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Abstract

Phenomenology is a research tradition in German and French philosophy which has had an inﬂuence in many other ﬁelds and disciplines, recently also in medicine and nursing. The main idea of phenomenology is to study the structure and content of lived experience from the ﬁrst-person perspective. This entry provides an overview of different ways in which phenomenology has proved useful as a method and inspiration for bioethics so far and how it could do so in the future. Phenomenological bioethics can be carried out either as an integrated part of, or as a critical perspective on, principle-based bioethics. Phenomenology can be used either to inform the application of principles by way of describing the experiences of moral dilemmas or to criticize the contemporary setup of bioethics and offer alternative approaches. The critical alternatives may be more or less radical in nature: offering alternative principles or abandoning the idea of application altogether. Phenomenological bioethics may also be viewed as an attempt to strengthen and thicken the philosophical anthropology implicitly present in contemporary bioethical studies by focusing on themes such as body, psyche, life, death, authenticity, suffering, vulnerability, empathy, compassion, integrity, dialogue, gift, and responsibility.

Introduction

In what ways is the philosophical tradition of phenomenology able to contribute to bioethics? Phenomenology has been rather absent in the bioethical ﬁeld up to the present date, but some examples of phenomenology are found in the neighboring ﬁelds of philosophy of medicine and medical humanities and in qualitative studies of medical phenomena carried out in disciplines such as nursing, medical psychology, medical sociology, medical anthropology, and science and technology studies. Phenomenology has also had an impact in certain subﬁelds of bioethics, such as caring ethics, narrative ethics, and feminist ethics. These subﬁelds have played important roles as alternatives to the principle-based bioethics that has developed into the mainstream tradition in the ﬁeld. In this entry an overview will be provided of the different ways in which phenomenology could prove useful as a method and philosophical inspiration for bioethics. The possibilities, as will become obvious, are multiple and to a large extent they still remain to be realized.

Phenomenology Of Medicine And Health Care: History And Definitions

Phenomenology is a tradition more than 100 years old, exploring and answering philosophical questions by proceeding from an analysis of lived experience; important classics are philosophers like Edmund Husserl, Martin Heidegger, Maurice Merleau-Ponty, and Jean-Paul Sartre (Moran 2000). The starting point for the phenomenologist is not the world of science but the meaning structures of the everyday world, that which the phenomenologist calls the “life world.” Contemporary phenomenology has branched out into many different disciplines from the tree that started growing in philosophy with Husserl and his successors. Scholars and researchers of art, literature, psychology, sociology, anthropology, pedagogy, history, and recently, also, nursing and medicine have tried to make use of phenomenology in investigating phenomena of concern in their ﬁeld.

The main topic of phenomenology of medicine and health care so far has been bodily experiences – experiences of phenomena such as illness, pain, disability, giving birth, and dying (Toombs 2001; Zeiler and K€all 2014). Everybody has a body – a body which can be the source of great joy but also of great suffering to its bearer – as patients and health-care professionals know more than well. The basic issue that the phenomenologist would insist on in this context is that not only does everybody have a body but everybody is a body. What is the difference?

That every experience is embodied means that the body is a person’s point of view and way of experiencing and understanding the world. Not only can I experience my own body as an object of my experience – when I feel it or touch it or look at it in the mirror – but the body is also that which makes a person’s experiences possible in the ﬁrst place. The body is my place in the world – the place where I am which moves with me – which is also the zero place that makes space and the place of things that I encounter in the world possible. The body, as a rule, does not show itself to us in our experiences; it withdraws and so opens up a focus in which it is possible for things in the world to show up to us in different meaningful ways. When I speak to another person, I am not attending to the way my body feels and moves, but I am focused upon her and the things I am trying to communicate to her; this is made possible, however, by the way my body silently performs in the background. The body already organizes my experiences on a subconscious level; it allows me to experience the things that are not me – the things of the world that show up to my moving, sensing body in different activities through which they attain their place and signiﬁcance (Gallagher 2005).

Thus phenomenology can be understood as transgressing any dualistic picture of a soul living in and directing the ways of the body like some ghost in a machine. The body is me. But phenomenology is also – and this is even more important – fundamentally from its beginnings an anti-naturalistic project; that is, the phenomenologist would also contest any attempt to reduce experience to material processes only. Experience, to the phenomenologist, must be studied by acknowledging its form and content for the one who is having the experience. Experience is always intentional in the sense of presenting something in the world to a subject. It is certainly possible to study experience from the third-person perspective of science also – we could study the ways light rays trigger nerve ﬁrings in my brain by way of the retina when I look at a person right now (if we hook me up to a technological device), but this picture of my brain in action would not be the experience of “me seeing him/her right now.” The picture could catch neither the “me-ness” nor the content of the experience that I am having – this is the ﬁrst-person perspective of intentionality, which the phenomenologist takes as the starting point of the analysis.

