Bioethics and Epistemology : A Response to Professor Arrast

Professor Arras' article' provides a fascinating and persuasive account of an important shift in bioethics. The move from theory-based systems of ethics to narrative-based systems of ethics is paralleled by shifts in several related fields. In legal theory, one can see this development in the rise of legal pragmatism and the questioning of abstract and comprehensive theories, whether those theories are rights-based and liberal, radical and Marxist, or economics-based and conservative. This shift is also evident in feminist theory, where there is a growing emphasis on context and a resistance to living within the restrictions of any one brand of feminism, whether it be liberal feminism, radical feminism, or cultural feminism. An important part of this development in feminist theory involves a fundamental change in epistemology. I would like to explore the epistemological implications of the shift from an ethics based on theory to one based on narrative because I believe that at the level of epistemology we can see a tension between the new ethical systems and the underlying assumptions of conventional science. The theory-based ethics that dominated bioethics in the first and second stages of Professor Arras' story were closely tied to a mainstream tradition in epistemology, which I will call Cartesianism. Cartesian epistemology presents a picture of the world in which an external and objective reality is available to individual knowers through the use of their reason, often combined with their sense perception. The knowledge attained is universally true, rather than merely true for a particular person in a particular place and time.2 Breaking this picture down into component pieces, one finds that it involves several important assumptions.' First, reality is objective in the sense that it is independent of human understandings of it. In other words, reality is simply "out there," and its character is unaffected by whether anyone recognizes or understands it. Second, this objective reality is, at least in principle, accessible to human knowledge. This assumption gives rise to the traditionally dominant theory of truth in Western epistemology: the correspondence theory. The correspondence