For a Materialist Bioethics

There is a spectre haunting bioethics—the spectre of materialist analysis and politics. While American bioethics prides itself on interdisciplinarity, mainstream bioethics literature and institutional academic training remains remarkably constrained. Principalism, while pragmatic in institutionally applied bioethics, remains overwhelmingly dominant within the broader academic literature and curricula of undergraduate and graduate-level training for bioethics. Largely absent from the conversation, however, are the ways extraordinary material inequalities in access, ownership, labor and political power — and the attendant capitalist profit motive shaping these inequalities — produce wildly varying health outcomes within and between countries. Dialogue with empirical and theoretical social sciences have contributed to advancing important feminist, relational, and care-centered approaches to bioethical problems. Discussion of Marx, however, is muted if found at all. This paper is a forceful call for the development of a robust materialist bioethics.

We begin by producing a brief historical view of the advent and trajectory of disciplinary bioethics. We engage in empirical analysis of the bibliometrics of the accumulated bioethical and related literature, including citation network analysis. We also summarize the dominant frames of bioethical syllabi for the largest bioethics masters degree programs in the United States to demonstrate the hegemony of a narrow principalist approach within these discipline-reproducing structures. We then trace an outline of a materialist bioethics program of research and practice. Finally, this paper seeks to decenter the mainstream vision of bioethics by advancing the ideas of authors from regions and traditions largely overlooked.

Gabriela Arguedas – Philosophy – Universidad de Costa Rica; Zackary Berger, MD, PhD – Berman Institute of Bioethics – Johns Hopkins University