Among important medical themes that can proﬁt from a phenomenological analysis, we ﬁnd not only embodiment itself but also related phenomena such as illness, disability, pain, dying, and giving birth (Carel 2008; Svenaeus 2000; Zeiler and K€all 2014). One ﬁnds elements of such analyses in the works of the major phenomenologists, such as Husserl, Heidegger, MerleauPonty, and Sartre, and even more in some less well-known ﬁgures, such as F. J. J. Buytendijk, Hans Jonas, Herbert Plugge, and Erwin Strauss, but the idea of a phenomenology of medicine as a distinct ﬁeld of academic studies is younger than that, maybe 30 years old or so (Toombs 2001). Long before that, however, phenomenology had a certain inﬂuence in one speciﬁc medical speciality, psychiatry, with scholars such as Karl Jaspers.

Phenomenological bioethics can be thought about as the part of the phenomenology of medicine and health care that focuses on ethical dilemmas in addition to and in connection with themes such as the ones just mentioned. Since the major phenomenological philosophers in the process of their explorations of lived experience and the life world of human beings have developed various types of ethical analyses, phenomenological bioethics could also make use of these moral reﬂections in a more direct way (Drummond and Embree 2002). This has, as mentioned above in the introduction, already occurred to some extent in ﬁelds such as caring ethics, feminist ethics, and narrative ethics. The details of phenomenological ethics will be dealt with below.

The ways phenomenological theories have been brought to the domain of bioethics are consequently several, and mostly indirect. Phenomenology has entered bioethics via the philosophy of medicine and medical humanities in studies of themes, such as embodiment, pain, and illness, or via parts of bioethics that go under different names than phenomenology, such as caring ethics, feminist ethics, and narrative ethics. In what follows, an overview will be provided of how the points of connection between phenomenology and bioethics could be systematized and thought about in a global context. The main concern is the question of what it may mean to do bioethics in a phenomenological manner, and the aim is to offer a structure that can encompass many different understandings of phenomenological bioethics by offering a generous interpretation of both concepts. Phenomenology will be considered as a tradition that is related to hermeneutics as well as poststructuralism and such neighboring schools will be included in the overview at certain points. The ways in which phenomenological bioethics is related to older traditions that have inﬂuenced not only phenomenology but also bioethics will be taken into account: mainly as concerns Kantian ethics and Aristotelian virtue ethics.

Phenomenological Bioethics

Different Understandings Of Phenomenology In Medicine And Health Care

Proceeding from the way the term phenomenology has been used in studies in and of medicine and health care, at least three different understandings of the concept might be discerned. These three, more or less established, understandings of phenomenology are helpful in drawing a map of phenomenological bioethics.

The ﬁrst, and probably most dominant, understanding of phenomenology in medicine is to give adequate and detailed descriptions of experiences and situations of importance. A doctor may speak about the “phenomenology of a case,” for instance. This is certainly a correct and important understanding of phenomenology, but as has become obvious from the overview of the phenomenological tradition above, it is insufﬁcient to get hold of the full meaning of the concept. The second understanding of phenomenology, less well-known in medicine, is that phenomenology is a research program in philosophy starting out with Husserl in the early twentieth century and including philosophers such as Heidegger, Merleau-Ponty, and Sartre but also names like Max Scheler, Hans-Georg Gadamer, Karl Jaspers, Paul Ricoeur, Emmanuel Levinas, Hannah Arendt, Michel Foucault, Jacques Derrida, and many others. According to such an understanding, phenomenology is not only a descriptive but also a theoretical and conceptual endeavor. The third understanding of phenomenology common to studies in and of medicine and health care is phenomenology in the sense of a qualitative research method, a method inspired by the philosophical tradition of phenomenology in which the researcher aims to give voice in an unbiased way to the experiences of research subjects. The phenomenological method can be applied in gathering and analyzing empirical materials consisting of interview transcripts, video recordings, ﬁeld notes, diaries, etc. This is a common understanding of phenomenology in nursing research.

