The American Journal of Bioethics

ISSN: 1526-5161 (Print) 1536-0075 (Online) Journal homepage: http://www.tandfonline.com/loi/uajb20

We Can and Must Rebuild the Bridges ofInterdisciplinary Bioethics
Darryl R. J. Macer
To cite this article: Darryl R. J. Macer (2017) We Can and Must Rebuild the Bridges
of Interdisciplinary Bioethics, The American Journal of Bioethics, 17:9, 1-4, DOI:
10.1080/15265161.2017.1353178
To link to this article: http://dx.doi.org/10.1080/15265161.2017.1353178

Published online: 22 Aug 2017.

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Date: 26 August 2017, At: 20:03

The American Journal of Bioethics, 17(9): 1–4, 2017
Copyright © Taylor & Francis Group, LLC
ISSN: 1526-5161 print / 1536-0075 online
DOI: 10.1080/15265161.2017.1353178

Editorial

We Can and Must Rebuild the Bridges
of Interdisciplinary Bioethics

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Darryl R. J. Macer, American University of Sovereign Nations
Although we can argue that bioethics is holistic and foundin every culture, and still alive among people of many
indigenous communities as well as the postmodern ones,
the academic discipline of bioethics as interpreted bymany scholars has attempted to burn bridges to both different views and to persons with different life trajectories
and training. The bridges between different cultural andepistemological foundations of bioethics have also beenstrained by the dominance of Western paradigms of principlism and the emergence of an academic profession of
medical bioethics.
This editorial reacts to the points made in the article by
Lee (2017), “A Bridge Back to the Future: Public Health
Ethics, Bioethics, and Environmental Ethics.” This issue ofthe American Journal of Bioethics (AJOB) includes a numberof commentaries on this theme, and challenges readers toreconsider the manner in which they conceive of bioethics,
as well as the range of literature and scholars that they consider to as legitimate sources of wisdom. Such a new
approach will not only breathe fresh light into the important work of all scholars, students, and teachers, but alsooffer some fresh references for contemporary policychanges that face us. Let us approach these issues like an
ostrich who is taking her head out of the sand after someyears of monodisciplinary focus. To be clear, Lee and someothers writing here have apparently not had their head in
the sand, as the interrelatedness of health and the environment is clear through the examples shared. What I would
urge readers to do, however, is to go beyond the usual
boundaries of time and space—look through history andglobally and understand bioethics as the love of life, which
can be argued to be prehuman and thus is as old as, orolder than, cultures themselves.
Lisa Lee is correct to point out the problem of compartmentalization of public health ethics, bioethics, and environmental ethics. The academic term “bioethics” wascoined 90 years ago by Fritz Jahr (1927) in his paper “The
Bioethical Responsibilities of Human Beings to Plants andAnimals.” Later authors Lee quoted included Leopold andPotter. We see efforts throughout bioethics scholarship toemphasize the inclusion of other beings into bioethics, but
in the United States almost all bioethics scholars anddepartments focus on medical ethics. Yet the term
“bioethics” has often replaced the former term “medical
ethics.” We cannot simply blame the “bioethicists” for this,however, since often those in the minority field of“environmental ethics” stress to emphasize that it is distinct from bioethics, as they try to mark their own turf.
Lee (2017) writes, “Public health ethics attends to thesebroad commitments reflected in the increasing concern
with the connectedness of health of individuals to thehealth of populations, to the health of animals, to thehealth of the environment; it is well situated to reconnect
all three ‘fields’ of ethics to promote a healthier planet.” I
would argue that all these fields are included for millennia
in the term we warmly use, “bioethics.” I would argue thatall public health issues are bioethics issues, but those in thefield of bioethics often focus on individuals rather thansystems. However, work is needed to build bridges
between all these and other related fields to promote a
holistic understanding and approach to bioethics. Even
more important than the name is the ideology we use, oneof inclusion, and one that includes a comprehensive
understanding that our individuality is a social construct.
We need to ensure that bioethics has a systems approach,be the system an ecosystem or a social system. It also may
be timely to understand that we do not have isolated individuals—such as whoever is reading this article, whether
it be a human being, an enhanced chimera, or artificiallyintelligent system that likes to read editorials of bioethics
journals. Let me illustrate with some examples.
Concepts of social justice were often articulated inancient value systems, as illustrated by interviews with
farmers in the Nile Delta conducted by Eldidi and Corbera(2017). Charitable water wells or fountains (sobol) are
widely established in Egypt, and provide both drinking
and irrigation water. As the farmers found, charity-oriented norms can safeguard water security and livelihood
survival for vulnerable people and enrich the moral economy of a society. Charity is a concept found in all major

