Bioethics and Wicked Problems

I have been associated with CBEC as visiting faculty for the better part of a decade and have taught cohorts in the Master’s and Post-graduate diploma programs. My focus has been introducing students to approaches to religious ethics, the history of the academic study of religion in the Western academy, and theorizing how the dimensions of our lives we might label “religious” or “religion” are entangled with the rest of our lives.

I was honored to be invited to the 20th anniversary of CBEC in January 2025 as one of the presenters at the event. My presentation drew on the history of medical applications of mesmeric trances in India in the 19th century and the hopes pinned on spiritual telegraphy in the US in the same century for elucidating an important distinction between two different ways of thinking about bioethical problems. What I want to share with us in this brief essay are the contours of that distinction and the implications it has for how we might think about bioethics as a “problem-solving” discipline or area of inquiry.

On the one hand, it is possible to conceive bioethics as a discipline that conceptualizes and resolves problems of a “tame,” finite, specifiable, and resolvable nature. The term “tame problems” was coined by Rittel and Webber in 1973 to designate problems where “the mission is clear.”¹ These are problems that can be clearly formulated, about which you can suggest finitely specifiable pathways of resolution, and you are sure when the problem’s been “solved.” Webber and Rittel provide the example of a game of chess as a tame problem. You can specify the rules of the game, you can unambiguously identify when a game has been won or lost, and, in some sense, each chess game is isolatable from other chess games or non-chess games. As they put it: “Chess has a finite set of rules, accounting for all situations that can occur.”²

If bioethics were to be conceived as a response to a set of tame problems, then it stands to reason that the essential task of bioethics is providing a set of frameworks and approaches that can offer pathways, rules, and guidelines, via which the bioethical equivalents of a game of chess, or mathematical problems, are conceptualized and resolved. My contention is that approaches such as Fitz Jahr’s – one of the early “founders” and architects of bioethics – engage in this sort of theorization when they offer Kant-inspired “bioethical imperatives” as frameworks for resolving bioethical problems.

In his commentary on Jahr’s bioethical imperative, Hans-Martin Sass notes: “The Bioethical Imperative is a necessary result of moral reasoning based on empirical physiology and psychology of humans, plants, and animals; as such it needs to educate and steward personal and collective cultural and moral attitudes and calls for new respect and responsibilities toward all forms of life.”³

Similarly, Beauchamp and Childress use the phrase “the common morality” to refer to “the set of universal norms shared by all persons committed to morality…It is not merely a morality, in contrast to other moralities. The common morality is applicable to all persons in all places, and we rightly judge all human conduct by its standards.”⁴ What I want to point out is that such principles are appropriate to bioethics, if bioethics is conceived as a way to address tame problems.

On the other hand, if bioethical problems are not clearly specifiable in the way that a game of football, cricket, or chess might be specified, and they are more akin to what Rittel and Webber call “wicked problems,” then, perhaps the way to go about them is not to come up with an exhaustive approach or a set of frameworks. Rittel and Webber attribute ten characteristics to wicked problems in order to distinguish them from tame ones. Unlike tame problems, wicked problems resist finite formulation and there are no clearly specifiable criteria through which one can conclude that a problem has been “resolved.” Wicked problems are “radical,” in  that,  they  require  us  to  figure  out  how  one  might live-well-with-a-problem rather than eradicate or resolve it and imagine a world without it. They may be thought of as “existential problems” that one has to negotiate and figure out as a matter of course, rather than address at a particular point in time.

While Webber and Rittel draw on social policy-related problems to make their case, their framework can be employed to make sense of problems that one has to “cope with,” “resist,” “palliate” rather than overcome, eliminate, and cure. If we are to think of bioethics as a discipline that theorizes and conceptualizes wicked problems, then its claims should sound less like clearly articulated principles, pathways, and guidelines, and more like Richard Rorty’s claims about philosophy.

Rorty notes that the quest for arriving at a programmatic “method” or a set of “principles” that will clarify the nature of the problems that vex us is wishful thinking: “It is useless to hope that objects will constrain us to believe the truth about them, if only they are approached with an unclouded mental eye, or a rigorous method, or a perspicuous language.”⁵  For Rorty, the only recourse available to us in the face of “wicked problems” – think climate change, justice, distribution of material  resources,  living  with  a  chronic disease – is “conversation”: “Our conversation with our fellow-humans [is] our only source of guidance. To attempt to evade this contingency is to hope to become a properly-programmed machine.”⁶

In the face of intractable problems, Rorty suggests that we count and rely on “our loyalty to other human beings clinging together against the dark, not our hope of getting things right… Our glory is in our participation in fallible and transitory human projects, not in our obedience to permanent non-human constraints.”⁷

To my mind, Rorty’s claims against the search for procedural fixes to intractable problems offer two important insights. First, the search for procedure and method as our “savior” can be a symptom of our desire to evade the responsibility of constructing a fallible course of action and to, instead, posit an undeniable “principle,” a “non-human” constraint as the source of our actions. Our search for such principles may belie  our  desire  to  evade  the  messiness  of  human construction in the hopes  of becoming a “properly -programmed machine.”

Secondly, and perhaps more importantly, conceiving our ethical task as the construction of principles, procedures, and rules, is a way of preventing our thinking from becoming capacious, expansive, and political. It carries the risk of directing our intellectual labor to the construction of “scripts” and “cogs” that work within bureaucratic and professional settings, which we have to take as “givens,” as non-negotiable parameters within which our principles, rules, and procedures have to find their place.

I can do no better than cite Rihito Kimura’s hopes about bioethics as more than a set of procedures for resolving tame problems. He noted in 1986: “Bioethics is a totally new form of discipline which goes beyond the notion of interdisciplinary studies: it is suprainterdisciplinary; it is deprofessionalizing medicine; it is a civil action movement.”⁸ To my mind, too, the degree to which bioethics is a discipline that addresses wicked problems, it ought to be akin to Rorty’s claims and Kimura’s rallying cry.

References:
¹ Horst W. J. Rittel and Melvin M. Webber, “Dilemmas in a General Theory of Planning,” Policy Sciences 4, no. 2 (1973): 160.
² Ibid., 164
³ Hans-Martin Sass, “Fritz Jahr’s 1927 Concept of Bioethics,” Kennedy Institute of Ethics Journal 17, no. 4 (2007): 283. Emphasis added.
⁴ Tom L. Beauchamp and James F. Childress, Principles of Biomedical Ethics (New York : Oxford University Press, 2013), 3.
⁵ Richard Rorty, “Pragmatism, Relativism, and Irrationalism,” Proceedings and Addresses of the American Philosophical Association 53, no. 6 (1980): 726.
⁶ Ibid.
⁷ Ibid., 727.
⁸ Quoted in Sass, “Fritz Jahr’s 1927 Concept of Bioethics,” 291.