Think like a copBMJ 2010; 341 doi: https://doi.org/10.1136/bmj.c3702 (Published 21 July 2010) Cite this as: BMJ 2010;341:c3702
- Tom Koch, ethicist and gerontologist1
In promising method in the “madness” of bioethics, Sokol offers “structure” as the preferred course of treatment. Did John steal the stethoscope? Think . . . thief. Did Tracy kill a child when she failed to intubate? Think . . . negligence.1
To think like an ethicist, in other words, think like a cop. Better, think like a lawyer. The only question is whether you are a lawyer for the defence (the hospital) or the prosecution.
In his examples, and his evocation of structural thinking without any thought of ethical values, we see the problem of the bioethics Sokol proposes. It has nothing to do with right and wrong, with what should be done to whom and when, only with the structural analysis of a situation irrespective of content.
This substitution of analytic structure for ethical content has a long history that predates bioethics. It is, for example, the subject of Foucault’s famous “Discipline and punish,” the way matters of justice and morality have given way to questions of procedure.2
What is remarkable, and sad, is that this does indeed encompass much of the bioethics of the past two decades, and Sokol’s allegiance to structure rather than ethical debate over what is right is these days perhaps as good as bioethics gets.
Cite this as: BMJ 2010;341:c3702
Competing interests: None declared.