Micha H. Werner (1998):

Catholic Compendium with Slight Blemishes

The new German "Lexikon der Bioethik" can only be recommended with reservations

Überarbeitete Fassung. Originalversion erschienen in: Biomedical Ethics 3 (1998), S. 67-70.

How does one write the review of a lexicon which includes within its three volumes a total of 2559 pages, with almost 800 articles from over 450 authors on 500 topics which are thematically widely diverse?

The Gütersloher Verlagshaus found its own answer to this question: they offer the reviewer of the "Lexikon der Bioethik" (from here on: LdB), in order to make this task easier, a "special edition for reviewers". This edition includes a preselection of 28 articles on 13 topics in 143 pages, proportionally an eighteenth of the entire work, along with the foreword, introduction and a table of contents and is bound with the promise to send further individual articles on request.

Fortunately I was able to use the complete library copy from the Interfaculty Center for Ethics in the Sciences and Humanities in Tübingen and saw myself therefore forced to deal with my initial question. It must be clear that no one person is competent enough to evaluate the contents of all the 800 articles within this rich spectrum of topics. The review's purpose, however, is to impart an overview of the lexicon's systematic construction as well as the basic contents of the main ideas; to evaluate to what extent these formal and contentual main ideas seem reasonable prima facie and in the context of the already given literature; to undergo a contentual evaluation on a reasonable, subjective selection of articles by making an extensive as possible survey and to evaluate to what extent other editorial criteria of quality are filled.

Zum AnfangSubject Areas

The editors Wilhelm Korff, Lutwin Beck and Paul Mikat use as a basis for their work a broad understanding of bioethics which goes beyond, "in crucial aspects, the Anglo-American use of the word bioethics which is a nearly synonymous term for our traditional [German] notion of medical ethics [Medizinische Ethik]" (I,5).1 "Under bioethics," so states Korff in his introduction, "is understood in this lexicon the ethical reflection of those facts which affect responsible human dealing with life." (I,7) Bioethics includes, therefore, "the categories medical ethics, human-ecological ethics, environmental ethics." (I,5) Furthermore, even through this liberal definition of "bioethics" the spectrum of the topics included within the LdB is still not adequately described. Many articles hardly can be assigned to one of the three specified topic areas "medical ethics, human-ecological ethics, environmental ethics." Thus the following topics can also be found in the LdB: "Auschwitz," "Data Protection," "Migration," "Occultism," "Unmarried Long-Term Relationships," "Self-organization,", and "Play".

The LdB surpasses the limits of the concept of bioethics as it was formulated in the forward in three different ways. Firstly, the LdB handles general ethical topics which can hardly be subsumed in the area "bioethics". This mainly concerns the areas of relationship ethics, sexual ethics with respect to the question of individual "good life", the problems of political ethics as well as social and business ethics. For the most part the LdB functions more as a universal compendium of morals. Secondly, the LdB handles a number of articles that do not include any normative or evaluative judging; for example "Fertilizer," "Formaldehyde," "Shipping," "Self-organization". So, for example, the article about formaldehyde could also be taken from a toxicological reference work. Thirdly, the LdB includes entries on legal positions, following the example of the "Lexikon Medizin, Ethik, Recht"2 which was published nine years prior to the LdB. The LdB is therefore a thematically widely conceived reference work which unifies subject information, ethical evaluations and information about legal norms on bioethical topics as well as many other practical questions about world view.

If it was a fortunate decision to conceive the LdB comprehensively in this way is doubtful. For many of the additionally handled topics there are already equivalent reference works. The thoroughness of the articles which can truly be classified as bioethical suffers as a result of the numerous entries; several medical-ethical articles are therefore hardly more comprehensive than those in the single volume "Lexikon Medizin, Ethik, Recht". Thus the widening of the areas created a certain randomness in the choice of topics as a result. Furthermore some of the individual subject areas are so general that their ethical reflection within a lexicon can hardly offer any concrete information. Symptomatic in this respect is the ethical final paragraph of the entry about "Sewage Purification," which is cited in full here:

"From a bioethical perspective the legal requirements and instruments of sewage treatment reveal especially clearly the normative and administrative struggle around the responsible handling of water which is on the one hand the source of life and an ecological resource, and on the other hand an economic commodity and consumer good. The ecological, economical and technological ambivalence find expression in the diverging juridical laws and decisions. In this existenial area of conflict the bioethical postulates - similar to the constitutional order to protect the natural foundations of life (Art. 20 a GG) - will have to limit themselves to guidelines and frames of reference, and cannot only present one correct solution."(I,69)

Zum AnfangFormal Layout

As is common among subject reference works the LdB's articles consist of entries from several persons who see a topic from different perspectives. However, not all of them orient themselves on the three part structure of "the state of the problem - legal situation - ethical orientation", which is described in the publisher's catalogue as its consistent systematic, as there is in some topics no legal or ethical discussion necessary. That is why the editors rightly have chosen different outlines according to the individual topic areas. Thus there is in the topic "Ethics" an article from a philosophical perspective, one from a Catholic theological perspective and one from a Protestant theological perspective.

