Toward Left-Bioethics: From Public Deliberation to Social Democratic Transformation

Traditionally, bioethics has tended to eschew political engagements or to recast political issues in the normative language of values, principles, or morality. Influenced by political philosophers such as John Rawls, Norman Daniels, Jürgen Habermas, and other scholars invested in deliberative democracy and consensus-based policymaking, bioethics has also tended to adopt a liberal orientation toward questions about democratic process and thus the role of bioethics in society. In this modality, the task of bioethics is framed mainly as holding open forums for debate that, per philosopher Peter Singer, “try to work out the best solutions to…difficult situations.” This paper offers an alternative articulation of the potential role of bioethics in society by drawing on political philosophies of the left which conceptualize politics in terms of struggles among factions that necessarily lead to certain interests dominating over others, rather than to consensus-based outcomes. I argue for a left-bioethics rooted in frameworks that valorize non-reformist programs of social transformation, achieving radical equity, and pursuing economic redistribution. I then suggest some intellectual resources for pursuing this project. I particularly emphasize frameworks of “agonistic pluralism” and “radical democracy” from political theorists Chantal Mouffe and Ernesto Laclau, the concepts of “war of position” and “war of movement” from Marxist intellectual Antonio Gramsci, and the anti-capitalist critique of American healthcare long advanced by physician-sociologist Howard Waitzkin. At a time when many health-related rights, programs, and entitlements are under assault from an empowered right-wing, the need for bioethical frameworks that prioritize social democratic transformation is apparent and urgent.