A normative framework of public bioethical discourse 2

Chapter One: Setting the Context: Public Policy Debates in Singapore Overview of Thesis This thesis aims to answer a single fundamental question, viz.: “How should we conceive of bioethical debate in the public arena?” In particular, what is the aim or purpose of such discourse? Is there a manner in which it should be conducted? Are there rules of engagement which ought to be adhered to? While the focus is on public debate in Singapore, it will become apparent that our discussion throws up issues, considerations and potential solutions that are pertinent, and even generalizable, to other countries and cultures grappling with concerns about the nature of public justification and the democratic legitimacy of public policy. Hence, any secular, pluralistic and multicultural democracy will face some version of the issues that will be addressed here. Public discourse is necessary in order to garner diverse views and feedback which ultimately influence the crafting of laws and policies that citizens are subsequently bound to. To the extent that such laws are coercive and restrict one’s liberty, or allow for some actions while prohibiting others, public justification is needed to determine why this should be so. Many bioethical debates are of this kind, for example, whether to allow for living organ donations, physician-assisted suicide, abortion, payment for egg donation or stem cell research. Liberty, however, does not have to be the main value undergirding the public justification of policies. Oftentimes, public policy deliberations have to with considering why we ought to proceed in a particular manner, and this may involve the prioritizing of a complex array of values and concerns. But even in such cases, public discourse is needed. The question is how such discourse should proceed. There are six chapters to this thesis. Firstly, in this chapter, I set the context of public policy debates on complex matters of morality as they have occurred in Singapore. Through an analysis of debates in the local media, an outline of a consensus position is given on proper discourse conduct. This aspect of the thesis is mainly interpretive and descriptive, although some critical analysis is also given. In particular, we begin with debates about the place of religion in public discourse because the larger issue of the public justification of policy emerged precisely because of this engagement with religion. Commentators have, however, argued for a deeper, more nuanced understanding of public discourse, and have advanced several proposals for moving the public justification debate forward. After noting some of these proposals, I devote the next three chapters to critically examining three different models of public justification as elaborated on by Robert Audi, John Rawls and Jürgen Habermas, and show their relevance and significance for bioethical debate. My critique of these authors will lead us to a revised normative conception of public discourse which incorporates various elements of their work, while also emphasizing the importance of cultivating appropriate character-based discourse virtues central to ethical literacy, rationality and reflective equilibrium. These authors were picked not only because of their importance in the philosophical literature but also because they have been explicitly mentioned in debates in the local media or, in the case of Habermas, represent lines of thinking that have recently emerged and which have been given greater prominence. Chapter Five will examine the notion of whether it is possible to base bioethical decisions on the “better” argument, and if so what this might look like. Hence, the state of play of public policy debates in Singapore sets the context of my thesis. The significance of my thesis will then lie in the various recommendations for moving public deliberation forward. I will argue that a revised normative conception of public bioethical debate has important implications for civic engagement and education. In particular, I want to examine, in the final chapter, some of the work by the Singapore Bioethics Advisory Committee (BAC), and consider how well they have aligned their arguments and recommendations to our considered judgments about public justification. Such an approach to evaluating bioethical discourse in Singapore has, as far as I know, not been attempted. I will then conclude by briefly noting the implications that my thesis has for education, and for a richer conception of ethical literacy. Religious Discourse and Public Debate The question of how complex matters of morality should be debated in the public sphere has been gaining importance in Singapore in recent years. The more heated debates reported in the press have involved concerns over the decriminalization of homosexual acts, whether to allow casinos to be built in Singapore and the role of religious groups in civic society, as reflected in the take-over of women’s