The three understandings of phenomenology obviously have a lot in common, and they support each other in offering a more complete account of what phenomenology is about in medicine and health care and, also, in bioethics. The conceptual endeavor is dependent upon having access to adequate and detailed descriptions of the type of lived experiences that are to be investigated, and the empirical research method proceeds from some of the points of departure stressed by Husserl and other phenomenological philosophers from the very start.

To see this more clearly, a practical example will be enlightening: the diagnosis of depression. What does it mean to develop a phenomenology of depression in contrast to other ways of understanding this psychiatric disorder? The phenomenologist will not primarily be interested in the ways the brain works when somebody is depressed. Nor will he take his starting point in cataloging typical symptoms of depressions in contrast to the symptoms of other psychiatric disorders or somatic diseases, the way it is typically done in contemporary diagnostic psychiatry. Instead the phenomenologist will be interested in what Heidegger calls the “being-in-the-world” of the depressed person (Heidegger 1996). What does it feel like to be depressed? How does the world appear to the depressed person and what sorts of thoughts does she have? What does she want to do (or rather not want to do), and how does she communicate and feel related to other persons (or rather not communicate and feel related to other persons)? To investigate these issues thoroughly, the phenomenological researcher needs to talk to depressed (or formerly depressed) people, at least if she is not herself (or has not been) depressed. Through the phenomenological analysis in which the typical structure and meaning of the lived experience of depression should be revealed, the researcher will perhaps come to the conclusion that depression consists in a particular form (or maybe several forms) of suffering in which the autonomy (and possibly also the integrity and authenticity) of the depressed person has become threatened. To be depressed means to live in a world that appears senseless and fearsome and in which the depressed person is losing her bearings and sense of self-worth and self-respect.

Phenomenology And The Application Of Principles

Take notice that already in this sketchily developed phenomenology of depression, some of the central notions in bioethics – suffering (the principles of doing good and avoiding harm) and autonomy (possibly also other principles connected to personhood, such as the duties to respect and enhance integrity or authenticity) – are encountered. In principle-based bioethics, the central notions are phrased in the manner of prima facie principles that are applied in situations that demand better moral understanding because of not being sure what is the right thing to do (Beauchamp and Childress 2013).

Let us say that a depressed person ﬁnds her life so hopeless and horrible that she wants to die. Should her decision be regarded as autonomous, and is she really right about her current situation and prospects in life? Leaving aside the problem of whether euthanasia should ever be allowed, it is obvious that the answers to these questions depend on the understanding we are able to develop of the lived experiences of the depressed person and of other parties engaged in the current situation (family, friends, health-care workers who have been in contact with the depressed person, etc.). To ask the question of whether the depressed person is to be considered autonomous in her wanting to die, and whether the suffering that she experiences can be remedied in some manner by intervening, is most often phrased as an application of the principles to the current situation (other important principles in bioethics besides respecting autonomy, doing good, and avoiding harm are the creeds of justice, empathy, veracity, conﬁdentiality, and ﬁdelity).

In this setup of the practice of bioethics as applying ethical principles to morally problematic situations in order to better understand the situations at hand and ﬁnding out what to do in them, one important role for phenomenological bioethics can be detected. Phenomenological bioethics, according to such an understanding, consists in carrying out investigations of the lived experiences – being-in-the-world – of the persons involved in morally problematic situations in order to better see how the main principles of bioethics will apply. It means very little to say that autonomy should be respected if you have not developed an understanding of a particular person’s situation and self-understanding. Likewise, it means very little to say that a patient should be helped and not harmed if you have not developed an understanding of the more precise ways this particular person (and possibly other people related to her) is suffering.

Phenomenological bioethics in this form will be a close relative to what is known since the 1990s as narrative bioethics (Lindemann Nelson 1997). To provide the phenomenology of an ethically tricky situation in health care means to give voice to the stories of the participants in the drama, throwing light on the experiences and different points of view on the situation and problem at hand. Phenomenology done by way of stories will develop into a hermeneutical undertaking because the embedded character of every lived experience in culturally narrated patterns will lead to questions regarding interpretation. The phenomenological analysis will supplement and strengthen the narrative approach, since phenomenology is proceeding from the embodied lifeworld account which makes out the basis of every narrated life plot in which human life and even personhood itself can take on culturally constructed patterns (Wiggins and Allen 2011).

