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ten Have • Potter’s Notion of Bioethics

Henk A. M. J. ten Have

Potter’s Notion of Bioethics

ABSTRACT: In 1970 Van Rensselaer Potter was the first to use the term “bioeth-
ics” in a publication to advocate the development of a new discipline to address
the basic problems of human flourishing. This article analyzes Potter’s notion
of bioethics in order to understand its origins, sources, and substance. In early
publications, Potter conceptualized bioethics as a bridge: between present and
future, nature and culture, science and values, and finally between humankind
and nature. In later publications, disappointed by a predominant focus on indi-
vidual and medical issues, and with a wish to underscore the need for a broader
perspective, Potter introduced the new term “global bioethics,” meant to tran-
scend ethics specialties and integrate them into a new interdisciplinary endeavor
to address global problems. A growing interest in global bioethics today means
that Potter’s original insights are more timely than ever.

Introduction: Bioethics as Bridge

B
ioethics, as a discipline combining scientific and philosophical
knowledge, originated forty years ago. It is not clear how the word
“bioethics” came into existence. Warren Reich concludes that it
had a “bilocated birth” in 1970–1971 with Van Rensselaer Potter and
André Hellegers, while Hans-Martin Sass attributes the origin of the word
to Fritz Jahr in 1927 (Reich 1994; Sass 2008). The controversy over the
coining of the term notwithstanding, the American cancer specialist Van
Rensselaer Potter was indisputably the first to publish a book on bioethics
(in 1971), using a bridge as a metaphor for the new discipline. In this book
and in subsequent publications he elaborates the notion of bioethics, a
notion that is different in many ways from the way bioethics is sometimes
conceived of today. The aim of this article is to analyze the substance of
Potter’s theory and the intellectual inspiration for his ideas.
Van Rensselaer Potter (1911–2001), son of a farmer in South Dakota,
was educated in biochemistry. After he obtained his PhD in 1938, he re-
ceived a postdoctoral fellowship and traveled to Sweden to work in the

Kennedy Institute of Ethics Journal Vol. 22, No. 1, 59–82 © 2012 by The Johns Hopkins University Press
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Biokemiska Institutet in Stockholm. One year later he moved to England


intending to undertake a second year of research but just as he arrived, the
Second World War broke out. He went back to the United States where,
in 1940, he was appointed to the faculty of the University of Wisconsin.
He worked for more than fifty years as a professor of oncology at the
McArdle Laboratory for Cancer Research at the University of Wisconsin
in Madison. Potter was an enthusiastic scientific researcher. Although he
was not involved in cancer therapy, he was one of the first biochemical
experts to study carcinogenesis. After his death, the memorial committee
of his faculty noted that he viewed science not as a “job” but as “an ethi-
cal, passionate, and creative experience” (Memorial Committee 2002).
Oncology, thought Potter, was essentially interdisciplinary; it cannot merely
focus on individual and medical perspectives, and he believed that the same
dimension of social responsibility characterized other areas of research
(see Potter 1975b; Memorial Committee 2002). In the 1960s he began to
publish on issues outside his initial field of cancer research, such as the
concept of human progress, the interrelation between science and society,
and the role of the individual in modern society. These earlier publications
are included as chapters in his first book on bioethics, Bioethics: Bridge
to the Future, published in 1971. This broadening of scope owed, on the
one hand, to the limitations of the research in which he was fully engaged.
Potter notes that progress has been made, but he also points out that the
goal of eliminating cancer was far away: we must be content with “small
victories” without expecting a breakthrough. There will be, he maintains,
some limited progress at the individual level (in terms of alleviation of
suffering and improved treatment), but he had come to believe that much
more could be accomplished at the population level (in terms of cancer
prevention).
On the other hand, Potter points out that his long-term preoccupation
with cancer research prevented him from realizing that there were more
important problems. He acknowledges that it took a long time before he
started to look around and take interest in “the major problems of our
time” (1971, p. 150). Although Potter does not systematically discuss
them, he organizes them into an alliterative list: population, peace, pol-
lution, poverty, politics, and progress. He regarded the consideration of
these issues as crucial to the survival of humankind, and their urgency
induced in him a growing concern regarding the future. What was neces-
sary, according to Potter, was a new science of survival: a new discipline
called bioethics.

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Potter’s Eureka Experience

In an interview in 1992 Potter remarks that the word “bioethics” just


came to him in a eureka moment (Reich 1994, p. 322), eureka itself being
a concept he ended up analyzing in connection with bioethics (see Potter
1975b). He defines eureka as the result of a new idea, concept, insight,
action plan, or experimental approach being formed subconsciously and
then erupting into our consciousness. The eureka moment has three prop-
erties: (a) suddenness; it cannot be willed and its occurrence is unpredict-
able; (b) euphoria; it is accompanied by a feeling of elation; (c) fallibility;
the idea itself is inherently capable of being in error. The second property
explains why new ideas often work—the accompanying euphoria invites
action, action leads to experience, and experience can lead to wisdom.
The first and third properties lead to the recognition that the basic char-
acteristic of bioethics ought to be, as Potter formulates it, “humility with
responsibility” (1975b, p. 2297; 1975a, p. 18). Because there is always
the possibility of error, scientists ought not assume that their own area of
expertise will provide the entire answer to a complex problem. In order
to make recommendations for public policy, scientists should develop a
realistic understanding of the relevant data, steering a course between
optimistic and pessimistic evaluations so that the most feasible policy will
result. They should also maintain a sense of the limitations of the data
and processes at hand, looking both to interdisciplinary collaboration and
empirical testing of ideas as a corrective measure.

