Empirical bioethics can contribute meaningfully to normative inquiry. The following is a non-exhaustive list of empirical bioethics approaches and how they can and cannot legitimately interact with the normative claims we aim to arrive at in bioethics (list taken from Sugarman and Sulmasy, Methods in Medical Ethics).

Purely Descriptive Studies: study what human beings believe about morality, how their beliefs change over time, and how they behave in situations of moral concern. Purely descriptive studies do not generate normative claims, but they can spark normative inquiry. Ex., neuroethics studies investigating the psychology, neurology, and genetics of moral decision making.

Studies Testing Established or New Norms: Seek to demonstrate and describe (non)compliance with existing moral norms. Ex., in the U.S., most believe that if a patient does not want life-saving treatment, they should not receive it, but the SUPPORT study revealed these such preferences are often overlooked (Support Investigators, 1995). If a moral norm accepted by a community is being consistently ignored or contravened, studies demonstrating as much can generate normative demands for policy changes designed to rectify the discrepancy, or accountability for those responsible. See also. (Morain, Largent, 2021) (Lavori, Sugarman, and Hays, 1999).

Empirical Testing of Normative Claims: Related to the principle attributed to Kant that “ought implies can”—a normative argument that someone ought to do something entails it is possible for the person to do it (which is an empirical question). Ex., someone argues that all premature infants must be resuscitated but empirical research demonstrates that survival for certain infants is virtually impossible.

Case Reports: Can serve as a springboard for substantial normative discussion. Casuistry (moral reasoning by analogies between cases) depends heavily upon good case descriptions. Ex., the case of Dax Cowart became a watershed case for bioethics concerning the right to die, patient autonomy, and (un)acceptable paternalism (Keith, 1989).

Demonstration Projects: Empirical projects can demonstrate the implementation of a normative idea or standard. Common in ethics education programs. Can also be used for ethics consult services.

You may find that the above research categories overlap in some ways, and that particular examples may fit into one or more categories, or fall between categories. That is to be expected, as they are not mutually exclusive!

To recap, empirical and normative approaches to bioethics can work productively together.

Normative Ethics can:

  • Generate claims that are associated with empirically testable hypotheses.
  • Set normative standards that must be operationalized and can be studied in educational or practice settings.

And Empirical (descriptive) Ethics can:

  • Generate lessons from studies to operationalize some set of moral standards or norms and feedback upon and influence normative theory.
  • Generate facts that normative arguments depend upon.
  • Generate new material for normative study.
  • Raise questions about the universalizability of normative claims.
  • Identify areas of disagreement that are ripe for ethical inquiry.
  • Give rise to new questions that have not been addressed.

Works Cited

Burton, Keith. 1989. “A Chronicle: Dax’s Case as It Happened.” In Kliever, Lonnie D., Ed. Dax’s Case: Essays in Medical Ethics and Human Meaning, 1–12. United States: Dallas, Texas: Southern Methodist University Press.

Lavori, P., J. Sugarman, and M. Hays. 1999. Improving informed consent in clinical trials: A duty to experiment. Controlled Clinical Trials 20(2): 187–193. 10.1016/S0197-2456(98)00064-6

Morain, Stephanie R., and Emily A. Largent. 2021. “Public Attitudes toward Consent When Research Is Integrated into Care—Any ‘Ought’ from All the ‘Is’?” Hastings Center Report 51 (2): 22–32. https://doi.org/10.1002/hast.1242.

Sugarman, Jeremy, and Daniel P. Sulmasy, eds. Methods in Medical Ethics. Washington, D.C: Georgetown University Press, 2001.

The SUPPORT Investigators. 1995. “A Controlled Trial to Improve Care for Seriously Ill Hospitalized Patients: The study to Understand Prognoses and Preferences for Outcomes and Risks of Treatment (SUPPORT).” Journal of the American medical Association 274:1591-98.