Phenomenology As A Critique Of Principle-based Bioethics

In the ﬁrst version of phenomenological bioethics delineated above, phenomenology forms part of applicative ethics by providing the careful and adequate descriptions of the terrain in which the ethical principles are to be applied. Phenomenology takes care of one of the balancing scales of what is referred to as a “reﬂective equilibrium,” the side on which our moral intuitions are taken into account (Beauchamp and Childress 2013). Phenomenological bioethics accordingly studies the lived experience of moral conundrums that are then to be determined via application of prima facie principles originating from ethical theories, such as utilitarianism, Kantian ethics, and liberal based rights ethics.

In the process of applying ethical principles, there is a mutual process of explication and illumination going on. To apply the principle of respecting autonomy to the case of the depressed patient makes us see new aspects of the situation, but the phenomenological investigation of the lived experience of being depressed also informs the matter of what it means to be an autonomous person. In this process of balancing the understanding of the case and the principles to be applied to it, phenomenology can take on a more critical role than simply providing the details of the case. Phenomenology may be regarded as an attempt to set up bioethics by way of alternative principles, or in a manner that is not understood as a procedure of application of principles in the ﬁrst place (Welie 1999; Wiggins and Allen 2011).

Inspiration for such endeavors can be found by proceeding from the ethical theories found in classic phenomenologists such as Max Scheler, Emmanuel Levinas, Jean-Paul Sartre, Hans Jonas, Hannah Arendt, and many others (Drummond and Embree 2002). These phenomenological moral theories have different emphases, but they are all united in questioning the ﬁrm distinction between what ought to be done (ethical principles) and what is the case (the situation we are applying the principles to in the moral analysis). In the next section, brief introductions to some major moral philosophers from the phenomenological tradition will be offered.

Some Major Examples Of Phenomenological Moral Philosophers

In the works of Max Scheler, particularly during the 1910s and 1920s, we ﬁnd an attempt to extract norms from the phenomenological analysis itself, what philosophers refer to as “objective value theory.” This is mainly done via an understanding of the feelings we experience in situations in which we encounter other persons and important life goals. Empathy, sympathy, compassion, and love are examples of such feelings, which provide a path to the most important values to be realized in a human life. The concept of personhood is interpreted to involve a hierarchically determined set of values involved in this endeavor of living in an ethically respectable or even excellent manner. The challenge to such a phenomenological framework, as we ﬁnd it in Scheler, is to prove the ethical values to be objective (global) in nature in contrast to just reﬂecting particular sets of culturally established norms. This is a question that is especially pertinent in the framework of global bioethics, in which moral relativism appears as a constant threat. Scheler’s moral philosophy is nevertheless of particular interest to bioethics because of its starting point in strong feelings connected to situations involving suffering, death, empathy, and compassion.

In Emmanuel Levinas, we also ﬁnd a phenomenological ethics that takes its starting point in the interpersonal meeting, spelling out the norms that are at stake there. However, this time the phenomenology of encountering the other person is interpreted as a radical asymmetry in which the “face of the other” forbids me to do any violence to her. This violence potentially done to the other person in the meeting is understood not only as a physical violation but also as an imposing on her of any norms that belong to my point of view rather than the other’s. Levinasian ethics can be understood as an ethics of integrity, defending the rights of the weak and vulnerable, but in essence it rests on a more radical claim that makes me the hostage of every other person I encounter. The critical questions to ask the advocates of a Levinasian ethics are if such an ethics does not put too high demands on the persons who are to exercise it, and if it is not possible that the other person may have some obligations to me in the meetings we enjoy. Nevertheless, the asymmetrical setup of Levinasian ethics appears to ﬁt the obligational structure of health-care meetings between professionals and patients in important ways and is therefore of particular interest to bioethics.

Levinas and Jean-Paul Sartre developed their moral philosophies at roughly the same time: the 1940s and 1950s, which were also the heydays of existentialism. In Sartre the primary ethical concepts are freedom and responsibility. Not an inﬁnite responsibility for the other person – the way things are framed in Levinasian ethics – but an inﬁnite responsibility for my own life and what I choose to do with it (including my interactions with other persons, certainly). The existentialist ethics of freedom appears to resemble autonomy-based approaches to ethics, such as we ﬁnd them in versions inspired by Kantian ethics or liberal ethics. However, Sartre is critical of Kantian philosophy, since he does not believe that any universal moral rules can be philosophically defended – categorical duties like the prohibition of killing or the obligation to always tell the truth. For Sartre what makes a decision ethical is that I aspire to the action in question no matter what public norms and duties may prevail. This looks suspiciously similar to a liberal, autonomy-based ethics – do with your life whatever you ﬁnd ﬁtting as long as you do not interfere with the capability of others to do the same – but it really is not, since Sartre understands every choice to be considered not only as a contingent wish but as an expression of who I really am. Sartrean ethics is an ethics of authenticity rather than an ethics of autonomy. The criticism of existentialist ethics could be voiced in many ways. Are people with different histories and abilities free to realize their potentials to an equal extent? In what manner are the perspectives and situations of other persons taken into account in my endeavor to live authentically?