A New Discipline

For Potter, “bioethics” was the name of a discipline combining science


and philosophy, with wisdom—“knowledge of how to use knowledge”
about human survival and flourishing—as its goal (1970, p. 127). Wisdom
is action oriented. When there are competing possible policy outcomes
and priorities are uncertain, biological knowledge must be combined
with value judgments. In these circumstances, one can only proceed with
humility. At the same time, caution requires assessment mechanisms and
feedback so that one can learn from experience. For Potter, bioethics is a
science—the science of survival—and ought to employ scientific methodol-
ogy: testing ideas in peer groups and in experiments and building on what
has been learned from previous investigation. What is new for bioethics
is the interdisciplinary nature of this approach. We should transcend the
boundaries between disciplines to develop ideas “that are susceptible to

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objective verification in terms of the future survival of man and improve-


ment in the quality of life for future generations” (1970, p. 132).
The two basic features—combining various categories of knowledge
and the need for continuous testing and assessing—are reflected in the
definition of bioethics that Potter provides a few years later: “a new dis-
cipline that combines biological knowledge with a knowledge of human
value systems in an open-ended biocybernetic system of self-assessment”
(1975b, p. 2299). Although the basic ideas were present in previous work,
they were now associated with and included in the notion of bioethics.

Bridge to the Future: The Inspiration of Margaret Mead

In the opening sentence of the preface of his first book Potter empha-
sizes that he wants to contribute to the future of the human species. He
observes that part of the reason why the future is in danger is that the
two cultures of modern society, namely, the sciences and the humanities,
are not communicating. This concept had been developed by C. P. Snow
in his widely read 1959 lecture “The Two Cultures.” In modern Western
society common culture had been lost, and with his book, Potter intended
to answer this challenge: the new discipline of bioethics could build a bridge
between the two cultures and strengthen future-oriented problem solving.
In the preface he remarks that he had noticed that during his thirty years of
cancer research a growing philosophical concern about the future was “a
constant thread of unity in my extra-curricular activities” (1971, p. viii).
He also mentions that his concern about the future was in fact instigated
by the publications and activities of Margaret Mead (1901–1978). She
was one the first anthropologists to use anthropological analysis to study
the future of human civilization, arguing for the importance of assessing
possible cultural outcomes on the basis of adequate information and
knowledge. If we want to be able to determine what ought to happen in
human society, we must determine what could happen and what is likely
to happen under controlled circumstances. In developing these visions of
the future, we must use two methods of approach, that of the humanities
and that of the sciences. Usually, Mead notes, negative visions are stronger
than positive ones, so to reverse this trend we need to deliberately develop
“vivid utopias” to guide our thought. In an age when the survival of hu-
manity is threatened by the proliferation of weapons of mass destruction,
the possibility of nuclear war, and the danger of ecological catastrophes,
this need for positive visions of the future was all the more pressing. Mead
even advocates that universities have special scholars—“chairs of the fu-

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ture”—who would apply humanistic and scientific tools in the service of


securing a livable human future (see Mead 1957).
Potter references this proposal several times in his own work, including
in his 1971 book (chap. 6) as well as in a 1965 publication with a very
similar theme. Potter was troubled by what he saw as an unfortunate
divide between knowers (science) and doers (technology): knowledge is
accumulating faster than the wisdom to manage it, which makes knowledge
potentially dangerous (as vividly illustrated, for example, in the case of
thalidomide).1 Further, policy decisions in most political systems tend to
focus on short-term effects, while longer-term perspectives are neglected
(1971, p. 78). Finally, complex decisions about a collective human future
involve facts as well as values—communication between the two cultures.
To remedy these deficiencies, Potter proposes the formation of a “Council
on the Future,” an independent institution that would be “charged with
predicting the consequences and interactions that might result from the
application of new knowledge” (1971, p. 77). The council should be
interdisciplinary and include experts from the natural and social sciences
and the humanities, and be balanced by a democratic forum, open to
“outsiders” and public debate on social problems. These mechanisms, he
states, could help bridge the gaps between knowing and doing, between
values and facts.
In the 1960s, the future became a serious subject of public and scholarly
interest. In 1965, the American Academy of Arts and Sciences initiated
the Commission on the Year 2000, the forerunner of what became the
field of futurism. Margaret Mead was one of its members. Rather than as-
suming that the future can be predicted, the commission aimed to identify
structural changes in society with long-term social impact. In 1967, the
World Future Society was established in the United States; within 12 years
its membership increased from a few hundred to 60,000. One year later,
the Club of Rome was founded. Its report Limits to Growth, published
in 1972, analyzing the interaction between the growing world population
and limited natural resources, argued that many key resources for the
survival of humanity will ultimately be depleted.
Potter paid tribute to Mead’s publication on vivid utopias in his 1971
book. Her ideas directed his attention toward the heuristic role of visions
of desirable futures in the development of culture, as well as the need to
bring together sciences and humanities for such visions to emerge. But
in contrast to Mead, who has no particular future in mind, Potter works
with a specific vision of the future: acceptable survival of the human spe-

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cies. He elaborates this vision more clearly in a later publication, singling


out the survival of humankind as the “vivid utopia” and general goal of
bioethics, attainable only by forging compromises between “sanctity of
life” and “quality of life” and between individual interests and the social
good (2001, p. 20). Mead’s ideas also enabled Potter to articulate some
specific topics on the bioethics agenda early on: his 1971 book highlights
the problem of “dangerous knowledge,” related to what we today call
“dual use.” Scientific knowledge is not inherently good; bioethics is needed
to provide the wisdom to manage dangerous knowledge and to assist in
policy decisions concerning the impact of new scientific knowledge by in-
tegrating facts and values (1971, pp. 76–77). These early ideas, presented
in an elementary way by Potter, would be more extensively elaborated by
others at a later stage. Potter was somewhat more specific in one of his last
publications where he identifies the specific goals of bioethics: promoting
public health and women’s rights, preventing overpopulation, protecting
the environment and biodiversity, and transforming society in such a way
as to achieve the common good. Bioethics can only reach its general goal
of global survival in the long term by addressing these particular issues
(see Potter 2001).

