the new bioethics, Vol. 20 No. 2, 2014, 186–198

Reframing Bioethics Education for NonProfessionals: Lessons from Cognitive Anthropology and Education Theory Nathan Emmerich School of Politics, International Studies and Philosophy, Queen’s University Belfast

It is increasingly common for universities to provide cross-curricular education in bioethics as part of contemporary attempts to produce ‘global citizens.’ In this article I examine three perspectives drawn from research into pedagogy that has been conducted from the perspective of cognitive anthropology and consider its relevance to bioethics education. I focus on: two metaphors of learning, participation and acquisition, identified by Sfard; the psychological notion of moral development; and the distinction between socialization and enculturation. Two of these perspectives have been particularly fruitful in understanding the processes of teaching and learning in a variety of domains. The third perspective has been developed in relation to the formal ethical education of medical students. I examine their relevance for ‘non-professional’ bioethics education suggesting that if we take seriously the idea that it is part of ‘educating for citizenship’ then the distinction between ‘ethics’ and ‘politics’ is blurred as such programmes aim at the development of student’s political subjectivity. keywords formal and informal education, socialization, enculturation, apprenticeship, citizenship, democracy

Aristotle was quite simply right when he said that whoever has not been trained into a real ethos - either by himself or others - cannot grasp what ethics is. What we are dealing with here is not some special task of philosophy. We are dealing here with a responsibility we all carry! (Hans-Georg Gadamer)1

1 The quotation can be found in: R. E. Palmer, (ed), Gadamer in Conversation: Reflections and Commentary (Yale University Press, 2001: 81).

ß W. S. Maney & Son Ltd 2014

DOI 10.1179/2050287714Z.00000000052

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Introduction Whilst there has been an increasing degree of interest in ‘Bioethics Education’2 for the most part existing work remains isolated from wider insights generated by research into teaching and learning, broadly conceived. In this short paper I introduce three conceptual distinctions that I consider vital if we are to develop a proper understanding of bioethics education and, given the meliorism that motivates the enterprise (Jonsen 1998: 392), bioethics as a whole. However, I do not propose to consider the totality of bioethics education but, instead, focus on what we might call ‘non-professional bioethics education’. Such education aims at developing the ethico-political awareness of students and does so as an end in itself. This stands in contrast to bioethics education delivered as part of a philosophy degree or as part of professional training. In the former case the purpose of teaching applied (bio)ethics is in order to develop the philosophical skills of students whilst in the latter its purpose is the production of ethical professionals. Of course, in both cases, such education may and, one might argue (Emmerich 2011b), should develop broader ethical and political awareness, but this is not its primary end of such pedagogical practices. At least to some degree, the ends of professional and philosophical education may conflict with what I take to be the more or less explicit end of non-professional bioethics education: the (re)production of citizens and ‘citizenship’. Of the distinctions discussed two are drawn from work in educational research connected to the disciplines of cognitive anthropology and cultural psychology and have been central to my previous research into medical ethics education (Emmerich 2013). The third distinction is something I developed as part of that research (Emmerich 2014) but can, in my view, be used to illuminate nonprofessional bioethics education. In my conclusion I suggest that the ‘rethought’ notion of apprenticeship found within the communities of practice paradigm and socio-cultural learning theory more generally hold significant potential for the development of a pedagogically sophisticated understanding of bioethics education as a ‘stand-alone’ pursuit. Before turning to my substantive discussion it is worth being clear about certain background assumptions. My work is informed by the view presented by Claudia Strauss in her award-winning article ‘Beyond ‘Formal’ versus ‘Informal’ Education: Uses of Psychological Theory in Anthropological Research’ (1984). Strauss does not seek to collapse the formal-informal dichotomy but, rather, to move to a more nuanced view of the difference between forms of learning that occur incidentally or informally and those that occur intentionally or formally. This is similar to Bourdieu and Passeron’s distinction between explicit and implicit pedagogy (2000: 46–47). Part of the point being made in these and similar texts is that the formal classroom is not a culturally neutral space but a particular social 2

Whilst I consider Bioethics to be an interdisciplinary topic of inquiry that can and should be seen to include sociology, history, education, philosophy, law, anthropology, etc. it seems clear that the vast majority of ‘bioethics education’ is primarily concerned with ethical reflection and analysis understood from within the framework of philosophical –- applied or practical – ethics. Thus my comments are broadly restricted to bioethics education as a type of formal education in ethics. That said, other perspectives have their own contribution to make to bioethics education as a form of citizenship education and, arguably, should be given greater prominence.