Something positive to mention is the notion concordance [Begriffskonkordanz] in which the most important key words are listed in their English, French and Spanish translations. There are also indexes for persons and subjects as well as a directory of authors. However, the incompleteness of the person index deserves criticism. In view of how many person entries were lacking, one supposes that those responsible intentionally made a selection. That would not have been a problem if it had oriented itself on reasonable selection principles and if these principles were clearly stated. The latter is however not the case and the former was not discernable. The number of language flaws was found to be within normal limits. Admittedly there are exceptions such as the article about "Blood Donations/Blood Transfusions" which contains several word blunders with distorted meanings.

Zum AnfangGeneral ethical lines of orientation

According to the introduction written by Korff the LdB's ethical judgements take into account the "plurality of moral convictions and ethical approaches, which characterize modern society in general and the scientific community specifically" (I,8). Under the title "General Ethical Lines of Orientation" Korff makes clear, however, that the spectrum of opinions remains within the frame of an ethics "which sees itself as being [...] within a specifically Christian horizon and which thereby also uses explicit theological arguments" (I,11). Even if Korff refrains from specifying this Christian value horizon confessionally, it is still obvious that the LdB is a Catholic moral theological project. Beyond its orientation on a concept of personality from a Catholic moral theological standpoint, as well as the partisanship for an "ecologically enlightened anthropocentrism", the introduction reveals as a further line of orientation a conservative-hegelian confidence in the orientation capacity of the actual societal ethos and existing institutions. Thus Korff stresses that "a large number of bioethical questions can fall back on an already existing ethical process of consensus finding which finds expression in the societal standards and institutional structures so that as a rule a questioning of the first general principles does not seem at all necessary" (I,8 f.). Along with Niklas Luhmann, Korff describes these institutions as the "»functional equivalents « of ethics" (I,9).

Zum AnfangPerspectives regarding the contents

It would seem reasonable to have along with the already available bioethics lexicons in English3 and the older "Lexikon Medizin, Ethik, Recht," this new work in German, because firstly although there are notable alignment tendencies there still exist clear differences between the German and Anglo-Saxon discussions which can be explained by the differences in the social structures, health and legal systems as well as the different moral philosophical traditions (some short notes on this can be found in the article "Medical Ethics" in the LdB [II,647-643]), secondly the "Lexikon Medizin, Ethik, Recht", is in parts out of date.

The LdB does not practice the virtue of some subject lexicons of briefly referring, in an exposition, to earlier and competing works at the beginning of each article. This would have oriented the readers quickly as to the current research and a would have made an overview on the development of the discussion easier. Also with the LdB it is difficult to view the differences within the international bioethical discussion. An example can illustrate this: it would have been interesting to illuminate more precisely the difference between a 'liberal' interpretation of the principle of "informed consent" characterizing the Anglo-Saxon discussion and stricter interpretations based on Kantian concepts of autonomy that play a role in the German discourse. In the LdB one can find entries for this problem under the titles "Consent," "Informing/Duty to Inform" and "Autonomy." The first two entries are short (each almost five pages) and do not contain an ethical section,4 while the article on "Autonomy" is even shorter, levels down the above mentioned differences and also remains in some respects too undifferentiated and unclear. Thus autonomy is introduced as both an "anthropological category" with "quasi ontological significance" (I, 291) and as a "necessary postulate" (I, 293) in which the difference between autonomy and human dignity is not explained (cf. I, 291). Whoever doesn't already know that in the general philosophical as well as in the specifically bioethical literature a plurality of autonomy concepts is being discussed does not find out about it at all in this article.

Unfortunately this diagnosis goes, mutatis mutandis, for many of the articles in the LdB: the presentation or even the critical-systematic reconstruction of research controversies5 is not one of its fortes. This has to be connected with the editor's above mentioned evaluation as the basic, fundamental questions and principles are often only of minimal importance within the bio-ethical discussion. Through this lack of critical reconstructive work, however, some value judgements seem out of context and subjective even in those areas where their validity is not anyway restricted to the frame of Catholic world view - which is the case in a high number of articles on questions of sexual ethics and on general questions of good life (cf. the entries on "unmarried long-term relationships" and "singles," among others).