Bridge between Nature and Nurture

The future, argues Potter, cannot take care of itself. Human beings
need to take their destiny into their own hands. Only by bridging the gap
between the sciences and the humanities can we hope to build a bridge
to the future (1971, pp. 150–51). This bridge between the present and
the future enables the creation of another bridge. Bioethics, as the science
of survival, can also forge connections between biological and cultural
evolution. Between these two processes many parallels and analogies
exist; both are directed toward survival; both are susceptible to external
guidance (see Potter 1975b). Potter elaborated his ideas in a publication
on human progress in a 1962 essay (included in his 1971 book) in which
he questions the general assumption, especially in the American context,
that progress toward a worthy social goal will take place on its own.
We need, argues Potter, the new discipline of bioethics to safeguard the
survival of humankind.
In this connection, Potter distinguishes between three concepts of prog-
ress. The religious concept considers progress as transcendent; it is the
transition from this world to the world to come. The materialistic concept
of progress is immanent; it focuses more on what already exists and on

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short-range interests. Because it has a long-range view, Potter advocates a


third concept of scientific-philosophic progress, for it is the only notion of
progress that addresses the survival of human beings as a species. In order
to make this notion operational, a combination of scientific know-how
and an understanding of history and humanities is required.
That the notion of progress should be redefined follows, according to
Potter, from a critical refinement of the ideas of evolutionism. Prima facie,
evolution might seem identical to progress, and Darwinian principles have
also been usefully applied by human beings to improve their lives— for
example, through agricultural improvements informed by evolutionary
science. But Potter argues that belief in evolution as progress is deceptive.
Natural selection does not necessarily produce perfection—it can also lead
to extinction. This is due to what Potter called “evolution’s fatal flaw”:
the biological predilection for self-preservation and reproduction in the
immediate present (1990, p. 89). Although species tend survive because
they are well adapted to their environment, adaptation alone is insuffi-
cient for survival because the environment itself is continuously changing.
Adaptability—change in the face of a changing environment—is therefore
an essential ingredient of progress (1962, p. 5; see also Potter1964). It
is, furthermore, not only important that we are able to adapt to existing
environments but also that we work to create environments that future
generations will be able to live with. Therefore, adaptability should be
guided by the long-term goal of survival of humankind.
Against this background, Potter’s vision of the new discipline of bioeth-
ics can be better articulated. First, the focus should be on long-term goals
(overcoming the fatal flaw of evolution). Second, the biological necessity
of adaptability, characteristic of Homo sapiens, should, so to speak, be
matched by a cultural evolution focusing on long-range values, such as
preservation of the natural environment (Potter 1973) and the voluntary
control of human fertility (see Potter 1973 and1990). For human beings,
culture is the main mechanism of evolution (see Potter 1973). Human
beings can deploy their knowledge of nature and evolutionary processes
to bring real progress to society: instead of separating nature and culture,
man should be “turning to nature and to his fellowmen to build a culture
that has survival and development as its goal” (1973, p. 45). He presents
bioethics as a “worldview” that advocates a culture that recognizes the
interdependency of the human, plant, and animal worlds (1973, p. 46).
Yet scientific knowledge of nature will only be useful if it relates to the
long-range goals of society (see Potter 1962). It is only by combining

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knowledge of the sciences and of the humanities that we can bridge nature
and culture and therefore build a bridge to the future.

Teilhard de Chardin

An important intellectual source of inspiration for Potter, especially


in his early publications, was the work of Pierre Teilhard de Chardin
(1881–1955). Potter references his work in the preface of his 1971 book,
explaining that he began to study it in 1964, and mentions Teilhard’s
books at the end of his 1970 article. In 1968, Potter published an article
on Teilhard, later included as chapter 2 in his 1971 book. He recognized
that Teilhard, too, was interested in the problem of human progress. They
share the view that human progress is the goal of the universe, that we
should try to bring about the best possible future, and that the best way
to do this is to combine the science of biology with human values. Potter
therefore took it for granted that he could regard Teilhard’s work as a
corroboration of some of his basic ideas.
Still, there are significant differences between the two men’s views.
Although both employ an evolutionary point of view, their objectives are
different. Potter’s approach is pragmatic; he is primarily interested in solv-
ing problems. Teilhard’s emphasis is on developing a vision of the future
oriented around the question of humanity’s place in the universe. For the
first time in its history, humankind is aware that it is part of a process of
evolution, that it is itself evolving. This predicament explains the uneasi-
ness, the discontent, the disquiet of modern humankind and the uncertainty
about its role in the world. The sciences, according to Teilhard, almost
never address this basic question; they focus instead on separate and iso-
lated issues but never pay attention to the whole picture. He is impressed
by the discrepancy between the accumulation of scientific knowledge and
the ability to create a responsible perspective of life, world, and history
on the basis of this knowledge. Potter shares this concern; in his view, the
sciences are too specialized and lack a general perspective. But instead of
developing a new encompassing vision, Potter primarily emphasizes the
need for interdisciplinary cooperation on the basis of which new visions
may be created (see Potter 1964 and 1970).
The challenge, for Teilhard, is to outline a vision of the world that
emerges from the accomplishments of science and that takes into account
the role of human values. Teilhard takes the notion of evolution as the
starting point for such an endeavor. He believes this biological notion can
clarify all dimensions of the human condition: matter, life, and mind (see

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Teilhard 2004). Teilhard suggests that the ongoing evolution of humankind