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context with a specific socio-cultural shape (Tishman et al. 1993: 150). This relates to the way in which the idea of apprenticeship was reconceived as the conceptual basis of a social theory of learning (Guile and Young 1998; Lave and Wenger 1991: 29). This notion has been highly influential, giving rise to Rogoff’s (1992) suggestion that the primary socialization of infants can be seen as an ‘apprenticeship in thinking’ and, elsewhere, to the idea of a ‘cognitive apprenticeship’ as a more general phenomenon (Collins et al. 1991; Hennessy 1993). One of the insights offered by the rethought notion of apprenticeship and by social theories of learning is that there is always an incidental dimension to formal, which is to say, methodologically organized pedagogy. Thus, whilst informal and undirected learning can occur in the absence of formal and directed learning the reverse is not the case. Formal and directed instruction always includes informal and undirected forms of learning. This indicates that we should consider all learning (and teaching) to be ‘situated’ and encourages the view that the classroom, the school and the university are social institutions within which education is culturally organized. They are, we might say, communities of (pedagogic) practice(s) (Lave 1991). Educational institutions provide the medium within which pedagogic messages, including those of bioethics education, are delivered. It is unavoidable that the educational medium is itself shaped by the wider social context. Formal education cannot be fully divorced from the wider informal social, moral and political culture(s). Indeed, I would argue that part of the purpose of bioethics education, particularly when pursued on its own terms rather than as part of professional training, is to encourage reflection and analysis of these wider realities and, as such, can be considered part of what we might call ‘education for citizenship’. Absent a ‘professional’ motivation for studying bioethics the primary end of such education can be considered the development of a specific form of ‘political subjectivity’, that appropriate to democratic citizenship (Osborne 1998: 224). An informal end of bioethics education is the (re)production of citizens; the normative political subject of late modernity.3 This essay sets out some tools to assist our understanding of this process. To do so I adopt a distinction between morality and ethics that lies at the heart of the best social scientific research into bioethics. It is present in Fox and Swazey’s ‘Medical Morality is not Bioethics’ (1984) and the anthropologist Kleinman characterizes it as follows:

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A number of UK Higher Education Institutions (HEIs) have recently been actively developing the kind of educational programmes I have in mind. Modules include, but are not restricted to, those focused on ‘ethics’. Examples include the ‘Curriculum Innovation Programme’ developed by the University of Southampton (http://www.southampton.ac.uk/ cip/), the ‘University College for Interdisciplinary Learning’ at the University of Manchester (http://www.college. manchester.ac.uk/) and University College London’s programme for Global Citizenship (http://www.ucl.ac.uk/globalcitizenship). We might also note the wider phenomena of ‘outreach’ projects, of the kind engaged in by Queen’s University Belfast (http://www.qub.ac.uk/sites/PhilosophyCitizenshipandSchools/), as well as the existing tradition of philosophy in schools (cf. http://www.sapere.org.uk/ and http://www.philosophy-foundation.org/) and those who are taking it forward in an innovative manner (http://thinkingspace.org.uk/). Of course teaching ethics to primary and secondary level students may well contribute to their personal moral development however, as this paper suggests and as is an explicit aim of the QUB outreach programme, it will also contribute to their ethico-political development, their development as and into citizens.

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Ethical discourse is a codified body of abstract knowledge held by experts about ‘the good’ and ways to realize it, moral accounts are the commitments of social participants in a local moral world about what is at stake in everyday experience … Moreover, the contexts and processes of moral life involve more than individuals. They are also based in collective orientations, social resources, and intersubjective action. The moral is actualised not only in subjective space but in social transactions over what locally matters, often vitally so, such as marriages, family, work, child rearing, education religious practice, health, death. (Kleinman 1995: 45)

Whereas ethics, and therefore bioethics, is a matter of reflection and cognition morality is a broader concept encompassing values and affect. Perhaps the most useful way of conceiving this notion of morality is by reference to Hegel’s sittlichkeit or the term ethos. As with the above discussion of different types of education, whilst we can have a moral culture without a formal ethics there can be no such ethics absent some moral culture. Any ethics is not only embedded in a particular moral culture or ethos, it is an expression of that same moral culture. Nevertheless, morality and ethics are, as Brodwin (2008) suggests, co-productive and they can be brought into a dialogical relationship. As such the idea of ethics, ethical reflection or ethical critique, suggests the potential for morality or ethos to be subject to some form of reconstruction. As we shall see, this suggests that the moral development prompted by bioethics education has the potential to involve the individual in a similarly reconstructive process as matters of ‘ethics’ are positioned as public or ethico-political questions rather than, simply, issues for private or personal contemplation. Such a perspective positions ethical reflection as a civic responsibility and, therefore, as located within a democratic ethos (Bernstein 1995).