group AWARE by a group of Christians in 2009. However, there has also been debate over the ethics of organ donation, end of life care (including euthanasia), stem cell research, abortion and research on human-animal combinations, amongst other bioethics topics, though at varying degrees of intensity. These debates show that citizens, aided and abetted by the various arguments and positions forwarded by journalists, academics, doctors, politicians and other stakeholders, have been increasingly forced to grapple with the idea and complexities of the public justification of laws and policies. Public justification is needed because there are different ways of arriving at moral decisions, which are based on different conceptions of “the good life”. Pluralistic societies like Singapore thus have to decide on a model of public deliberation and decision-making that can be deemed acceptable, and which can lead to legitimate policy outcomes. For instance, on what basis or grounds should decisions about the moral permissibility of physician-assisted suicide or stem cell research be based? Should reasons grounded in one’s own religion be excluded from public debate? This last question is especially pertinent in Singapore, where 83% of the population professes a faith.1 Religious influences have also never been far away from public bioethical debate. Hence, Ho, Capps & Voo note that public feedback garnered from individuals in preparation for the BAC’s Stem Cell Report in 2002 and Egg Donation Report in 2008 reflected mainly religious views.2 Journalists Chang & Tan, who surveyed public reaction over a decade from 2001, observed that BAC topics that drew the most public feedback either affected people personally or else had implications for their religious views.3 It is thus not surprising that various meta-level discussions have taken place, questioning the role that religion can or should play in public policy debates. In particular, questions have been raised about how this role should be played out and Department of Statistics Singapore. 2010. Singapore Census of Population 2010: Statistical Release 1: Demographic Characteristics, Education, Language and Religion. Singapore: Singapore Department of Statistics. W.C. Ho, B. Capps & T.C. Voo. Stem Cell Science and its Public: The Case of Singapore. East Asian Science, Technology and Society: An International Journal 2010; 4(1): 7-29: 9. A.L. Chang & J. Tan. 2010. Engaging the Public: The Role of the Media. In Bioethics in Singapore: The Ethical Microcosm. J.M. Elliott, W.C. Ho & S. Lim, eds. World Scientific Publishing Company: 51-70: 63. what kind of limits, if any, should be placed on religious speech in the public arena.4 Hence, rather than focusing on a first-order analysis of bioethical issues, this chapter will limit itself to a second-order analysis of the way public ethical debate has proceeded in Singapore, and include views on how it ought to proceed. The result of this analysis can contribute to reflections on how actual bioethical debates should be conducted whenever they involve religious inputs into policy discussions in the public sphere. The following are some examples of views and feedback given in the media against the role of religion in public discourse:5 “…a Straits Times reader disagreeing with Prof Thio's argument wrote in to this newspaper, stating: 'Religion-based arguments have no place in public debates about policies. Only logic and reason should dominate discourse in the public sphere.’ ”6 Speech may be regarded as being “religious” for various reasons, for example, because of its source or content, such as appeal to a holy book or tradition, to the authority of God or to a particular interpretation of God and his will or commandments, or even when it refers to something spiritual. However, in the context of civically virtuous public debate, all such religious speech, regardless of its source or content, will need to be expressed in secular terms, as will be elaborated on in Chapter Two, and be open to the prospect of moral deliberation. I will limit my analysis to how the debate has been carried out in the English language media. One reason for this is because English is the common language of Singapore. The main Englishlanguage newspaper, The Straits Times, also has a readership of 1.4 million, and in combination with other English-language newspapers, would account for a large proportion of readers from the million people in Singapore. However, considering the fact that the major Mandarin, Malay and Tamil newspapers (like most of the major English-language newspapers) are all published by the Singapore Press Holdings, one can perhaps expect a certain uniformity of presentation and reporting on the relevant issues. See: H.H. Chua. 2009. The Straits Times maintains its lead; Nielsen survey also shows its online site increasing its reach. The Straits Times. 23 October. X.Y. Hong. 2009. Religion's Gathering Pace: Far from Receding, It Has Risen with Modernity as an Ever-Present Force. The Straits Times. 