will reach an “ultrahuman” phase characterized by greater complexity and
consciousness. In Teilhard’s view, humanity was becoming more unified,
more interdependent, and increasingly cooperative and would eventually
converge into a cosmopolitan community. Growing unification within
complex diversities and an increasing feeling of solidarity between human
beings are stages in the process of evolution that will lead to what he calls
the “planetization of mankind” (1975, p. 252). The world population
grows while the surface of the earth remains the same; therefore, people
will be forced to cooperate even more intensely: “We can progress only
by uniting” (2004, p. 66).
For Potter, this view of evolution is too optimistic. Recall his view of
the “fatal flaw” of evolution: natural selection is based on short-term
considerations; it aims at survival in terms of the present environment. It
does not take into account the fact of a continuously changing environ-
ment; as soon as the organism is adapted to its specialized environment, it
is increasingly vulnerable to changes. Both natural selection and cultural
evolution, which appreciate ideas for their present rather than future value,
are “incapable of seeing into the future” (Potter 1971, p. 109). Given
these conditions, as we have seen, Potter argues that the key concept in
evolutionary thinking should be adaptability.
Potter also blamed Teilhard for blurring the distinction between biologi-
cal and cultural evolution (see Potter 1971). Indeed, for Teilhard, these
two types of evolution are one and the same process in different stages;
such progress encompasses the whole of reality and thus there is continuity
between cosmic, biological, human, and cultural evolution. In his view,
progress is a force; it is built into living matter and human beings bring it
into culture (see Teilhard 2004). For Potter, there is no progress in matter:
biological evolution often goes into the reverse direction, leading to extinc-
tion. According to Potter, the crucial actors are human beings, who should
continuously strive to build a better future society. A sustained effort is
required since, according to Potter, the ultimate destiny of humankind is
unknown. Potter criticizes Teilhard for not considering the desirability of
multiple alternative evolutionary pathways; he believes, in Potter’s words,
that humankind “can know where [evolution] is going and how to get
there” (1971, p. 30). This is possibly a misunderstanding of Teilhard’s
thinking, which is generally not characterized by naïve optimism. The
ultimate completion of evolution, in the perspective of Teilhard, is only
a possibility not a certainty; “an almost limitless field of action lies open

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to us in the future” ( 2004, p. 63). Humankind itself will evolve into a


cosmopolitan phase only if we use our knowledge diligently and wisely.
Teilhard argues that since humanity has the capacity for reflection, we
can give direction to our own evolution, “collaborating” with and ulti-
mately shaping this ongoing process. Seeing to the progress of the human
world is, for Teilhard, the foundation of ethics. Humankind is at a critical
crossroads; we may choose a future orientation: progress, retrogression or
decline (see Teilhard 1975). If Potter’s criticism of Teilhard as naively opti-
mistic was slightly misplaced, it is only because Teilhard, too, emphasized
the possibility of self-correction in the progression of human development.
Finally, Potter criticizes Teilhard for being too positive about science.
Scientific knowledge is not always reliable; it can lead to undesirable ap-
plications and unintended results. As we have seen, Potter was especially
concerned with the issue of “dangerous knowledge,” a key instance of
which he took to be the problem of the population explosion. This is
perhaps also an underlying reason for disagreement with Teilhard. As a
Jesuit, he is for Potter a representative of so-called “primitive religion,”
believing in revelation, prophecy, and an afterlife that he regarded as more
important than earthly life. Religious ideas, in Potter’s view, help to main-
tain the unlimited growth of populations (1971, p. 85). Still, Teilhard is
also a critical representative of religion. In a note Potter added to Bioeth-
ics, he expresses the expectation that Teilhard, had he been living then,
would have supported the goal of zero population growth (1971, p. 29).
Regardless of the differences, it is clear that Potter shares many ideas
with Teilhard: the necessity of adopting an evolutionary perspective, the
importance of progress, a concern for the future, the need to combine
scientific knowledge and values. Above all, they share the belief that evolu-
tion cannot be explained from its starting point; it can only be understood
by focusing on the endpoint, the human being, and the possibilities for
the future.

The Influence of Pragmatism: James and Dewey

As we have seen, Potter’s views on bioethics are characterized by a


mixture of theoretical perspectives, especially evolutionary thinking and
a concern with the future. But they are also developed within a theoreti-
cal context that is less explicit: the philosophy of pragmatism. Several
of the basic ideas of Potter’s conception of bioethics are connected with
pragmatism, although Bioethics refers only once to a specific pragmatist
work (1971, p. 146) and mentions the names of key thinkers without

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going into details (1971, pp. 80, 113, 135). An influential philosophy
during the first half of the twentieth century, pragmatism is perhaps best
understood as an ambitious effort to synthesize scientific knowledge and
methods with ethical judgment, an attempt to integrate knowledge and
values long before Snow’s lecture (Thayer 1973). Pragmatism is centered
on several ideas that are seminal in Potter’s thinking: rejection of dualisms,
orientation toward the future, and a concern with notions of progress
and responsibility.
Pragmatism anticipated the midcentury angst over the division between
“cultures.” It envisaged itself as a mediator between what William James
(1842–1910) called the tough-mindedness of science and the tender-mind-
edness of religious and moral values. In his history of modern philosophy,
John Passmore actually refers to James’s devotion to “bridge-building”
(1968, p. 104). John Dewey (1859–1952) was even more outspoken in
his rejection of dualisms in all the forms that they have occurred: science
versus values, acting versus thinking, theory versus practice, mind versus
body, human beings versus nature, organism versus environment. In the
view of these pragmatists, the separation of moral values and scientific
knowledge had been characteristic of modern thought since the seven-
teenth century. The historical mission of pragmatism was to “reconcile”
or “bridge” these separations. This is the main thread in Dewey’s long
philosophical career: “Certainly one of the most genuine problems of
modern life is the reconciliation of the scientific view of the universe with
the claims of the moral life” (1931, p. 43).
The task of philosophy is thus reconstructive: to bridge the separation
between science and values, to forge continuity. The pragmatist solution to
this apparent gap was the theory of knowledge as valuation. Both valuing
and knowing are logically common modes of intelligent action; knowing
is itself an evaluative activity. Scientific knowledge is a paradigm of moral
activity. For Potter, this intrinsic link between thinking and acting is at-
tractive as a bridge between science and values. Ethics, in Dewey’s view,
is nothing more than the placing of physical, biological, and historical
knowledge in a human context as a means of guiding human activities.
Ethics is not different from science; both use the same methodology.
Bridging the gap between knowledge and action allows us to use scientific
knowledge in the formation of moral standards and ideals. That is why
Potter argues that bioethics must be based on modern concepts of biology
and not on unsupported introspection (1971, p. 4).