The lack of interest in principle questions might also explain why the entries with a more philosophical fundamental thematic are mainly weak. One of the laudable exceptions here is the article on "determinism" by Armin G. Wildfeuer which is both intructive and rich in material. In view of the often out of place and seemingly subjective ethical judgements the attempt, through the above mentioned tripartite of many entries, to pull out a clear dividing line from empirical, legal and ethical statements, is definitely welcome. Unfortunately one has to realize that this attempt does not succeed in some cases. The entries on the "State of the Problem" are frequently pervaded with value judgements. That goes, for example, for the entry from the molecular biologist Alfred Pühler, who reviews the "State of the Problem" regarding the release of genetically manipulated organisms (GMOs). Altogether only two pages long, the entry contains exactly ten lines of descriptive information and dedicates itself then exclusively to the refutation of evolutionary, ecological and health "considerations". Accordingly the editors refrained from an additional entry which explicitly would have dealt with the ethical assessment of the release of GMOs. This example exemplifies also that the editors failed to set reasonable contentual emphases: why is the important bioethical problem of the release of GMOs treated so briefly, and only from the view of a molecular biologist, and at the same time plenty of room given to an article with the topic "Shipping" for example? Similar questions arise in many other places.

An extreme case of methodically unreflected judgements in articles on the "State of the Problem" is Herwig Birg's article on "Migration." The author ascertains here, among other things: "The degree of immigration to Germany is so high that because of it serious problems result especially in integrating immigrants without simultaneously reducing the problems in the country of origin."(II,693) Birg places side by side and qualifies "the very high rate of criminality in certain groups of foreigners, which is far greater than its corresponding proportion within the population," and the "violent criminality of certain groups against foreigners" (II,695) and promotes in what one can hardly call a subtle way the fear of cultural foreign infiltration. The article reveals nowhere that, for the ethical assessment of migration phenomena, individual claims, individual rights and priciples of justice could have relevance; Birg judges exclusively in the frame of an ethnical collectivism. To find such kind of text in a lexicon which wants to offer something to ethical refection is somewhat disconcerting.

This sort of political-ideological faux pas is admittedly not typical for the LdB. On many topics from "Ederly/Growing Older" and "Species Protection" to "Civilization Sicknesses" and "Compulsory Treatment", the LdB offers serious and helpful information. However, one cannot speak of a constant academic level within the entries. At several points one regrets that competent authors such as Bettina Schöne-Seifert or Dieter Birnbacher are lacking. Perhaps the editors thought they had to pay that price here in order to keep a unity in terms of worldview within the LdB. Thus one notices in some articles an exaggerated carefulness among authors who, in terms of the topic, do not belong to the inner circle of proven experts (see, for example, the articles on "Emancipation" or "Consensus Building"). In the ethical entries a choice between conflicting rights is sometimes in an all too general way demanded without having discussed enough and clarified enough the conflicting arguments and value options so that the outcome of the ethical orientation remains minor; that goes for example for the ethical articles on issues of atomic energy.

Some of the LdB's entries are not only weak but qualitatively unacceptable. This is true for the article on "Business Ethics" (III, 766-778), in which one learns literally nothing of the current discussion in business ethics within its twelve pages, but has the chance to learn all the more about the personal preferences of the author, Wolfgang Kluxen (who unfortunately contributed another five entries to the LdB). Even if one did not want to or could not win over Peter Ulrich, Horst Steinmann, Karl Homann, Margit Osterloh or Ursula Hansen for a contribution, there should have been some authors within the spectrum of Catholic opinions who could have written more competently about business ethics - one just has to think of Friedhelm Hengsbach.

Zum AnfangConclusion

Although in many areas there is useful and current information in comparison to the Lexikon Medizin, Ethik, Recht, the LdB is only a somewhat helpful tool for orientation in bioethical controversies because of its conceptual weaknesses, the fluctuating academic quality of the entries and the limited validity, in terms of worldview, of some ethical judgements. A work equal to the "Encyclopedia of Bioethics" in the German language is still, therefore, not in sight.

Lexikon der Bioethik, as commissioned by the Görres-Gesellschaft, is edited by Wilhelm Korff, Lutwin Beck and Paul Mikat. Gütersloh, Gütersloher Verlagshaus 1998.


1 [Translator's note: Within this article, all citations from the LdB have been translated by the translator of this article, not by the authors of the LdB, nor by Micha H. Werner. EMZ]

2 Eser, Albin, Markus von Lutterotti and Paul Sporken 1989 (Eds.), Lexikon Medizin, Ethik, Recht. Freiburg/Basel/Wien: Herder.

3 The most important naturally being Reich, Warren Th. 1995 (Ed.) Encyclopedia of Bioethics. New York: Simon & Schuster Macmillan.

4 In contrast to the article "Information/Duty to inform" in the "Lexikon Medizin, Ethik, Recht."

5 as for example Bettina Schöne-Seifert excellently demonstrated in the following: Schöne-Seifert, Bettina 1996, Medizinethik, in: Angewandte Ethik: Die Bereichsethiken und ihre theoretische Fundierung, edited by Julian Nida-Rümelin, Stuttgart: Alfred Kröner, 550-648.