27 June. “…Prof Thio's… understanding of pluralism and secularism… derives from the American religious right. It is they who insist pluralism cannot ultimately be plural; it is they who demand public policy be informed by religious beliefs.”7 There have also been voices in favour of giving religion a role in public debate: “If religion is taken to be synonymous with morals, then morality should also be allowed to guide an argument.”8 Catholic priest William Goh said: 'When policies affect the moral life and basic rights of the people, the Church has a duty to speak on their behalf and stand up for what is morally right and just.’9 “Religiously motivated individuals are welcome to contribute to secular society. But the actions of individuals motivated by religious beliefs should not impose on the private and public space of others who not share those beliefs…. Religious expression is allowed, but not religious imposition.”10 In the context of multireligious, multicultural but secular Singapore, advances have been made in the public understanding of the place of religion in public discourse, where such understanding was previously unclear. Indeed, a kind of consensus position could be discerned as the media debate continued to progress. J. Devan. 2007. 377A Debate and the Rewriting of Pluralism. The Straits Times. 27 October. Hong. op. cit. note 6. Review-Insight. 2006. Can Politics and Religion be Separate? The Straits Times. 19 August. 10 A. Wong. 2009. Any Intrusion by Religion into Secular Space is Alarming. The Straits Times Forum.30 May. Consensus Position in Singapore It has been argued that there are two forms of secularism: “thick, militant secularism” and “thin, agnostic secularism”.11 The former is anti-religious and proscribes the encroachment of religious sentiments in the public space. The latter is neutral about religion as such, and so allows for the use of religious arguments in public debate.12 This latter approach defines one aspect of Singapore-style secularism (SSS). Indeed, in affirming that religious convictions ought to play a part in civic discourse, the 1989 White Paper on the Maintenance of Religious Harmony Act states that: “It is neither possible nor desirable to compartmentalise completely the minds of voters into secular and religious halves, and to ensure that only the secular mind influences voting behaviour.”13 This statement acknowledges that it may be psychologically impossible to achieve such compartmentalization. But compartmentalization is also not desirable if inclusivity of perspectives and authenticity of commitments are thought to be civically important. Other aspects of SSS include: (a) the separation of religion from politics (and vice versa); 11 L.A. Thio. 2009. Singapore’s Political Arena: No ‘Bright Line’ between Religion and Politics. The Straits Times. 27 May. [Excerpt of speech given in Parliament] 12 For a more in-depth discussion of this distinction, see: C.L. Ten. 2010. Secularism and Its Limits. In State and Secularism: perspectives from Asia. M. Heng & C.L. Ten, eds. New Jersey: World Scientific Publishing Company: 7-21. 13 Quoted in M.H. Chua. 2007. Is There a Place for God in Public Morals Debate? The Straits Times. 18 May. To be more precise, the consensus is that religiously motivated concerns can play a role in public debate, even if these concerns have to be couched in terms of public reasons. The latter has been discussed more explicitly in the media only in recent years. (b) guarantees on the freedom of religion;14 (c) equal treatment between religions; and (d) equal treatment between the religious and non-religious.15 These aspects are important because they help promote the peaceful co-existence of the different religions in Singapore.16 It is generally accepted that religious participation in public discourse has to be done sensitively given Singapore’s pluralistic community. In addition, Singapore’s high population density means that social conflicts that may arise from insensitive comments have the potential to quickly spread in the community. The goal of sensitive 14 The Constitution, however, limits the freedom of religion to what is “within the bounds of public order and morality”. See: M.H. Chua, et al. 1996. Three Religious Groups Banned in Singapore. The Straits Times. 19 Jan. Freedom of religion in Singapore is subject to the “beliefact” distinction. The Court of Appeal thus ruled that: “It is… not illegal to profess the beliefs of Jehovah’s Witness per se, nor is it an offence to be a Jehovah’s Witness. A citizen’s right to profess, practice or propagate his religious beliefs, even as Jehovah’s Witness, has not been taken away. It is the manner of carrying out these activities that is circumscribed by the relevant orders”. Quoted in E. Tan. 2008. Keeping God in Place: The Management of Religion in Singapore. In Religious Diversity in Singapore. A.E. Lai, ed. Institute of South East Asian Studies: 55-82: 63. 