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The pragmatic theory of knowledge is also intrinsically oriented toward


the future. Knowledge is successful practice. James characterizes ideas
and beliefs as “plans of action” (1907, p. 32). Theories and concepts are
instruments, not answers to enigmas; they have the capacity to lead us to
future facts and experiences. Dewey shares this emphasis on the future:
“Pragmatism . . . does not insist upon antecedent phenomena but upon
consequent phenomena, not upon the precedents but upon the possibilities
for action” (McDermott 1973, p. 50). Judgments of facts and judgments of
value have the same orientation: both are predictions concerning the future.
The implication is that in ethics one should use the same methodological
approach as in science: ethical principles, standards, and rules should be
regarded as hypotheses. They are, in Dewey’s words, “intellectual instru-
ments to be tested and confirmed—and altered—through consequences
effected by acting upon them” (McDermott 1973, p. 592).
Potter clearly reiterates these ideas. He repeatedly argues that all ideas
are tentative and subject to evaluation (1971, pp. 110, 164; 1975b).
Ethical concepts are not fixed but evolving (see Potter 1977). The new
discipline of bioethics is characterized by fallibility (see Potter 1975b).
Therefore, continuous testing and assessment are imperative. First, we
have to determine what the consequences of an action will be. Second, the
consequences have to be assessed. This requires empirical investigation
(for the first level of activity) as well as evaluation of the meaning and
value of the consequences (for the second level of activity). What is new
in bioethics is that disciplinary boundaries are crossed: the two levels of
activity will necessarily combine scientific knowledge and knowledge of
human values (see Potter 1970).
But bioethics is also innovative in its focus on action (1971, p. vii). Since
we can no longer be satisfied with the contemplation of nature but are
challenged to modify and improve it, the traditional spectator perspective
of knowledge is inadequate. In the new discipline of bioethics, ethics is
not an isolated, theoretical activity: it is not speculative or meditative but
rather strives to change and improve the world. Ethics only has a meaning
when we are involved actors. This possibly motivates Potter to close his
two books with a “bioethical creed” presenting five statements of belief
each followed by a commitment to action (see Potter 1971 and 1988). The
focus on action is promoted by a pragmatist interpretation of the notion
of progress. As already noted, Potter is careful and critical with this no-
tion, having criticized Teilhard for being too optimistic about progress.
He argues for a middle road between optimism and pessimism about the

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future: the world can be improved, although we have no guarantee that it


will be improved (see Potter 1975a). As long as evolution is not finished
and the universe is still “plastic” (Dewey 1931, p. 25), improvement is
possible. This is what Potter calls “long range pragmatism”: ideas and
action should aim to ensure the long-term goal of the survival of human-
kind (1962, p. 3).
Finally, Potter builds on another basic tenet of pragmatism: responsibil-
ity. He characterizes bioethics as “a morality of responsibility” (1988, p.
153), and like James, he assumes that the starting point for ethics is the
moral experience of responsibility for action (see James 1907). This expe-
rience of responsibly choosing requires that choices are free, that the free
acts of human beings introduce novelty in the world: these acts determine
the future of an underdetermined cosmos. Exercising our freedom can thus
be decisive for the future of the world and the survival of our species (see
Potter 1988). Scientific knowledge and biological science in particular can
help us in making these responsible choices, as Dewey argues: we have a
responsibility to use advanced knowledge and technology to control the
social consequences of the application of science. But where do we find
guidance, directive standards, if we no longer can rely on familiar and
traditional values? Dewey’s answer is in the findings of natural science. The
separation between knowledge and action has deprived scientific knowl-
edge of “its proper service as a guide of conduct” (McDermott 1973, p.
589). However, if we can—as Potter argues—reconnect science and eth-
ics, we can also relate our value judgments to the conclusions of science.
The interrelation between progress and responsibility and between
science and philosophy is echoed in Potter’s characterization of bioethics
as an enterprise combining humility with responsibility. Since we have
freedom of choice, we are responsible for the future, but at the same
time the possible outcome is always uncertain. The only thing that the
“evolving morality” of bioethics can do is work to continuously develop
“the best possible understanding of the world and humankind’s place in
it” (1990, p. 90).

The Influence of Aldo Leopold

Another theoretical perspective Potter draws on is environmental eth-


ics, a field that burgeoned in the 1960s as worries about nuclear warfare,
the impact of pesticides, pollution, and the rapid depletion of natural
resources came into public focus. During this same period, policy makers
as well as the general public became more aware of the significance of

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kennedy institute of ethics journal • march 2012

the environment. In 1970, American environmental activists organized a


nationwide day called Earth Day to raise awareness about environmental
issues; in the same year, the U.S. government established the Environmental
Protection Agency, and in 1971 the United Nations proclaimed the annual
celebration of an international Earth Day.
During the same period, biology was rapidly expanding, with the emer-
gence of ecology as a new discipline that studies the interrelations between
plants, animals, human beings and the physical environment. Public
awareness of the fact that the natural environment of humankind is not
limitless was increasing. Although environmental ethics as a philosophical
discipline emerged later in the 1970s, new approaches to ethics that would
take account of environmental problems were advocated earlier (Attfield
2003). Aldo Leopold (1887–1948) played an especially influential role.
He worked in forestry and wildlife management before being appointed
professor of game management at the University of Wisconsin-Madison
in 1933. Leopold was a staunch advocate for the preservation of wildlife
and wilderness areas. He had a strong and early influence on the ecologi-
cal movement with a book published in 1949 shortly after his death. In
this publication he introduces the notion of a “land ethic,” which extends
the notion of community from human community to a community that
includes soil, waters, plants, and animals. The land should be regarded
as one living organism, a system of interdependent parts, an ecosystem,
of which human beings are merely a part. Leopold formulates a central
tenet of this ethic as follows: “A thing is right when it tends to preserve
the integrity, stability and beauty of the biotic community. It is wrong
when it tends otherwise” (1949, pp. 224–25).
Potter dedicates his first book on bioethics to the memory of Aldo Leo-
pold, “who anticipated the extension of ethics to Bioethics” (1971, p. v).
He quotes Leopold in arguing that there are three stages in the develop-
ment of ethics. The first stage concerns the relation between individuals,
the second stage the relation between individual and society, and the third
stage—which does not yet exist—the relation of human beings to their
environment: the land and the animals and plants growing on it. Potter
was convinced that his new discipline of bioethics would be the realization
of Leopold’s third stage of ethics (see Potter 1988). “I had continued Leo-
pold’s line of thought,” he writes (1987, p. 158), though he later admitted
that he was unaware of Leopold’s existence when they were colleagues in
the same university (see Potter 2000). Notably, he added the dedication
to Leopold when the 1971 book was ready for publication but he did not