Participation and Acquisition In her classic paper ‘Two Metaphors for Learning’ Anna Sfard (1998) suggests that the metaphor of ‘acquisition’ dominates the commonsense understanding of teaching and learning. Our common sense of these activities indicates that the knowledge of teachers surpasses that of learners, suggesting that the aim of education is the transference of this knowledge from one to the other. This relies on the container metaphor of mind and suggests knowledge can be ‘decanted’ from one mind into another. So strong is this metaphor that it not only abounds when we think of teachers informing learners that, say, the four principles of medical ethics are respect for autonomy, beneficence, non-maleficence and justice, but also prevails when we think of teachers demonstrating how to apply concepts or make use of them. However, the correct use or application of such concepts is not simply ‘transferred’ merely though being presented, or even demonstrated, to students but through students actively participating in their use. As Young and Muller (2010) suggest any form of education, even formal forms of education such as applied philosophical ethics, involves the transmission of culture. To this end Sfard promotes the term ‘participation’ as a metaphor for learning, one that exists alongside that of ‘acquisition’. Both are required if we are to properly understand the way education successfully promotes the transmission of knowledge and culture.

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One of the primary areas of Sfard’s research has been mathematics education and in this context we can appreciate the notion that learners acquire the ability to calculate various sorts of sums, additions and subtractions, multiplications and divisions. However, we should resist the idea that they learn to do so because the relevant knowledge has been ‘decanted’ from one mind to another but instead consider the way these abilities are practically developed (see following section). These abilities result from students being involved in a participatory process within which the relevant mathematical understanding and cognitive skills or abilities are built up. As has been amply demonstrated by research into language acquisition, the definition of a term alone is insufficient knowledge to guarantee its use will be correct (Brown et al. 1989: 32 n 2). What is required is experience of the way in which the term is used, and to participate in its use. Furthermore, the development of skills in one domain does not indicate that they can be transferred to another with ease. The mathematical skills displayed by a retail assistant in the course of a workday may not mean the same individual can solve problems with the same logical structure when posed in the abstract. Similarly, abstract learning may not be transferable without some degree of prompting, contextualization and scaffold experience in using one’s skills in the new domain in a way that ‘makes sense to students’ (Collins et al. 1991: 3 and 8; see also: Sfard 2010: 9–15). Such thinking is consistent with the often-raised point that, if it is to be successful, the ethics education of medical students must be vertically and horizontally integrated (cf. Parker et al. 1997; Goldie 2000; Stirrat et al. 2010). The basic point is that language, and therefore ethics, is such that it involves following rules. This is a social activity (Taylor 1993) that requires interpretation or, we might say, judgement (Larmore 1987: 8). Furthermore, in order to follow a rule one needs to know where and when it should be applied (Osborne 1998: 221). The correct way to follow a rule is not only situated and, therefore, given in relation to a particular community. It is also contextually relative, and given in relation to particular circumstances. In order to develop the ability to follow both the substantive and methodological rules of ethics one has to be inculcated into the relevant language game and the particular ‘community of practice’ within which it takes place and is practiced. Given that rules do not contain the principles of their own application then, properly understood, knowing a rule involves more than knowing-that, it involves knowing-how to follow it knowing where, when and how it should and should not be applied (Ryle 1945: 7). In this view if we are to teach ‘bioethics’ then we must engage those who would learn it in the relevant practices. The only way to achieve this is by encouraging them to participate in discussion and debate using the relevant concepts (and examples) that form the central cases of bioethics. This should not be taken to imply that, like learning to talk, simply being exposed to a linguistic community is sufficient to develop that ability. It is more like learning to read and write where a structured programme of teaching and learning provides for the cumulative development of skills and understanding. Furthermore, as with the teaching and learning of mathematics, we might start with some relatively simple and clearly structured problems before introducing more complex variables, problematic contingencies and contextual variations. However, unlike mathematics, we should recall that the vast majority of those receiving an education in bioethics have