15 L.A. Thio. 2007. Secularism, the Singapore Way. The Straits Times. 30 October. 16 Singapore is a multi-religious society, with 83% of the population professing to have a religion. According to the 2010 census, the religious makeup of Singapore is approximately 33% Buddhist, 11% Taoist, 15% Muslim, 18% Christian, 5% Hindu and 17% without a religion. [See: Department of Statistics Singapore. op. cit. note 1]. These figures may lead to a criticism of the focus of this chapter. It may be objected that the examples given in this chapter highlight mainly Christian involvement in public debate. Given that 44% of Singaporeans are either Buddhists or Taoists, such a focus is not representative of the diversity of religious voices in Singapore, since Christians account for approximately 18% of the population. But while such a focus may not represent the religious makeup of Singapore, it is (for better or worse) representative of the way public discourse has proceeded in Singapore. Whenever strong religious voices have been heard in the media, they have tended to be Christian, even though Islamic voices are increasingly being heard as well. Hence, this chapter only reflects the pattern of religious discourse currently at play in the Singapore media. engagement is social harmony and cohesion, and this takes precedence over the assertion of (e.g. constitutional) rights.17 It is also agreed that the objective of public policy is national or public interest and the collective good. Hence laws cannot issue purely from the dictates of a particular group or community, including particular religious communities.18 The principle of reciprocity grounds this last point, since no group would want to be on the receiving end of policies 17 Hence, Senior Minister and Coordinating Minister for National Security, S. Jayakumar, was quoted as saying: “If everyone insists on doing things on the basis of entitlement and rights, without regard to the nature of our society and the interests of others, we will have big problems… In the United States, both sides have taken hardline extreme positions, arguing on the basis of constitutional rights (to abortion, to gay partnerships, etc) or on absolute scriptural proscriptions. The result is unending culture wars. Why we want to import them to Singapore?” See: Insight. 2009. Foolhardy to Take Harmony for Granted. The Straits Times. 25 July [interview with S. Jayakumar]. The implication seems to be that the “nature of our society” calls for a different approach, perhaps even one where different values can be asserted as having priority over one’s rights, constitutional or not. In any case, Singapore has been criticized for not respecting various constitutional rights, such as those that guarantee free expression and assembly. See: Human Rights Watch. 2009. World Report 2009: Singapore. Available at: http://www.hrw.org/world-report/2009/singapore [Accessed: 24 April 2012]. Hence, it should not be surprising that a different set of values may override or qualify appeals to rights in Singapore. Whether this is justified, or what it may mean for Singapore as a constitutional democracy, is a different issue. 18 While this is a basic tenet of secular societies, and one which the local authorities would accept, the public rhetoric does not always measure up. Hence, Emeritus Senior Minister Goh Chok Tong noted that former Minister Lim Boon Heng did not vote against the setting up of casinos in Singapore based on his own religious convictions as a Catholic, but voted in favour of the proposal instead based on his role as a union leader. However, the reason for this was not the inappropriateness of someone in public office voting on the basis of their personal religious convictions, or that the role-based duties of public officials ought to trump personal convictions. Instead, the decision was attributed to the national ideology of “pragmatism”: “… in the end, he took the practical solution - jobs would have to come first knowing very well the social evil of having casinos in Singapore”. We will have more to say about pragmatism as the basis of public policy decisions in the final chapter. See: Prime: GE 2011. 2011. SM Goh on…Why Lim Boon Heng Broke Down. The Straits Times. 19 April. that reflect only the interests of a sub-group. At the same time, the principle of fairness dictates equality in the application of laws to everyone in the community.19 The various points made in this section constitute a consensus position in Singapore on the role of religion in the public sphere and the way that the religious should be engaged and treated in the formulation of public policy. This is not to say that every Singaporean on the street would be able to recite the consensus position. It is only meant to point out the way that public debate on this subject has proceeded and evolved over the last few years, and to note that there is widespread acknowledgment in the media on the wisdom of such a position. Moving the Public Debate Forward Although consensus has been reached on several issues, some ambiguity remains. Law professor Eugene Tan notes that: “… the rules of engagement are still in a developmental and testing stage. 