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ten Have • Potter’s Notion of Bioethics

include any references to Leopold’s work. Potter’s second book, Global


Bioethics, published in 1988, more fully recognizes Leopold’s influence
(2000, p. 89).
From the beginning, Potter’s primary concern was to bridge the divide
between humankind and nature. He argues that “human ethics cannot be
separated from a realistic understanding of ecology in the broadest sense”
(1971, p. vii). His criticism of evolutionary thinking—that it does not take
into account the central notion of adaptation—is intrinsically linked to
his appreciation of the significance of an environment that is continuously
and rapidly changing. The concept of an “optimum environment” plays
a central role in chapters 8, 9 and 10 of his book. The environment is
changing, mostly owing to human influences. Rethinking ethics is neces-
sary since the survival of the total ecosystem is at stake. In the end, the
question is what kind of environment will be able to sustain and improve
the civilized world (1971, p. 130). That is why ethics should be enlarged
or extended, including in its scope not only individual and social issues
but also environmental issues. This requires that we reflect on the long-
term consequences of science as well as develop a common value system
with our obligations to future generations as a core element (1971, p.
192). Two challenges are particularly highlighted: peaceful preservation
of our earthly environment and achieving a balance between population
and environment.
In Potter’s view, it is evident that ecological problems arise from hu-
man population growth (1971, p. 179). In his list of major problems of
our time, population is at the top. Potter highlights two aspects of the
problem (1971, pp. 154–55): first, that population-level interventions
have contributed more to advancing human welfare than individualized
medicine. There is effective and available knowledge that is currently
not applied but should be applied to whole populations—for instance,
vaccination for infectious diseases. If we really want to use scientific
knowledge for improving the human condition, the focus should be on
survival as a species rather than on prolongation of individual life. But
the advancement of science has also contributed to out-of-control nature
of the world population. More effective public health interventions will
only exacerbate the population problem.
Secondly, Potter notes that the usual ethical approach of moral persua-
sion—appeals to individual conscience—will be insufficient to solve the
population problem (1971, p. 155). It is not clear how Potter himself be-
lieved the problem should be addressed, though he suggests that mandatory

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kennedy institute of ethics journal • march 2012

and broadly applied measures, enforced by government, will be necessary.


Governmental policies should aim at developing and applying technolo-
gies of birth control; “controlled reproduction” should be imposed even
if there is no agreement in the population (1971, p. 157). However, in a
subsequent chapter in the book Potter argues that a voluntary change in
the birth rate might be achieved using a combination of economic rewards
and the “power of reason”—which seems to imply that people could be
persuaded to attain an optimum human world population that contributes
to an optimally functioning ecosystem (1971, p. 180).
The emphasis on controlled human fertility is even stronger in Global
Bioethics. Here it is called “a basic ethical imperative for the human spe-
cies” (1988, p. 2). Advances in science and health care cannot be success-
ful without zero population growth, a concept that according to Potter
was first enunciated by Leopold (1988, p. 17). At the same time, fertility
control is now easier to implement because there is an increasing range of
options available, from various contraceptive methods to education. Potter
drops the reference to coercion but still emphasizes the need for an ethic
that no longer gives “top priority to the principle of autonomy” (1988,
p. 131). Several years later he referred to “a moral constraint on human
fertility” or “voluntary limited reproduction” (Potter and Potter 1995,
p. 187) and argued later that “world-wide availability of contraception”
should be one of the goals of bioethics (2001, p. 25).
Potter’s conception of bioethics was obviously influenced by the emer-
gence of ecology as a separate scientific discipline and the public move-
ment of concern for the environment. Like others, he advocated the need
for a new ethics that would include the environment, and he relied on
the idea that ecology in particular can serve as a moral guide. Still, it is
possible that Potter was too ahead of his time in his concern to make en-
vironmental considerations a part of bioethics. When his 1971 book was
published, environmental ethics has not yet developed; the first systematic
publications on environmental ethics begin to appear later in the 1970s,
and policy documents on environmental protection began to be developed
in the 1980s. Given recent developments in the field, Potter’s view of the
encompassing nature of bioethics seems especially prescient: his definition
includes medical bioethics as well as environmental or ecological bioethics
(see Potter 1975b, 1977, 1988).

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ten Have • Potter’s Notion of Bioethics