Address correspondence to Darryl R. J. Macer, President, American University of Sovereign Nations, PO Box 1701 Sacaton, Gila River
Indian Community, AZ 85147, USA. E-mail: provost@ausn.info

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The American Journal of Bioethics

religions and is a lifesaver for many vulnerable people, justas much today as it was in the past. Often charity was toprovide access to environmental resources.
The same is true in the provision of food, and the topic
of food ethics is explored in the commentary by Thompson(2017). Neither water or food is much mentioned in bioethics, though the Food and Drug Administration (FDA), theU.S. government agency that sets standards for medicines
and also licenses most institutional review boards (IRBs),
actually starts with the F of Food (and Drug Administration). Very few IRBs, however, deal with trials of food! The
right to food, however, is still one of the most critical issuesof practical bioethics today (Macer et al. 2003).
There are challenges in applying historical evidence incontemporary discourse; not least of these are the changing patterns of historical analysis that writers often use to
selectively quote examples that support their present-day
arguments. Although there are important methodologicaldifferences between philosophical discourse and religions,discussion of ethical values is common in religious scriptures. Shaw (2017), an archaeologist, attempts to correctsome common misunderstandings of the link of Buddhism
to environmental ethics through case studies of Buddhist
land and water management in central India, with a lensof human- versus non-human-centric frameworks of wellbeing and suffering, purity and pollution, and broader
Indic medico-ecological epistemologies. We cannot simply
look at religious texts on their own, but rather in the waythat they were applied by societies.
In another example, we could think that Shinto animistic beliefs would have led to human choices to favor thepreservation of nature; however, the history of Japanreveals that forests were converted to agricultural fields,
and more recently to industrial estates and roads, in amanner similar to land development in Europe (Macer
1998). There was no greater general preservation of naturedespite ecocentric belief systems. The limits to environmental pollution imposed by policymakers of the 1960s
onward were put in place because of anthropocentric
health concerns such as Minamata disease. In South Asia
we can see the presence of sacred groves of biodiversity
inspired by Hindu belief systems as an example of environmental preservation for ecological and spiritual reasons(Bosworth et al. 2012).
In Asian bioethics there has been a dialogue for decades on whether the principlism of American textbooks isapplicable to other societies, which may place more value
on harmony, love, relationships, or virtues (Macer 1998).
However, we can see debates over principlism, virtue
ethics, relational ethics, feminist approaches, and so on, in
public health ethics, environmental ethics, and bioethics.
In this issue, Gribble (2017) also illustrates some of thesequalms with his examples of environmental virtue ethics.
In applied ethics there are various principles that we cansee applied to different fields of inquiry. Liu et al. (2011)list the following ethical issues for consideration of water
ethics: human dignity and the right to water, equity, ecosystem requirements, principles of vicinity, frugality,

