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Abstract

How should members of a liberal democratic political community, open to value pluralism, decide bioethical issues that generate deep disagreement? All too often, reasoned debate yields no answer equally acceptable to all participants and affected persons. One political means of reaching binding because authoritative decisions are majoritarian democratic institutions. A core feature of this means is proceduralism, the notion both that no rule is acceptable apart from a formal method, and that the acceptable method yields an acceptable rule. I argue that two procedures in particular can deliver “legitimate” bioethical decisions. I advance this argument in three steps. (1) I develop the thesis with the example of human germline gene editing. (2) I propose a general understanding of proceduralism, toward coping with the bioethical questions raised by germline engineering. (3) I combine two types of proceduralism toward deciding difficult bioethical issues: expert bioethics committees and deliberative democracy. I call this approach political bioethics on the claim that bioethics belongs to the political sphere where issues of regulation, legislation, and public policy are decided. Resolving such issues often involves decisions that cannot be “correct” but can be “procedurally legitimate.”

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