Care and Respect in Bioethics

This book discusses the philosophical foundations of bioethics, with a particular focus on the tensions and potential dilemmas generated by the intuitionist meta-ethical commitments of the predominant normative theory, namely “the four principles approach.” This view is based on the prima facie norms of respect for autonomy (one ought to respect the autonomous choices of subjects of scientific research/patients), non-maleficence (one ought to refrain from inflicting harm), beneficence (one ought to do good and prevent, or remove, harm) and justice (one ought to treat people fairly). The tensions in applying these basic principles may lead to inaction in scientific experiments involving human subjects or to arbitrary applications of the norms in the art of caring. The problem can be made explicit in these terms: on the one hand, caring without respecting seems blind, degenerating into forms of paternalism when, for instance, the carer imposes her conception of the good life or a particular procedure on the cared-for; on the other hand, respecting without caring amounts to indifference or individualism when, for example, a person does not look after a vulnerable being properly. The initial hypothesis of this book, then, is that the concept of respectful care can be built up, working from an ethico-philosophical perspective, to be a leading notion capable of guiding our daily actions and bioethical practices.