Rashad Rehman argues that bioethicists should turn their attention to the shared moral heritage of both Western and non-Western bioethics.

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As clinicians and bioethicists turn towards cultivating non-Western conceptual apparatus to inform their theoretical and practical work, equally meritorious of attention is shared conceptual territory between Western and non-Western traditions. One remarkable case of shared conceptual territory concerns a shared moral heritage, what is called in the East the tao or dao, and what is called in the West practical reason. The noun tao, from 道, translated as way, right way, reason, is in the Western tradition practical reason, natural law, morality.

In Tom L. Beauchamp and James F. Childress’ Principles of Biomedical Ethics (2013), the domain of descriptive ethics lies in the common morality or universal morality, in which, empirically and historically, “there are core tenets in every acceptable particular morality that are not relative to cultures, groups, or individuals”, “the set of universal norms shared by all persons committed to morality”. Among these “generally binding, standards of action (or rules of obligation)” are morals like nurturing the young and dependent, moral character traits or virtues like trustworthiness, and moral rights like the right to healthcare. Additionally, it is plausible that the common morality features the Golden Rule.

Photo Credit: flickr/Stuart Rankin. Image Description: Golden, extruded Japanese kanji 道 (“michi”, meaning road).

Christopher Tollefsen and Farr Curlin, in their The Way of Medicine (2021), place the common morality in its historical and anthropological context: “The requirements of practical reason have been known under a number of names…C.S. Lewis identified another name, the Tao, as a synonym for practical reason and natural law…the identification of that which is genuinely good for human beings—that is, to human flourishing—and the corollary implications as to what we should do and how we should live”.

The Chinese noun tao is translated literally and etymologically as way, path, guide, road, principle, right way, reason. In The Abolition of Man (1943), C.S. Lewis writes that the tao is “the doctrine of objective value, the belief that certain attitudes are really true, and others really false, to the kind of thing the universe is and the kind of things we are”. Moreover, the tao or “Natural Law or Traditional Morality or the First Principles of Practical Reason or the First Platitudes, is not one among a series of possible systems of value. It is the sole source of all value judgements”.

Lewis gives direct evidence that such moral laws are transcultural absolute moral norms – citing not only ancient Indigenous, Egyptian, Roman, Greek, Chinese, and Babylonian cultures, but also transreligous absolute moral norms – citing Christianity, Judaism, and Hinduism as examples.

There is also an indispensability or consistency argument for these moral laws. Clinical and bioethical practice both assumes that there is moral common ground, and that such common ground is indispensable. These value-laden assumptions feature in nearly all areas of clinical and bioethical practice. The doctor-patient relationship depends on the tacit (and explicit) mutual commitment to shared values like solidarity and trust. Moreover, even the (un)conditional respect for autonomy requires a (tacit or explicit) moral commitment to beneficence: others are better-off when, ceteris paribus, their autonomy is respected. While each moral law must be enacted and developed fittingly, as Lewis says “from within the Tao itself comes the only authority to modify the Tao”. Dispensing with any version of the tao or natural law or common morality forfeits the possibility of a shared moral ground for reflective equilibrium. For example, therapeutic privilege (i.e. withholding the truth from a patient) requires that truth-telling is generally morally obligatory, from which follows various views about the justification (or lack thereof) for therapeutic privilege. Without the assumption that truth-telling is generally morally obligatory, the trustworthiness of clinicians and their practice seems morally opaque.

In sum, there are three reasons why the tao or practical reason is relevant to clinical practice and bioethical theorizing. First, clinicians using the tao have a ground for an inclusive, cross-culturally-informed, and practical moral methodology. The synonymity of the tao and practical reason cuts at the heart of the non-Western versus Western bioethics dichotomy and emphasizes historical, anthropological, and philosophical unity in our common moral heritage. Our shared humanity is emphasized in our shared morality.

Second, clinicians have further reason to respect the health of their patients in the broader context of the plurality of human goods specified in the tao. Attention to the broad array of human goods, in which goods like health and autonomy are situated, matters. Because health is one good among many, clinicians who appreciate the tao have a deeper conceptual repertoire to help their patients approach, navigate, and pursue these goods.

Third, clinicians have further conceptual resources to navigate moral disagreement by means of the tao. Moral disagreement happens when two parties diverge in judgment regarding the permissibility, goodness, or badness of a particular action. While various mechanisms might be used to navigate moral disagreement that need not be enumerated here, the tao serves as a reminder that we are able to begin, methodologically, with moral agreement before disagreement.

As bioethicists turn their attention to non-Western bioethics to enrich their conceptual inventory to govern their theoretical and practical work, so too should the shared moral heritage of both Western and non-Western bioethics be featured into this endeavour.

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Rashad Rehman is Assistant Professor of Philosophy and Member of the Center for Bioethics at Franciscan University of Steubenville, Ohio.