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already undergone most, if not all, of what we might call their primary moral development. Compared to young children the average human adult can be considered a ‘moral’ (if not ethical) expert (Driver 2013). If we consider academic or philosophical (bio)ethics to be a disciplined mode of moral thought then we might understand bioethics education as inviting students to ‘refine’ their ethical thinking, at least in a particular domain, by participating in the particular mode of thought called applied (bio)ethics. However, we might go beyond the notion that participating in modes of thought offered by bioethics education involves refining one’s ethical perspective. Certainly one aspect of such education might be that it adds detail and nuance to the existing or established ethical commitments of students. Nevertheless it is true to say that bioethics education can, in some cases, result in the rejection of previously held views. It would, therefore, seem misguided to suggest that individuals are merely refining or even extending their ethical views to issues they have not previously considered. As a formal pedagogic endeavour bioethics education has the potential to be transformative. It encourages those who study it to move from the informality of ordinary or everyday morality and moral opinion into the formality of reflective ethical argument, analysis and justification. To be clear, for the most part this can do nothing more than add a level of detail to the existing ‘ordinary morality.’ The success of the endeavour is to be found here, and not in achieving the impossible task of turning everyday individuals into applied ethicists. In the same way as formal mathematical education augments most people’s informal mathematical practices, becoming part of their ‘everyday’ mathematical repertoire, formal bioethics education augments most people’s informal moral practices, becoming part of their everyday ethico-moral perspective. Nevertheless, the implications are not insignificant and, to anticipate my remarks below, whilst applied ethics is a discipline of philosophical thought it is, more broadly, characteristic of the moral culture of late-modern liberal democracies. As Collins’s (2010) analysis of the history of ethics suggests, the emergence of that philosophical mode of thought we now identify as applied or practical ethics was dependent on (and intertwined with) a particular set of sociopolitical and historical circumstances. The morality of our socio-political culture, our democratic ethos, is increasingly aligned with the perspective of applied ethics. As such the kind of augmentation, or disciplining, of private, individual and informal moral views that bioethics education promotes is such that it makes them suitable for the public square, it renders them compatible with the morality of the political domain, with the democratic ethos of late-modernity’s liberalism. It is because it promotes this kind of consistency that bioethics education can be positioned as a form of citizenship education and, therefore, as an ethico-political, and not simply ethical, pedagogy.

Bioethics education and moral (or ethico-political) development Whilst the substantive focus is usually on students of the health care professions there has been some research into the connection between bioethical education and ‘moral development’. However most of it suffers from a problematic assumption

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regarding the psychology of human development. No doubt drawing on a biological model, psychological development is often implicitly assumed to end at the point of adulthood or ‘maturity’. However it is increasingly acknowledged that psychological changes continue throughout the life course. The participationist model of sociocultural learning theory is committed to a similar perspective and insists that development does ‘not mean a transformation in people, but rather in forms of human doing’ (Sfard 2010: 80).4 Both of these views are in accordance with conceptions of professional development, both during and after formal educational programmes. Furthermore they indicate that any pedagogic activity has some form of human development as its end. Whilst we can continue to acknowledge the existence of basic or primary forms of both biological and psychological development, the participationist perspective facilitates the recognition of broader forms of psychological development and, in particular, forms of socio-cultural development. This view facilitates a distinction between the (formal) ethical practices appropriate to different (informal) moral domains. At least, in part, social roles are constituted by the moral responsibilities or, better, moralities attached to them. It often escapes notice, but it is clear that one aspect of the moral responsibilities of health care professionals is to make ethical decisions in a particular manner. This differs from the way in which we are enjoined to make ethical decisions in our everyday lives and explains why formal ethics has become central to modern professional education.5 However, higher level bioethics education – or, for that matter, formal ethics education – is not only delivered as part of professional training but is often part of what we might call a liberal arts education and as part of the modern phenomenon of ‘educating for citizenship,’ something that is increasingly prevalent within UK higher education.6 Considered in this light we might think of bioethics as drawing attention to the moral concerns generated by biomedicine, bioscience and biotechnology. However, bioethics education seeks to do more than this. The aim is not only that individuals address these problems for themselves but also to consider how these problems should be addressed by society as a whole. Whilst some may conclude that their own ethical perspective ought to be accepted by all and consider the problem of collective or democratic decisionmaking no further, others will take this concern more seriously. This should not be taken to mean that bioethics education is really concerned with political theory; whilst it can be germane to some debates it is not directly 4

