In the two main versions of phenomenological bioethics outlined so far, the field is understood either as an integrated part of, or as a critical outside perspective on, principle-based bioethics. Phenomenology can be used either to inform the application of principles or to criticize the contemporary set-up of bioethics and offer alternative approaches. The critical alternatives (namely, offering alternative principles or abandoning the systematic set-up of application altogether) may be more or less radical in nature concerning the way bioethics should be done. It is typical of the phenomenological moral philosophies presented above that they offer meta-ethical – or, perhaps, proto-ethical – approaches rather than a normative theory in the sense of utilitarianism or of liberal rights-based or Kantian ethics. Ethics is pursued not as a development of rules to guide actions, but as a spelling out of the meaning of the good and the just in the first place. Levinas’s philosophy is prototypical in this regard: the face of the other is what informs and gives meaning to human existence, not something that appears subsequent to identifying the other human being (and myself) as persons. In the same way, the radical freedom approach of existentialist ethics is built up as a philosophy of personhood that needs to be developed in order to even formulate the question of what actions are good or just in an institutional framework à la contemporary bioethics. In these regards phenomenological bioethics will be similar to the forms of criticism and alternative ways of doing bioethics found in caring ethics and feminist bioethics (Zeiler and Käll 2014).
We will certainly return to questions of what self- and personhood mean from a phenomenological perspective in the ensuing chapters of this book, since such an exploration opens up a third avenue regarding how phenomenological bioethics could be pursued in comparison and combination with the two I have identified so far. Phenomenological bioethics may be viewed as the task to scrutinize and thicken the philosophical anthropology more or less visibly at work in contemporary bioethics. The concept of personhood in such an analysis will be connected to an understanding of such concepts as embodiment, vulnerability, dignity, and authenticity. To be a person is not only to be a rational agent; it is to be an embodied, cultural creature relying on intersubjective bonds formed through what the phenomenologist calls ‘being-in-the-world’ (Heidegger 1996; Merleau-Ponty 2012). Bioethicists need to deal with the gravitational points and details of this phenomenology of human being in their analyses, and this book is an attempt to present one way in which this could happen (for a similar attempt to bring phenomenology to contemporary moral philosophy, see Hatab 2000).
Phenomenological bioethics pursued via a study of the essential components of human personhood will bring us to the question of what it means to encounter another human being. The medical meeting, as it occurs between doctors and other health-care professionals and patients, is an obvious point of gravity for bioethics. As we have seen in the survey above, the encounter with the other person forms the cornerstone of several phenomenological moral philosophies – not only the one found in Levinas, but also those in Stein and Jonas. In such a phenomenological analysis, more or less hermeneutical prolongations of philosophical anthropology will occur when we strive to articulate the essence and structure of good medical practice (Gadamer 1994, 1996; Ricoeur 1992; Taylor 1991). Empathy and other capabilities (virtues) needed to understand and help the suffering person are the relevant phenomena to explore here (Halpern 2001). The phenomenological perspective opens up possibilities to understand the clinical encounter as a meeting with a suffering person and not only as a scientific investigation of the diseases of his body. In cases that concern the implementation of medical technologies, in addition to the face-to-face encounter, questions regarding reification or even instrumentalization of patients and their bodies will come to the fore. In addition to this, the societal framework of health care and medical research raises issues regarding responsibility and justice that concern the actions of not only physicians but also of politicians and, indeed, of each and every one among us. (p. 14-15)