Global Bioethics

Although Potter reiterates many of his earlier ideas in Global Bioethics,


what Potter wanted to accomplish with this new volume was twofold.
First, we need an ethics that seeks a better balance between humankind
and the natural world; the ecological perspective should be included in
bioethics. The strong emphasis in this book on Leopold’s ideas underlines
the significance of the environmental point of view for ethics: Potter singles
Leopold out as “the first bioethicist” (1988, p. xiii). Second, if bioethics
has the long-term goal of survival of humankind, it should take a broad
view, relating medical concerns to social and environmental issues. It
should overcome the divides between nature and culture, science and
values, humankind and nature. In order to better articulate this broader
approach Potter introduces the concept of “global bioethics.” The word
“global” suggests what should be new—the approach should be “unified
and comprehensive” as well as “worldwide in scope” 1988, p. 78).
The dimension of globalization is, curiously, not articulated in Potter’s
conception of bioethics in the 1970s. There is no explicit mention of the
global scope of problems or the global nature of required solutions.2 This
is remarkable since what we call “globalization” today plays an important
role in the work of Teilhard de Chardin, already cited as one of Potter’s
chief intellectual influences. Owing to the processes of “planetary com-
pression” (intensified communication, travel, exchanges through economic
networks) and “psychic interpenetration” (increased interconnectedness
and a growing sense of universal solidarity) humankind will be involved
in an irresistible process of unification, according to Teilhard (2004, pp.
106ff). Shortly after the Second World War, Teilhard wrote that even in-
cidental recurrences of racism and nationalism do not have importance in
the overall process of cultural and social evolution of the planet; they are
disastrous for individuals but compel us sooner or later to come together on
the basis of human solidarity (2004, p. 108). Leopold, too, emphasized the
need for a global perspective in ethics. The fact that many environmental
problems have a global nature will require a rethinking of ethics on the
basis of notions like global community and global citizenship.
At the same time, we might say that the global dimension was always
implicit in Potter’s work. Bioethics’ basic problems, such as population
growth and poverty, affect all of humankind. Bioethics’ goal of survival
is global since what is at stake is the survival of humanity. And bioethics’
methods are global in the sense that they combine all available intellectual
resources for long-term approaches. In the closing pages of his 1971 book.

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kennedy institute of ethics journal • march 2012

Potter expresses the hope that bioethics will create “a worldwide move-
ment” (1971, p. 194). However, there was a specific reason why Potter in
the late 1980s and 1990s promoted the new name of “global bioethics.”

Potter’s Dissatisfaction

Potter notes, disapprovingly, in ”Aldo Leopold’s Land Ethics Revisited,”


that “the original term ‘bioethics’ . . . was restricted to the medical applica-
tion by the people at Georgetown University” (1987, p. 159), a point he
had already made, not long after he introduced the term in the early sev-
enties (Potter 1975b). He was surprised that its meaning had “migrate[d]
from its initial usage” (1996, p. 2) in his own work to a restrictive emphasis
on medical ethics (1975b, p. 2300), redefined as “clinical ethics” (1996a,
p. 1). The problem, in Potter’s view, is not so much that bioethics focused
on medical issues but rather that it elaborated an ethics of individuals and
individual relations (Leopold’s first stage of ethics) and therefore neglected
ecological, population and social problems. The Georgetown approach
to bioethics took a short-term view (1987, p. 159) rather than focusing
on the continued existence of the human species. Finally, it considered
“old problems” (abortion, euthanasia) rather than problems that really
matter for the survival of humankind ( 2000, p. 89). Potter also criticizes
environmental ethics; it went its own way, separated from bioethics (see
Potter 1995), becoming an ethics specialty without a broader perspective
(see Potter 1977 and 1999). Potter’s broad vision of bioethics had, in this
divergence, become an “orphan” (1995, p. 369). By rebranding his vision
as “global bioethics,” he hoped to reintegrate the two domains.
Potter indicates several times that there were also personal reasons for
his dissatisfaction. He did not feel recognized by the bioethics community,
observing that his books were not read by most scholars (see Potter 2000).
He notes that when the Institute for Human Reproduction and Bioethics
at Georgetown University was founded, all mention of his books was
omitted (see Potter 1995). While he was successful in cancer research,
he wondered why he was “so unrecognized in the U.S. when I began
to write about ethical questions” (1996, p. 3). He seemed to regret that
“professors of philosophy” had taken over the field of bioethics, turning
it into an ethics specialty, noting that he himself was without credentials
in philosophy (see Potter 1987, 1996, and 1999). Like Teilhard, Potter did
not want to be philosopher. The emphasis on philosophy also tended to
downplay Potter’s scientific experience as a cancer researcher, along with
the lessons about trade-offs between individual and global perspectives

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ten Have • Potter’s Notion of Bioethics

he drew from it (see Potter 1988, 2001). Potter passionately believed that
environmental and future-oriented concerns could not be separated from
a medical perspective, since all are necessary to secure for human health.
Bioethics cannot be reduced to biomedical ethics (see Potter 1987).
Reich (1995) offers several explanations as to why Potter’s ideas about
bioethics were marginalized, some of which relate to Potter’s own work.
For instance, the 1971 book is actually a compilation of mostly journal
articles published during the previous nine years. The connection between
the chapters in the book is not always obvious, and so it is difficult for
the reader to summarize Potter’s theory by the close of the volume. The
writings are complicated and eclectic; they are a mixture of components
from various theories and scholars, difficult to articulate in a coherent
and systematic way. This eclecticism means that his expositions have little
appeal as a vision. One also gets the impression that he at times seems
to present his own ideas through the work of others, using long quota-
tions, leaving the reader to implicitly assume that they reflect the thinking
of Potter himself. Reading Potter’s early work produces a kaleidoscopic
feeling. The various bridges that he wanted to construct are the result of
“bricolage”; they are the outcome of trying, testing, and tinkering rather
than the result of a conventional, analytical style of solving problems.
Drawing upon future-oriented thinking, evolutionary science, pragma-
tism, and ecological philosophy, he further introduced ideas from systems
theory and molecular biology in order to address the pressing problems of
his time. The 1988 book is more readable but has similar heterogeneous
characteristics: many issues are discussed, but it is difficult to highlight
the main ideas. The book presents many practical issues and dilemmas,
but the analysis is often brief and inconclusive.
Another factor is that although both of his monographs are on bioethics,
the ethical component is rather underdeveloped. Potter says little about
ethics itself. The role of ethics is not articulated even as the need for a new
ethical perspective is continuously underlined. Rather than elaborating
the substance of a new ethics, Potter prefers to dwell on the procedures
that might be used to develop bioethics. This is perhaps consistent with
his image of the bridge. The important feature of bioethics is its inter-
disciplinarity. Bioethics is a kind of hyperscience; it should use scientific
methodology (generating new ideas, testing them in peer groups, in ex-
periments, and in discussion with the literature) while at the same time
crossing the boundaries between disciplines. The best way to proceed is
therefore to establish groups of experts from various disciplines in which