2 ajobtransaction, multiple and beneficial use of water, mandatory application of quantity and quality measures, compensation and user pays, polluter pays, participation, andequitable and reasonable utilization. Rai et al. (2010) listed
the following principles in their review of the principles ininternational environment treaties: human rights, equity,common but differentiated responsibilities (and capabilities), vulnerability, precaution, sustainable development,
participation, peace, respect for nature, shared responsibility, and a value of biodiversity for its own sake.
Indigenous cultures have also looked at their values
post colonization. Waiya (2017) argues that people
learned the Three Basic Laws firsthand: Limitation,
Moderation, and Compensation. All indigenous cultures
argue that the relationships between each other andnature were articulated in value systems before colonization of the past centuries, and we can see that in thecases where there are written records (Macer 2015). The
fact that there were close relationships of place andspace in nature made the crime of taking lands fromthese people during colonization/invasions, and the failure to return the land to them today, even more unethical. There have been numerous health impacts also
linked to the changes in food, water, and environmental
issues—so all aspects of bioethics, public health andenvironment are intertwined. For example, dependency
on modern Western industrialized food has direct links
to diabetes, obesity, and lower self-esteem.
We can elaborate many examples in life ethics of theneed for an integrated approach. Resnik (2017) in his
commentary mentions the need for this approach when
considering the use of genetically modified insects for disease control. The holistic approach is recognized in thisapproach as seen in the World Health Organization reporton this topic (Macer 2003). There may not be sufficient
linkages made between these policy reports and academic
philosophy. Policy has always been more successfulwhen all evidence and philosophy is included. McLaughlin et al. (2017) also provide a relevant example with theissues associated with cancer registries. As those of us
who worked on ethical, legal, and social implications(ELSI) issues during the 1990s with the Human Genome
Project (HGP) know, the U.S. Department of Energy wasa major proponent of the HGP because only throughwhole-genome sequencing can you pick up mutations
caused by diet and environmental pollution (such asradiation or carcinogens that originate from energy
production.)
This issue of AJOB includes a potpourri of commentaries that explore the theme. Dupras et al. (2017) call for consideration of epigenetics and biopolitics in broadening theapproach of bioethics to include public health and environmental concerns holistically. Shriver et al. (2017) use theterm “environmental neuroethics” as an appropriate term
for us in the Anthropocene, and discuss the impacts of pesticides and lead on our health. This approach is interesting
to link the fields of decision making, mental health, andenvironmental pollution. Beever and Morar (2017) look at

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Public Health Bridge

what is the gap between approaches to bioethics and environmental ethics, and argue that the interconnectedness ofall beings needs to be reemphasized. Bovenkerk et al.
(2017) focus on “One Health” with examples of animal
ethics, and the interrelation between health, environment,
and animals. Annas (2017) brings us back to the legal
importance of human rights, and argues that we cannot behealthy as both individuals and a society unless we recognize that recognition of human rights is essential for
health.
As illustrated in this issue by all authors, there aremany fruitful examples that can and should be used in
education to show the interdependence between healthand the environment. So what should we call this knowledge? One approach to dealing with the disciplinary limitations is to include all terms to hedge all bets; forexample, in the American University of Sovereign
Nations, we established the “Doctoral Program in Bioethics, Sustainability and Global Public Health,” a programon Native American sovereign land. The objectives seem
similar to the arguments made in Lee’s article, with thefact that we seem to include all these fields in the namebecause academics try to divide what needs to be
together. Sodeke and Wilson (2017) in their commentary
promote the term “integrative” bioethics, as a bioethics
that integrates all disciplines and knowledge together.
The term is more familiar to me in integrative environmental sciences, which was developed to include socialand human sciences into the environmental sciences.
Integrative is certainly the epistemology that we need touse to proceed with bioethics.
In conclusion, there is much to do in bioethics and public health, and bridge building through time, space, culture, and discipline is essential to ensure we have solid
research–policy linkages to build our bridges to the future.
This dialogue reaffirms my belief that we do not have any
better term than bioethics because as the love of life it
encompasses all these fields—though most will probably
continue to demarcate ever more specialized fields of thestudy of life. Whether bioethicists will rise to the calling tobe across all disciplines and specialties is another issue,
however.
At a time in the United States when there is significant
political support for an isolationalist view, as seen in thewithdraw of the federal government from the Paris Accord
on combating climate change, we can applaud the local
and state authorities who understand the importance of a
glocal approach (global and local) to bioethics. Througheffective work of bioethicists we can bridge all the artificial
boundaries that stifle the progress of our society, for thesake of all beings, for our dear planet, for our heritage.
Heritage includes the concepts of past, present, and future
in one word. Let us renew our efforts to make informed
decisions so we can all make better choices in all realms oflife. We certainly need to build bridges over troubled
waters—whatever your preference after reading thesearticles, reflect on whether academics seem to complicate
the messages of bioethics (and/or whatever terms we

September, Volume 17, Number 9, 2017prefer). We thank all the scholars and our ancestors forwhat we have been given, and let us promote evidencebased policy as the message of bioethics for empowering
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