The ﬁnal question in the previous paragraph is precisely the point of departure for Hans Jonas in The Imperative of Responsibility, a work written in the late 1970s in which he takes on the challenge of how to face the threats of modern technology (including biomedical technologies) to make the planet uninhabitable (1984). Jonas, a former student of both Husserl and Heidegger, claims that we have an overarching ethical responsibility to save and protect the earth for future human generations. This responsibility becomes visible with a special acuteness in certain key situations – like when we welcome and care for a newborn child. Jonas’s work is of special concern for bioethics, since his endeavors to develop a phenomenology of life and death during the 1960s were of interest to the founding fathers of the ﬁeld, and he was probably the ﬁrst phenomenologist to later combine such studies of medical phenomena with the development of an ethics (Jonas 1984). Medical technology is increasingly the topic of various forms of bioethical studies, and Jonas can be considered an inaugurator in this subﬁeld of bioethics.

The most widely read work by Hannah Arendt, friend and colleague of Jonas at the New School in New York for many years, is her philosophical analysis on the “banality of evil” following the 1961 trial in Jerusalem of the Nazi war criminal Adolf Eichmann. Arendt claims that the evilness of Eichmann, who was in charge of transporting millions of Jews to the concentration camps, consists in his inability to reﬂect upon and take responsibility for his own actions. Eichmann pleaded not guilty in the trial (he was found guilty, however, and was executed in 1962) on the grounds of having only performed his duties as a citizen and soldier at the time, and exactly in this inability, or perhaps unwillingness, to understand what he was really doing, we ﬁnd his “banal” evilness, according to Arendt. Such a moral perspective, distinguishing between a philosophically reﬂected way of life and a life in which you think and do as everybody else thinks and does, we ﬁnd also in Sartre and before him in the famous book that inspired both of them: Martin Heidegger’s Being and Time, published in 1927 (Heidegger 1996).

In other works than the Eichmann report, Arendt went on to develop her ideas about a philosophically reﬂected, authentic life into a political philosophy. This political philosophy of Arendt’s is inspired by her readings not only of the phenomenologists, Kant, and Marx but also notably by Aristotle and his idea of a “practical wisdom” central to moral human interaction. In Arendt’s phenomenological ethics, we consequently ﬁnd links not only to Kantian ethics but also to virtue ethics – a tradition that has been voiced as a complement to principle-based bioethics from the very start (Pellegrino and Thomasma 1993).

The most inﬂuential ﬁgure in bioethics descending from the tradition of phenomenology is without doubt Michel Foucault. Foucault did not name himself a phenomenologist, and in many ways he rebelled against the Husserlian tradition of phenomenology in France (Sartre, Merleau-Ponty), but he belongs nevertheless to the twentieth century continental tradition of philosophy of which phenomenology forms the backbone.

The Foucauldian idea that has been most inﬂuential in bioethics – and in what in Foucault’s legacy is named “biopolitics” – is that our thinking and our actions in the modern age are governed by oppressive norms that make what is natural, good, and just appear to us in a certain unquestioned manner (Mills 2010). Such norms, which he named “technologies of power,” govern the way we handle questions of health, sexuality, productivity, etc. In a Foucauldian analysis, the set of principles applied by bioethicists would form an important part of the contemporary prevailing power technologies used to keep the population under control. The principles thus need to be critically scrutinized from a historical and cultural perspective rather than uncritically applied, if bioethics is to prove to be a liberating endeavor.

Phenomenological Bioethics As Philosophical Anthropology

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 setup of bioethics and offer alternative approaches. The critical alternatives may be more or less radical in nature concerning the way bioethics should be done: offering alternative principles or abandoning the systematic setup of application altogether. It is typical of the phenomenological moral philosophies presented above that they rather offer metaethical, or, perhaps, proto-ethical approaches than a normative theory in the sense of utilitarianism or liberal rights-based or Kantian ethics. Ethics is not pursued 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 questions of what actions are good or just in an institutional framework á 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 K€all 2014).

