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This essay explores ontological issues that lie at the foundations of bioethics. Throughout, I draw on H. Tristram Engelhardt, Jr.'s philosophical analysis to demonstrate why even in principle to talk about the possibility of a canonical morality to guide medical practice or to frame health care policy requires at least the equivalent of a God's-eye perspective, not out of religious but out of epistemic considerations. I argue that one must invoke God, or at least a God's-eye perspective, to preserve the unity and force of reality and morality. Since nothing in particular follows from general concepts of the right, the good, the just, or the virtuous without such a canonical perspective, morality and truth become plural. As a result, without God, or a God's-eye perspective, to secure moral content, all claims to moral truth are demoralized, reduced to socially and historically conditioned judgments, culturally relative virtues, personal intuitions, and particular political ideological commitments. Moreover, there is no definitive reason to choose any one particular moral perspective from among the various competing moral theories or sets of moral intuitions to guide medical decision-making. As a consequence, I argue that rather than providing an authoritative bioethics to guide medicine and frame public policy, secular bioethicists routinely create their own idiosyncratic criteria for veracity, rationality, and reliability, as well as rationalizations for ideologically driven political advocacy.

DOI: 10.1007/978-3-319-18965-9_9

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