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Duncan Wilson

The international growth and influence of bioethics has led some to identify it as a decisive shift in the location and exercise of 'biopower'. This book provides an in-depth study of how philosophers, lawyers and other 'outsiders' came to play a major role in discussing and helping to regulate issues that used to be left to doctors and scientists. It discusses how club regulation stemmed not only from the professionalising tactics of doctors and scientists, but was compounded by the 'hands-off' approach of politicians and professionals in fields such as law, philosophy and theology. The book outlines how theologians such as Ian Ramsey argued that 'transdisciplinary groups' were needed to meet the challenges posed by secular and increasingly pluralistic societies. It also examines their links with influential figures in the early history of American bioethics. The book centres on the work of the academic lawyer Ian Kennedy, who was the most high-profile advocate of the approach he explicitly termed 'bioethics'. It shows how Mary Warnock echoed governmental calls for external oversight. Many clinicians and researchers supported her calls for a 'monitoring body' to scrutinise in vitro fertilisation and embryo research. The growth of bioethics in British universities occurred in the 1980s and 1990s with the emergence of dedicated centres for bioethics. The book details how some senior doctors and bioethicists led calls for a politically-funded national bioethics committee during the 1980s. It details how recent debates on assisted dying highlight the authority and influence of British bioethicists.

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Consolidating the ‘ethics industry’

A national ethics committee and bioethics during the 1990s

Duncan Wilson

6 Consolidating the ‘ethics industry’: a national ethics committee and bioethics during the 1990s During the 1980s many of the individuals who were pivotal to the making of British bioethics sought to establish what the British Medical Journal identified as a ‘national bioethics committee’.1 Ian Kennedy, for one, regularly called for a politically funded committee based on the American President’s Commission, and his proposals were often endorsed by newspapers and other bioethicists. They were also endorsed by senior figures at the BMA, who believed a national

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Duncan Wilson

Introduction What is bioethics? Recent decades have witnessed profound shifts in the politics of medicine and the biological sciences, in which members of several professions now consider issues that were traditionally the preserve of doctors and scientists. In government committees and organisations such as the General Medical Council, professional conduct is determined by a diverse group of participants that includes philosophers, lawyers, theologians, social scientists, doctors, scientists, healthcare managers and representatives from patient or pressure

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‘Who’s for bioethics?’

Ian Kennedy, oversight and accountability in the 1980s

Duncan Wilson

”’.110 In the book chapter based on his sixth Reith lecture, Kennedy 120 The making of British bioethics argued that support for outside involvement was growing and that paternalistic attitudes were ‘clearly out of line with the political tenor of the day’. ‘Consumerism is with us’, he stated, and ‘the doctor has the choices only of accepting it willingly and cooperating, or of accepting it unwillingly.’111 But Kennedy had to rely mainly on American examples to support this claim, including the ‘series of ethics committees’ that included a majority of nondoctors

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‘A service to the community as a whole’

The emergence of bioethics in British universities

Duncan Wilson

use budget cuts to ‘downgrade the arts’.78 In a newsletter, the Society for Applied Philosophy outlined how the UGC had warned that fields such as philosophy ‘will be receiving low priority in its deliberations in the coming years’, and reported that they had advised philosophers to set up a review to ‘assist in the closing of some departments’.79 In 1985 philosophers formed a committee to defend their subject 198 The making of British bioethics against UGC cuts. This National Committee for Philosophy (NCP) submitted a report to the UGC arguing that cuts to

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‘Where to draw the line?’

Mary Warnock, embryos and moral expertise

Duncan Wilson

’s involvement with IVF highlights the British emergence of what Jasanoff calls ‘official bioethics’, in which philosophers, lawyers and others serve on ­government committees and assist in policymaking.1 Once appointed, Warnock became a vocal supporter of external oversight. In language reminiscent of Conservative politicians and Ian Kennedy, she regularly argued that the public were ‘entitled to know, and even to control’ professional practices.2 Like Kennedy, she also claimed that this would benefit researchers by safeguarding them from declining public and political trust

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Duncan Wilson

Conclusion While she became associated with British bioethics following her engagement with IVF and embryo research in the 1980s, Mary Warnock is better known today for her views on euthanasia.1 Warnock first engaged with this issue in 1993, when she was appointed to a House of Lords Select Committee that investigated whether there were circumstances in which ‘assisted dying’ might be permissible, when a doctor would not be prosecuted for ending a patient’s life or helping them end their own lives. After deliberating for a year, Warnock and her fellow committee

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Duncan Wilson

, his profession, and the local ethical committee which has to approve any line of research’.172 The report also echoed Edwards’s publications when it claimed there was ‘no 88 The making of British bioethics objection’ to the development of IVF, provided that it was used by married couples and ‘that only the husband’s sperm will be used for fertilization of the ova removed from the wife’s ovaries’.173 Members of a CIBA symposium on reproductive medicine, which included Edwards and Steptoe, reached similar conclusions when they agreed that IVF posed fewer ethical

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Ethics ‘by and for professions’

The origins and endurance of club regulation

Duncan Wilson

influential. In 1883 the government decided the AAMR should review all licence applications before they were passed to the Home Office, which led to a significant increase in licence approvals.57 Professional control over animal experiments increased further after 1913, when a second Royal Commission, now weighted in favour of scientists, recommended that a new advisory body should consider licence applications. Members of this Home Office advisory committee were selected by the Home Secretary from a list of names submitted by 32 The making of British bioethics solely

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Paul Greenough, Stuart Blume and Christine Holmberg

health authorities whenever they institute arbitrary programmes of surveillance and compulsion. 38 If in the classic liberal framework, bioethics favours autonomy and individual choice, proponents of the new sub-discipline of ‘public health ethics’ argue for the priorities and perspectives of collectives and communities. 39 Public health ethics argues, for example, that high levels of vaccination coverage (‘herd immunity’) serve the collective