U.S. bioethics emerged in the late 1960s and early 1970s, during a period of tumult in religious communities and the society at large, when secularism "crested as a social movement" on the American scene —a movement in which some theologians figured prominently. In addition, the academic milieux in which the majority of U.S. participants in bioethics—whether philosophers, theologians, physicians, or lawyers—received their professional training, and in which many now work, are "resolutely secular" institutions that "nurture and reward secular habits of thought." Partly as a consequence of these patterns, "most religious ethicists entering the public practice of ethics," writes physician-philosopher Leon Kass, "leave their special insights at the door and talk about 'deontological vs. consequentialist,' 'autonomy vs. paternalism,' 'justice vs. utility,' just like everybody else." In common with other professionals engaged in bioethics, they define their religious beliefs as private matters . . . and remain largely silent about them.

Thus reflection on basic and transcendent aspects of the human condition and on enduring questions of meaning that are integral to health, illness, and medicine have been relegated to the borderlands of bioethical concerns . . . What philosopher Simone Weil has called these "ponderable imponderables" are described by moral theologian Courtney S. Campbell as "problems [that] cannot be solved but must still be faced." For the most part, however, U.S. bioethicists have not faced these problems. They have left them out of the bioethics repertoire or, as theologian Stanley Hauerwas would contend, they have deliberately and steadfastly excluded them.

The secular rationality of U.S. bioethics in combination with its autonomous individualism has contributed to the narrowing of its outlook in still another way. It downplays communal values and qualities of the heart, like caring, kindness, devotion, compassion, generosity, service, altruism, sacrifice, and love. These values involve recognizing and responding to close and distant others in a self-transcending way— to "neighbors" and "strangers," members of future generations in distant lands, as well as "sisters" and "brothers" who inhabit this time and this familiar place.

Excerpted from A Matter of Principles? Ferment in U.S. Bioethics, edited by Edwin R. DuBose, Ron Hamel, and Laurence J. O'Connell.