It also seems clear to me that wherever females enjoy rights, schooling, and career opportunities, the birth rate declines. The state of Kerala is a good example.
We need ways of thinking that make apparent the injustice of our contemporary situation and ways of responding that address injustice. In short, we need to focus on health, justice, and responsiveness. Climate change, the most urgent and serious environmental problem of all, shows how we might think and respond. Because human are emitting more greenhouse gases than the natural world can recycle, the climate is changing. Temperatures are hotter, storms more intense, droughts more prolonged, wildfires more frequent, and much more. These changes have a profound impact on human health. As a result of climate change, more people die in heat waves; “natural” disasters kill people, displace others, and damage croplands; infectious diseases increase; and millions of people become environmental migrants.
Although we are all at risk from the impacts of climate change, we are not equally at risk. Younger people and future people are at higher risk. People in flood prone areas are at higher risk. Poor and marginalized people are at higher risk.
Many people who have contributed very little to the problem are at very high risk. According to Shoibal Chakravarty and colleagues, the wealthiest 10% of people in the world are responsible for 49% of carbon dioxide emissions. The poorest 50% are responsible for 10% of these emissions. According to Lucas Chancel and Thomas Piketty, the top 10% of emitters are responsible for 45% of greenhouse gas emissions (measured in carbon dioxide equivalents). The bottom 50% of emitters are responsible for 13%. We don’t need a particular conception of justice to judge this situation as unjust.
The manifest injustice of the situation leads to questions about responsiveness – about why and how we should respond. We have duties to change the situation because we are human beings, citizens in a globalized world, and agents implicated in the problem. We need to try to make the situation less unjust. That requires political change. There is no easy and simple way to bring about that kind of change. It will take creative citizens, with a forward-looking sense of responsibility, acting in civil society. That’s what the situation requires of us.
James Dwyer is Professor of Bioethics and Humanities at Upstate Medical University in Syracuse, New York.