This does not mean that development does not involve the transformation of people or their dispositions, it may well do. However, what is important is that primary focus should be on changes in practice, not least because such things can be empirically discerned. 5 The existence of an ethics or, better, a morality has always been essential to the constitution and ongoing maintenance of profession. A formal ethics is all but a sociological prerequisite for the social institutionalization of a profession. 6 Whilst formal constituted Liberal Arts degrees are largely an American phenomena there has recently been some move towards providing this form of higher education in the UK, including UCL’s Bachelor of Arts and Sciences (BASc) (http://www.ucl.ac.uk/basc/) as well as those delivered by King’s College London (http://www.kcl.ac.uk/ artshums/depts/liberal/index.aspx), the University of Bristol (http://www.bristol.ac.uk/prospectus/undergraduate/ 2014/sections/XLIB/dept_intro) University of Exeter (http://humanities.exeter.ac.uk/liberalarts/), the University of Kent (http://www.kent.ac.uk/courses/undergraduate/261/liberal-arts), and the University of Birmingham (http://www. birmingham.ac.uk/undergraduate/courses/govsoc/arts-science.aspx). A Liberal Arts education is also part of the philosophy that informs the curricula of the New College for the Humanities (http://www.nchum.org/undergraduatestudy/courses). I would argue that the spirit of a liberal arts education informs the curricula innovations noted above.

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relevant, at least for the most part. Rather, it is to say that there is a political aspect to bioethics education. Bluntly stated, as part of educating for citizenship, bioethics education offers an opportunity for moral development by engaging students in a particular form of ethical discourse, one that is considered appropriate to the contemporary or, we might say, democratic public square. This can be clearly discerned when we reflect on the connection between the methodology of applied bioethics and Rawls’s veil of ignorance or the proceduralism of Habermasian discourse ethics. However, the point is larger than methodology. Bioethics education and the public square are constituted as secular spaces. This is not to say that no religious talk occurs in these spaces but, rather, to point out that certain constraints are placed on such talk and the kinds of motivations and justifications it can offer. Furthermore, whilst personal (moral) experience has a role to play in bioethics education, the pedagogical point is to encourage students to go beyond ‘the subjective’ and to engage in the intersubjective task of evaluating reasoned justifications. This becomes the central objective of ethical discourse and, therefore, of bioethical education. Nevertheless, when speaking of development we should not solely attend to explicit pedagogy – that mode of inculcation methodologically formulated as such (Bourdieu and Passeron 2000: 46–47) - we should also consider implicit pedagogy. This latter phenomenon is well recognized in the study of medical (ethics) education usually being termed ‘the hidden curriculum’ (Hafferty and Franks 1994). Whether it is related to the task at hand or not, all formal pedagogic endeavours are attended by informal instructions. As is the case with medicine’s hidden curriculum, this might involve tacit instruction on what it is to be a doctor, lessons about what the role (normatively) demands and what sort of relationships ought to obtain between doctors, patients, other health care professionals and, for that matter, bioethicists. To study this aspect of medical education sociologically is to contribute to our understanding of professional reproduction. If we seek to do similarly in the case of bioethics education per se then our focus will be broader and embrace ideas regarding social and cultural reproduction. It should be obvious that this has a political dimension; social and cultural reproduction are the processes through which the ‘political subject’ (citizens) are reproduced and, therefore, through which ‘the polity’ as a whole is renewed and maintained. As such educating for citizenship has, at minimum, the potential to promote political development of students. The ‘hidden curriculum’ of bioethics education concerns the nature of politics in late modern neoliberal democracies and the relationship between this and morality in the context of ‘multiculturalism’ or, we might say, ethical pluralism. Bioethics education plays a role in inculcating students into our contemporary political culture and, given the nature of education, ethics, and politics, it should also be understood as having a role to play in questioning that culture. As such, bioethics education is not simply implicated in the moral or ethical development of those who study it, it is involved in their ethico-political development. Too often bioethics adopts an apolitical perspective, positioning itself as prior to politics (Radcliffe-Richards 2012: 134). Whilst this is not an illegitimate and, perhaps, a methodologically laudable aim for those who engage in the disciplined practice of academic bioethics, we should not allow this presumption to guide our

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understanding of bioethics as a whole and bioethics education in particular. Properly understood the bioethics education delivered as part of a liberal arts degree or of a citizenship programme does not simply aim at the moral development of students but their development as ethico-political subjects. This should not be taken to suggest that bioethics falls into the trap of being ideology in disguise. Certainly, as with any form of moral education, there is a risk that bioethics education can become a form of moral domination. However, this simply makes the matter clearer. Bioethics education has the potential to develop the ethico-political awareness and agency of those who study it; bioethics education should, therefore, adopt and promote the ends, or ethos (Bernstein 1995), of democracy, or at minimum, of a participatory (if procedural) politics.7 Indeed, my argument has been that, at least implicitly, this is already the case.