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New York: Routledge. 344 [...]... “rational tangibility” approach of Glover and Harris; (b) the “moral transcendence” approach of Kass and Sandel; and (c) the “everybody’s acceptance” perspective of Habermas and Green He then proposes what he terms a “nonconfrontational notion of rationality”, where he finds each of the three approaches mentioned to be equally rational Häyry assumes that each of the three approaches has attained internal coherence... moral reasoning provide grounds for those who wish to abandon moral argumentation altogether and to embrace instead some notion of public reasons Political theorists like Rawls, for instance, have offered an alternative to moral argumentation as the basis of legitimate public policy In particular, because of the reality of pluralism, Rawls believed that even the most sincere, well-meaning and logical... sociologist Matthew Matthews noted that: 56 L Wenar 20 08 John Rawls In The Stanford Encyclopedia of Philosophy E.N Zalta, ed Available at: http://plato.stanford.edu/archives/fall2008/entries/rawls [Accessed: 26 April 20 11] In my chapter on Rawls, I will dispute this reading of Rawls and argue that he later abandoned incorporating principles of reasoning into his conception of public reasons 57 See:... renders problematic, the use of public reasons Wenar, for instance, interprets one aspect of Rawlsian public reasoning as the justification of public policy on the basis of public standards of inquiry These are “principles of reasoning and rules of evidence that all citizens could reasonably endorse… [P]ublicly acceptable standards are those that rely on common 29 sense, on facts generally known, and on the... conclusions of science that are well established and not controversial.”56 However, these two proposals seem contradictory insofar as better argumentation may appeal to epistemic, logical or even normative standards that are higher than commonplace public standards A different reading of Rawlsian public reasons” is needed if we are not to hold incompatible positions I supply such a revised reading in my later... notwithstanding their power over oneself.”39 39 S.H Tan 20 10 Authoritative Master Kong (Confucius) in an Authoritarian Age Dao: A Journal of Comparative Philosophy 9 (2) :137-149: 143 Hence, we can perhaps infer that even within a Confucian society, bioethical debates with public officials would be welcomed in the interest of crafting more ethical policies, and that citizens are obligated to speak up against... provide practical guidance), casuistry (a focus on particular cases and the intuitions that arise from them), triumphalism (which asserts that one normative theory really is (rationally) better than all others) and what he terms “rising above the ruins” (which is a Rawlsian-inspired appeal to constitutional elements that will allow reasonable people to rise above the messiness of moral debate to resolve... The Straits Times 25 Oct; Hence, Gillian Koh, a research fellow at the Institute of Policy Studies, also argues that faith-based groups will “have to learn to make their cases based on moral reasoning that is accessible to people of all the other faiths” C Chew 20 09 Public Debate Must Be Secular, In Public Interest The Straits Times 17 August 28 12 The Context and Possibility of Rational Morality Historically,... Policy, has also argued that the media should portray more nuanced positions beyond polarizing arguments for and against particular issues .26 At the same time, one should do away with the secularreligious distinction in public discourse, as this had the tendency to sow seeds of suspicion rather than encourage fruitful dialogue .27 Several other commentators have also focused on the importance of giving public. .. and the spirit of fallibility are logically incompatible with each other Hence, even when arguing that religions, and in particular the Christian faith, have a role to play in public deliberation, Chia (writing under the auspices of the National Council of Churches of Singapore) argues that “insofar as Christian bioethics is constructed on the basis of the Gospel, it enters into the public sphere of . not a Game. AsiaOne. 25 April. Available at: http://news.asiaone.com/News/AsiaOne%2BNews/Singapore/Story /A1 Story20110 425 - 27 5543.html [Accessed: 26 April 20 11] 16 speaking. Hence, The Straits. The Case of Singapore. East Asian Science, Technology and Society: An International Journal 20 10; 4(1): 7 -29 : 9. 3 A. L. Chang & J. Tan. 20 10. Engaging the Public: The Role of the Media the fact that the major Mandarin, Malay and Tamil newspapers (like most of the major English-language newspapers) are all published by the Singapore Press Holdings, one can perhaps expect a certain