Kyle Edwards: Methods of Legitimation: How Ethics Committees Decide Which Reasons Count (Podcast)

The most recent St. Cross Ethics Seminar took place on February 28th, 2013. Kyle Edwards, who is currently a DPhil Candidate at Oxford, led it. Her informative and compelling presentation was entitled “Methods of Legitimation: How Ethics Committees Decide Which Reasons Count.”

(A podcast of the seminar is located here: http://media.philosophy.ox.ac.uk/uehiro/HT13STX_KE.mp3)

Edwards began her presentation by outlining two distinct but related sets of questions that are of interest to her. The first set of questions is empirical. How do ethics committees actually reason about what they ought to do? Which reasons do they take seriously in their deliberations? The second set is normative. How ought such committees to reason about what to do? Which reasons ought they to consider salient to their thinking?

The majority of Edwards’s presentation was devoted to answering the first, empirical set of questions. Both these and the second, normative set of questions have taken on new importance in light of increased public participation in policymaking and the rise of bioethicists who comment on and seek to influence policy. There is in general, Edwards notes, a proliferation of people believing themselves to be experts in ethics, making the felt need for her research palpable.

In answering the empirical questions, Edwards drew on the research she conducted on the reasoning processes exhibited by the ethics committees found in two bodies who are responsible for regulating Assisted Reproductive Technology, namely, the United Kingdom’s Human Fertilization and Embryology Authority (HFEA), a statutory body regulating the use of gametes and embryos in research and in fertility treatment, and America’s American Society for Reproductive Medicine (ASRM), a self-regulating body that aims to promote high standards in and sound non-binding guidelines for reproductive science.

In her research, Edwards found that the HFEA emphasized and relied on moral considerations that were distinct from those accepted by the ASRM.

The members of the HFEA’s ethics committee that Edwards interviewed were concerned with the idea of balancing and weighing rival ethical considerations. Edwards found that in their reasoning the HFEA’s ethics committee achieved this by relying exclusively on the notions of welfare and health. They took these to be paramount. They took a dim view of arguments that appealed to what is natural or unnatural. This came out clearly in their reasoning about the ethics of saviour siblings.

Edwards pointed out two difficulties with this approach. First, focusing only on health and welfare concerns was inconsistent with the purpose of the HFEA’s ethics committee, which is to consider a broad range of ethical considerations. Second, the exclusive focus on health and welfare led the HFEA’s ethics committee to ignore other moral considerations that might be relevant to their reasoning.

The members of the ASRM’s ethics committee that Edwards interviewed were less concerned with balancing. Instead, the value on which they focused was autonomy. The members of the ASRM’s ethics committee aimed to arrive at policy that would promote letting people make their own decisions about reproductive matters. The ASRM then employed marketing language to determine to what extent the public would accept their proposals; it did not try to actively engage the public in the search for some kind of support.

The difficulty with this, Edwards argues, is that it led the ASRM ethics committee to ignore the other reasons that might be relevant to the regulation of ARTs. In addition, in its deliberations the ARSM often placed more emphasis on what would help sell a policy to the public than on important ethical considerations. This happened in the case of unlimited sperm donation. The ASRM ethics committee felt there was no problem with it. But the public did: many members of the public worried about incest, a worry that was not shared by the ASRM. The compromise position was a limit of ten families per sperm donor. This conflict occurred because of the exclusive focus on autonomy.

A helpful question period followed the talk. One important question concerned what accounted for the differences between the HFEA and ASRM. Was it the case, as Edwards suggested, that the two bodies differed only on what reasons they thought mattered? Or, did they differ in addition on the method by which they arrived at the reasons they accepted? It is possible after all that they had similar methods but that contingent factors (e.g., social milieu) influenced which reasons this method delivered.

Another question concerned Edward’s criticism of HFEA. In their deliberations they seemed to take a dim view of appeals to what is natural or unnatural. Edwards was critical of this. However, this seems right. It is very difficult to say what is natural and what is not. True, the HFEA should, it seems, consider such views, which may be widespread, but in the absence of sufficient content this is hard to do. After all, we tend to accept a lot of things that are strictly speaking unnatural. Edwards is on firmer ground with her worry that in focusing exclusively on health and welfare, the HFEA ethics committee overlooks other, important ethical considerations. However, it is far from clear that these cannot be captured by broad accounts of welfare and health, notions that are uniquely positioned to facilitate balancing and other forms of moral reasoning.

Edward’s ambition in the future is to transition from focusing on the empirical questions at issue in her presentation to the normative questions mentioned at the outset. The relation between these two sets of questions is not exactly clear at the moment. However, whatever it turns out to be the research Edwards plans to conduct promises to shed much-needed light on it.

(Thanks to Kyle Edwards for helpful comments on a previous draft of this post.)

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