Daniel Beck

The need for explicit theoretical reflection on cross-cultural bioethics continues to grow as the spread of communication technologies and increased human migration has made interactions between medical professionals and patients from different cultural backgrounds much more common. I claim that this need presents us with the following dilemma. On the one hand, we do not want to operate according to an imperialist ethical framework that denies and silences the legitimacy of cultural values other than our own. On the other hand, we do not want to backslide into a form of cultural relativism that is unable to critically appraise cultural practices that are harmful, unjust, or oppressive. I examine two prominent attempts – the principlism of Tom Beauchamp and James Childress and the Contractarianism of Robert Baker – to frame cross-cultural bioethics between these two extremes and argue that both approaches have significant flaws. The principlist approach fails to provide a non-question begging way to identify cross-cultural norms that does not already assume the universal legitimacy of moral principles dominant in North American society. Baker's contractarianism cannot grapple with the realities of political power imbalances that often characterize cross-cultural moral disputes. I suggest that a naturalized feminist framework, though not free of its own theoretical difficulties, provides the best alternative for approaching moral diversity respectfully and critically

This chapter considers several prominent methods in bioethics and evaluates each according to how well they avoid idealizing assumptions and account for the effects of three kinds of positioning of moral agents: within institutions, along axes of social oppression, and as psychologically and culturally constrained human beings. Feminist naturalized moral epistemology is then presented as an antidote for these idealizing assumptions, and a more substantive version of naturalized bioethics is developed through a re-interpretation of the concept of common morality along naturalist lines. This naturalized common morality invokes three interlocking layers: the common morality as shared ecological predicament, as shared evaluative space of reasons, and as external coherence. Each layer on its own is necessary, but incomplete as a specification of a naturalized and nonideal common morality. The three layers combined provide a comprehensive approach to accounting for the nonidealized positioning mentioned earlier.