Moral socialization and ethical enculturation If we are to think about bioethics education in the terms outlined above – which is to say by considering participation to be at least as important a metaphor as acquisition for learning, and by considering the moral development promoted to be connected to changes in our ethico-political practices – then we owe ourselves an account of how this occurs. The question is how formal education (explicit pedagogy) is connected to informal education (implicit pedagogy) as a function of the social and cultural reproduction achieved in the bioethics classroom. Whilst there is interesting research being conducted in moral psychology, including work within the new synthesis paradigm (Haidt 2007), work that goes beyond this paradigm (Narvaez and Lapsley 2009) and research into moral development (Lapsley and Narvaez 2004; Narvaez and Lapsley 2014), the methodological individualism of this discipline tends to limit the contribution it can make.8 What is required is a broader, sociological and anthropological perspective on what Bourdieu calls ‘the collective enterprise of inculcation’. To this end I have developed the anthropological term enculturation, using it as a complement to the more commonly used sociological term, socialization. In this section I consider its utility for bioethics education as a whole, and not just the ethics education of medical students as I have previously done (Emmerich 2013; 2014). Given that we do not need to accept the Kohlbergian paradigm to draw on empirical research conducted under its aegis, we can be confident that the moral and ethical practices expressed by the different developmental stages he identified can be discerned in the real world. Furthermore it is clear that, understood as an applied ethics, bioethics education has the potential to inculcate the postconventional mode of thought identified as ‘Universal Ethical Principles’ (Level 6). 7

This latter point, that bioethics education promotes a` participatory (if procedural) politics’ is itself an interest facet of its ‘hidden curriculum.’ Like Habermasian discourse ethics, applied or practical ethics has an anti-ethos ethos (Anderson 2005: 173 and 178) that tries to conclude (bio)ethical debates. This contrasts with an agonistic perspective regarding (bio)ethics and politics (cf. the work of Chantel Mouffe). In this view all ‘conclusions’ are temporary, considering that ethical problems can never truly achieve the kind of resolution that applied (bio)ethics implicitly posits, i.e. a political resolution, this is a view we might well prefer. 8 Strauss (1984: 196) explicitly positions her paper as an attempt to develop common ground between psychology and anthropology.

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From his post-metaphysical perspective, Habermas makes use of Kohlberg’s theory of moral development to support his normative political theory; Habermasian discourse ethics is understood as a practical possibility and not, merely, an idealized normative prescription precisely because it reflects the highest stage of moral development identified by Kohlberg. However, this should not be taken to mean, as it too often is, that discourse ethics and the kind of principled ethical reasoning we describe as universal can be taken to be an a-cultural or ‘objective’ mode of ethical thought. As we learn from the history of science objectivity is a cultural value and its practical operation can vary according to the particular ethos of the time (Daston and Galison 2007: 40 and 204). Arguing in a similar vein, Anderson (2005: ch. 6) suggests that we see the normative prescriptions offered by Habermas as embodying an anti-ethos ethos and I would extend the same analysis to applied (bio)ethics. As such, whilst bioethics education provides an introduction to a particular mode of ethical reasoning that values objectivity this does not mean that it is, in fact, an a- or trans- cultural style of thought. Rather, it is a style of thought that values and promotes ‘ethical objectivity’ and the ethos associated with this objectivity promotes an a-cultural or ‘anti-ethos’ style of thought. The notion of enculturation can be used to theorize the social transmission of such styles of thought and do so in a manner that connects to the idea of socialization, a term that more readily springs to mind when considering the way individuals are inculcated into particular cultural context, its norms, values, practices or, we might say, its ethos. Of course, as part of educating for citizenship or of a liberal arts degree that aims at the development of the whole person, those who study bioethics are not being introduced to a new (sub)culture in the way that is true of medical students, say. Rather the ‘anti-ethos ethos’ Anderson identifies with democratic proceduralism, and that I would extend to applied philosophical (bio)ethics as a style of thought, is a facet of contemporary or ‘modern’ culture. It may be one that students have no direct experience of but, nevertheless, it is an aspect of those moral norms that we hold in common. As such we will find that the moral socialization of those who study bioethics will likely be such that they will be receptive to this formal mode of ethical thought and predisposed to reproduce it, which is to say, to be enculturated into its particular logic or methodology. Such enculturation is achieved by engaging students in (bio)ethical debate. Through participating in bioethical arguments students engage in conscious ‘deliberation and choice [facilitating the] reconditioning and reorientation’ (Shimahara 1970: 144–45) of their substantive views regarding the bioethical problems they encounter, and their methodological perspectives on ethics and how it ought to be done. Through adopting an ‘enculturative’ perspective on bioethics education we can appreciate that part of its pedagogic aim is to change, which is to say develop, the underlying ethical practices those who study it subsequently engage in.