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kennedy institute of ethics journal • march 2012

scientific competence is combined with humility. Because bioethics is a


branch of science, in Potter’s view, the bioethicist is first of all a biologist.
Bioethics is a “new holistic biology” that includes the social sciences and
humanities. Potter argues that we need “a new breed of scholars” trained
in the humanities and social sciences but in particular in molecular biology
(1964, p. 1022; 1971, p. 66). He explicitly rejects a bioethics based on
“unsupported introspection” (1970, p. 130). He does not explain what
he means, but presumably he refers to philosophical and ethical reflec-
tion. How the wisdom that Potter advocates will emerge in the practice of
interdisciplinary activities is not clear. If biological science is a source of
value judgments, the risk is that bioethics will only reproduce the values
already implicit in science itself.
Instead of engaging in theoretical reflections concerning ethics, Potter
demonstrates a pragmatic approach, as mentioned. Both monographs end
with a bioethical creed for individuals, listing five beliefs and commit-
ments in 1971 and seven in 1988. This approach to ethics is not unusual
for scientists. Academies of science are used to making codes of conduct,
and researchers commit themselves to some ethical “rules of engage-
ment.” Formulating a creed demonstrates that for Potter ethics is a matter
of conviction and action rather than reflection and argumentation. His
work is filled with practical proposals, charts, diagrams, and lists: twelve
fundamental biological concepts for the development of bioethics and
seven principles for an optimum environment (1971, p. 105), as well as
charts and schemes to illustrate processes, interactions, and developments
(e.g., 1971, p. 111; 1988, pp. 159–60). This is in line with his pragmatist
philosophy that the value of new ideas is in their application, and that
the goal of reflection is problem solving. But it also suggests that the new
bioethics is like an empirical science; as long as we use clear methodologies
and procedures that have proven their value in the domain of science, we
will reach new solutions to ethical dilemmas.

The Development of a Global Perspective

Potter’s concept of global bioethics is attracting more attention today


than in the past, when Reich could only identify a “modest” legacy for
Potter (1994, p. 322). His work has received more recognition outside
the United States in particular—for example, in Colombia (Osorio 2005),
Croatia (Segota 1999) and Italy (Furnari 2002). In 2000 Potter was
awarded the first Bioethics Prize of the International Society of Bioethics
(convening in Gijon, Spain). More importantly, the idea that biomedical

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ten Have • Potter’s Notion of Bioethics

ethics should broaden its mission has been gaining support (Brock 2000;
Daniels 2006; Holm and Williams-Jones 2006; Turoldo 2007; Dwyer
2009; Gruen and Ruddick 2009; Ross 2010; Verkerk and Lindemann
2011). In Global Bioethics, Potter argues that global bioethics provides
the bridge between medical and ecological bioethics; in the 1996 “Real
Bioethics” and the 1999 “Fragmented Ethics and “Bridge Bioethics,” he
includes agricultural ethics, social ethics, organizational, and religious
ethics.3 Echoing this shift, there has recently been much more attention
paid to global issues in bioethics, including issues such as global health
(Wikler and Cash 2009), population control (Callahan 2009), and global
justice and poverty (Pogge 2010).
Potter also had noticed that the search for a global scope for ethics had
been undertaken by world religions, especially through the activities of
Hans Küng (see Potter 1994, 1995). In one of his last publications, Potter
advocates for the involvement of the United Nations in bioethics and even
for the establishment of a “Bioethics Development Section” in the orga-
nization (2001, p. 29). Today, UN agencies as WHO and UNESCO have
sections for bioethics, and member states of UNESCO have unanimously
adopted the Universal Declaration on Bioethics and Human Rights (An-
dorno 2007; Ten Have and Jean 2009). Potter’s idea of global bioethics
is reflected in the principles of this declaration, which is concerned with
health care, the biosphere and future generations, and social justice.

The first drafts of this paper were written during a visit as the Oscar M. Ruebhausen Visiting
Professor in the Department of Bioethics at Case Western Reserve University in Cleveland,
Ohio. I am grateful for the support of the Greenwall Foundation and the assistance of my
colleagues in Cleveland. I would particularly like to thank my Duquesne colleague Gerard
Magill for helping to improve the text.

Notes

1. Thalidomide, a sedative drug introduced in the late 1950s, was withdrawn


from the market in 1961 after it was proven to be the cause of congenital
deformities such as phocomelia in thousands of patients, mostly in Europe.
The case stimulated the introduction of more stringent legislation requiring
tests for safety during pregnancy for new drugs.
2. In his early publications, Potter only mentions once that bioethics is address-
ing “global problems” (1977, p. 251).
3. Potter used the name “‘real bioethics”’ for this comprehensive category, which
embraces agricultural, environmental, medical, organizational, and religious
ethics globally (1996b, p. 182).

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kennedy institute of ethics journal • march 2012

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Contributors

Alan Rubel is an assistant professor in the School of Library and Information


Studies and Program in Legal Studies and faculty affiliate of the law school at the
University of Wisconsin-Madison. He is a former Greenwall Fellow in Bioethics
and Health Law Policy at Johns Hopkins University and Georgetown University.
James Rocha received his doctorate from the University of California at Los
Angeles with a dissertation on the value and limitations of an autonomous
life. He held positions at Pierce College and California Polytechnic at Pomona
before becoming an assistant professor at Louisiana State University. He cur-
rently teaches and researches applied ethics, feminist philosophy, and philoso-
phy of race at LSU.
Henk A.M.J. ten Have is director of the Center for Healthcare Ethics at
Duquesne University. He worked as a physician and researcher in Leiden and
Rotterdam before being appointed professor of philosophy at the University
of Limburg, Maastricht, and as professor of medical ethics and director of the
Department of Eth­ics, Philosophy, and History of Medicine at the Radboud
University Nijmegen Medical Centre. In 2003 he joined UNESCO as director of
the Division of Ethics of Science and Technology in Paris, France, and in 2010
he moved to Pittsburgh to direct the Center for Healthcare Ethics at Duquesne
University.
Reproduced with permission of the copyright owner. Further reproduction prohibited without permission.

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