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Buddhism and Bioethics.
By Damien Keown. London: Macmillan Press, and New York: St Martin's Press, 1995, xvi+208 pages, £40 / $50
Reviewed By James P. McDermott
Canisius College
This book is an attempt to apply Buddhist principles to some major contemporary problems in biomedical ethics. It is the first contribution of its kind and is written for a broad general readership ranging from specialists in Buddhism who may know little about medical ethics to ethicists with an interest in medical issues who know little or nothing of Buddhism. It will also be of interest to the growing number of Buddhists in the West and elsewhere who would like to see these issues receive a higher priority than they have been given so far either by the tradition or the academic community. (p. ix)
So begins the introduction to Damien Keown's Buddhism and Bioethics . I have taken the liberty of beginning with this extensive quotation simply because Keowns study so admirably fills the niche which he sets out to define in this paragraph.
The work presents itself as a systematic contribution to the field of "applied cross-cultural normative ethics" (p.188). "[T]he approach adopted here is based on the conclusions concerning the theoretical basis of Buddhist ethics" (p. xi) reached in Keown's earlier study, The Nature of Buddhist Ethics (London: Macmillan, 1992). Keown further describes the "intellectual framework within which the issues are addressed... as Aristotelian" (p. xī). He considers the views expressed in this book to be "based on the canonical and commentarial literature of the Theravàda school," which, following widespread practice, he considers to be "the closest we are likely to get to the teachings of the Buddha" himself (p. xi).
After raising a number of methodological issues in the introduction, the book begins with a clear, non-technical sketch of Buddhist concepts necessary to make the study accessible to the general reader with no prior knowledge of Buddhism. Specialists in Buddhist studies likely will want to argue with some of Keown's choices of English equivalents for Pali terms. Two such choices in particular appear problematic in spite of Keown's careful rationale for their use. First is his use of the term "spirit" in some contexts as a translation of the Pali viññāna. This could wrongly be construed by the neophyte or insufficiently careful reader as implying a concept of a soul-like entity in Buddhism. Second, and not unrelated, is Keown's choice of "intermediate being" to render the Pali term gandhabba. While such usage is consistent with that of the Sanskrit and Tibetan sources, it simply will not work for the Pali tradition, especially as exemplified by the commentaries of Buddhaghosa.
Having set the Buddhist context, Keown then turns to a description of what the Theravāda texts and commentaries have to say, both explicitly and implicitly, of relevance to biomedical ethics apropos the beginning of life and, in a later chapter, the end of life. This essay into descriptive ethics, especially as it relates to the Buddhist approach to abortion, is particularly well done.
Once the scriptural foundation has been laid, Keown turns at length to the formulation of a normative Buddhist bioethic. Special attention is given to the question of the beginning of life, and the related issues of abortion, embryo research, and fertility control, on the one hand, and the definition of death and euthanasia, on the other. In the context of this discussion, Keown enters into debate with a number of Western writers who have preceded him in a more limited way in testing the waters of these issues.
In this context, he raises an important question which is equally applicable to the work at hand. Following Keown's example, "we may enquire... as to whether the views presented are offered as (i) the Buddhist view, (ī) a Buddhist view, or (īi) a Western... hybrid" (p. 107). I would argue that Keown's book is best to be understood as a Western hybrid. This conclusion is based in large measure on its Aristotelian intellectual framework, and seems substantiated by Keown's statement in his section on "Buddhism and marriage" that "[i]n the absence of any Buddhist moral theory on the question of sex within marriage, perhaps we could borrow from the traditional Christian view of the matter as an opening gambit" (p. 127). But if I am right in suspecting that this work is best taken to be a Western hybrid, it is a hybrid fully consistent with a Buddhist view founded on the warrant of Theravāda scripture and cross-cultural in its application, both in theory and in fact. In this sense, it represents a view more universally Buddhist than the interpretations with which Keown debates.
Keown's book is thus an important and ground-breaking contribution to the study of Buddhism and bioethics. It is explicit in raising significant methodological issues, and, like all good philosophy, will no doubt engender further serious study and debate by specialists, without sacrificing accessibility to a more inexperienced, general audience.