Conclusion Whilst it has not always been the case, a form of applied or practical ethics dominates bioethics, both of which are rightly considered to be derivative forms of ‘analytic’ or ‘modern moral’ philosophy. Those whose perspective is rooted in these disciplines

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have productively debated facets of bioethics education (Lawlor 2007; Benatar 2007; Lawlor 2008; Benatar 2009). However, whilst it is no surprise that their concerns are informed by and rooted in the concerns of their intellectual discipline as a whole we might still lament the degree to which bioethics evinces serious engagement with pedagogy and the variety of disciplinary perspectives that have been brought to bear on the topic. Whilst the history of bioethics can provide us with examples of work that consider bioethics education in more comprehensive terms (cf Callahan and Bok 1980; Radest 2000) the perspective offered in other work seems to consider teaching ethics a matter of teaching ‘critical thinking’ (Davson-Galle 2009). Such perspectives appear distinctly limited in the light of more interdisciplinary work (Maxwell 2008) and mistake the pedagogic ends of philosophical ethics education for those of professional ethics education. The views outlined above are rooted in a perspective quite different to that of modern moral philosophy and applied ethics. Therefore the direction it takes might seem quite alien to some bioethicists. However, it does accord with the view of morality as ethos and, as a normative aspect of our embodied practices, (re)produced via socialization. As such it accords with the Bourdieuian notion of habitus and Kukla’s (2014) recent analysis of common morality. In this view ethics, or ethical reflection, is a cognitive practice reproduced via enculturation. However, the apprenticeship model draws on both participation and acquisition as metaphors for learning and therefore ‘defies the traditional distinction between cognition and affect’ (Sfard 1998: 11). Such a view can provide theoretical support for the dialogical integration of socialization and enculturation within, for example, a Bourdieuian conception of the collective enterprise of inculcation (Emmerich 2014). If bioethics education is considered part of ‘educating for citizenship’ and involves the moral, or ethico-political, development of students then we might consider them as, in some sense, apprenticed to democracy or the wider democratic culture. Following Fox and Swazey’s (1984) suggestion that medical morality is not bioethics we can say the same about our contemporary political culture: democratic morality is not (bio)ethics. As such applied (bio)ethics is only one part of this apprenticeship in citizenship. Such view provides scope for widening bioethics education beyond the ‘applied ethics’ paradigm to include the kind of broader humanist education that liberal arts degrees paradigmatically represent. I have, elsewhere, argued that this has much to recommend it (Emmerich 2011a). If bioethics education is in the business of reproducing citizens then we have good reason not to restrict ourselves to the pedagogy of applied ethics and instead embrace a broader, more humanist, vision, one that includes both the arts and the social sciences in its curricula.

References Anderson, A. 2005. The Way We Argue Now: A Study in the Cultures of Theory. Princeton, NJ: Princeton University Press. Benatar, D. 2007. ‘‘Moral Theories May Have Some Role in Teaching Applied Ethics.’’ Journal of Medical Ethics 33: 671–72. ——— 2009. ‘‘Teaching Moral Theories is an Option: Reply to Rob Lawlor.’’ Journal of Medical Ethics 35: 395–96.

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Notes on contributor Nathan Emmerich is Visiting Research Fellow, School of Politics, International Studies and Philosophy, Queen’s University Belfast. Correspondence to: Nathan Emmerich, email: [email protected]

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