The discussion about what type of perspective phenomenology is able to offer opens up a third avenue regarding how phenomenological bioethics could be pursued. The ﬁeld may be viewed as an opportunity to strengthen and thicken the philosophical anthropology more or less visibly present in contemporary bioethics. The concept of personhood in such an analysis is connected to an understanding of concepts such as body, psyche, life, death, authenticity, suffering, vulnerability, empathy, compassion, integrity, dialogue, gift, and responsibility (this list is not exhaustive but it includes some of the most important concepts).

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). Bioethicists need to deal with the gravitational points and details of this phenomenology of human being in their analyses.

Rather than abandoning the idea of a reﬂective equilibrium, this third understanding of phenomenological bioethics could be viewed as a needy contributor to what is called a “wide” reﬂective equilibrium (Beauchamp and Childress 2013). As developed above, the main idea of a more narrow reﬂective equilibrium is that the moral principles should be brought into equilibrium with (be balanced by and cohere with) the moral intuitions that we ﬁrst have when confronted with the situation under ethical analysis. To judge the situation from an ethical point of view will mean going back and forth between moral intuitions and moral principles, letting them mutually enlighten each other. By way of this procedure, one reaches a more complete picture of what is at stake and, ideally, also a wise judgment about what to do in the situation, a judgment that is philosophically informed but still close to the situation at hand by engaging with it emotionally in a considered sense.

This version of reﬂective equilibrium in bioethics might be too narrow, however, since the scrutiny of intuitions and principles will soon bring the bioethicist to more detailed theoretical considerations regarding the meaning of concepts that are brought up in the analysis. In the methodological version referred to as a “wide reﬂective equilibrium,” these theoretical considerations are explicitly brought into the analysis. This is achieved not only by taking into consideration full-blown ethical theories from which principles are derived but also theories concerning different aspects of what it means to be human, including philosophical anthropology, developmental and social psychology, sociology, and political theory. As developed above with the example of the depressed patient, such considerations will appear in the ethical analysis directly or indirectly as soon as one starts describing the situation to be dealt with and the way persons think and feel about it.

A phenomenological version of philosophical anthropology will concern not only the meaning of personhood and autonomy but also various aspects of human suffering and the intersubjective aspects of being-in-the-world related to empathy and justice. It could play a fundamental role in a clinical ethics, spelling out the structure of the encounters between patients and health-care professionals, but it could also be used to analyze the borderline situations of human life (coming into existence and dying) as well as various technological practices of contemporary biomedicine. Philosophical anthropology is, indeed, a core part of every type of ethical analysis, whether the moral philosopher acknowledges this to be the case or not, and the phenomenological tradition is a rich source in doing that type of reﬂective, considered moral analysis. In bioethics this means not only to tell rich and adequate stories about ethical dilemmas but also to provide a conceptual structure in which the well-known prima facie principles can be anchored or critically transformed in a sustained way.

Conclusion

Phenomenology has been brought to the domain of bioethics in several, and mostly indirect, ways. Phenomenology has entered bioethics via the philosophy of medicine and medical humanities in studies of themes such as embodiment, pain, and illness or via parts of bioethics that go under names such as caring ethics, feminist ethics, and narrative ethics. In this entry an attempt has been made to tell this history and to systematize three ways in which to think about phenomenological bioethics in the future.

Phenomenological bioethics can be carried out 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 by way of describing the lived experiences of moral dilemmas or to criticize the contemporary setup of bioethics and offer alternative approaches. The critical alternatives may be more or less radical in nature as concerns the way bioethics should be done: offering alternative principles or abandoning the systematic setup of application altogether. It is typical of moral philosophers in the phenomenological tradition that they offer metaethical approaches rather than normative theories in their own right. Ethics in the phenomenological tradition has not been pursued as a development of rules to guide human actions but as a spelling out of the meaning of the good and the just in the ﬁrst place.

The discussion about what type of perspective phenomenology is able to offer opens up a third alternative regarding the characterization of phenomenological bioethics in addition to the two approaches just mentioned. The ﬁeld may be viewed as an opportunity to scrutinize and thicken the philosophical anthropology implicitly present in contemporary bioethics. The concept of personhood in such an analysis is connected to an understanding of concepts such as body, psyche, life, death, authenticity, suffering, vulnerability, empathy, compassion, integrity, dialogue, gift, and responsibility, to mention some of the most important ones. Some of these concepts deal not only with the essence of human being, e.g., embodiment, but also with the normative nature of encounters between human beings, e.g., compassion, and they are therefore normatively saturated in a very obvious sense.

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