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This research paper examines the ethical dimension of cultural diversity and its challenges in relation to disagreements about social policy in medicine and biotechnology. It presents key normative ideas concerning social conﬂicts arising from cultural diversity and three approaches to culture based reasons in public deliberation of bioethical issues: exclusive, inclusive, and critical-inclusive.
Diverse cultural traditions, identities, and groups coexist in modern society. The plurality of cultures in our globalized world can be enriching as well as challenging. Diversity is enriching when different ideas and traditions enable variety and innovative ways of living. It is challenging when cultural differences lead to conﬂict, undermine social cooperation, and make it difﬁcult for opposing groups to respect their differences. It is especially challenging when groups have conﬂicting views about the kind of public bioethical policy the government should impose on its culturally diverse citizenry – when different groups appeal to their own cultural norms. Should we exclude culture-based reasons in justifying claims in public debates because these reasons are based on speciﬁc cultural traditions that do not appeal to the public at large? Or should we include such reasons to give recognition to the diverse cultural identities of those who practice traditions on which these reasons are based? If excluding culture-based reasons is meant to prevent cultural differences from hindering compromise or if including these same reasons in public debate is meant to ensure that conﬂicting parties will be able to support any compromise that could come out of public debate, then it may not be exclusion or inclusion of culture-based reasons per se that is crucial in dealing with conﬂict between cultures. Instead, we need to evaluate every culture-based reason to establish whether it might contribute or hinder compromise and resolution of conﬂicts. If culture-based reasons facilitate compromise, then these reasons deserve inclusion in public debate. However, if culture-based reasons silence opposing views by imposing the primacy of one’s own traditions over others – preventing conﬂicting parties from achieving compromise – then such reasons cannot help us deal with the challenges of cultural diversity. UNESCO’s Universal Declaration on Bioethics and Human Rights Article 12 calls for respect for cultural diversity stating that “The importance of cultural diversity and pluralism should be given due regard.” But is also states that “.. .such considerations are not to be invoked to infringe upon human dignity, human rights and fundamental freedoms, nor upon the principles set out in this Declaration, nor to limit their scope.”
Culture, Recognition, And Freedom
The term culture can be as broad as to include all sorts of practices and traditions. Notwithstanding the multiplicity of deﬁnitions of culture, there seems to be a core concept shared by different understandings of the term. The core concept of culture refers to the pattern of ideas and their attached values and prescriptions that guide behavior (Baldwin et al. 2006, p. 8 cf. Kroeber and Kluckhohn 1952, p. 181). As patterns of ideas and values, cultural traditions are sources of reasons for justifying our claims about what we should do together in society. But how do we assess the relative value of different cultural traditions when they clash?
Charles Taylor (1994) advised that we should give cultural traditions recognition without prejudging their worth based on our own cultural standards (Taylor 1994, pp. 65–72) since cultural traditions “have provided the horizon of meaning for large numbers of human beings, of diverse characters and temperaments, over a long period of time” and “have something that deserves our admiration and respect, even if it is accompanied by much that we have to abhor and reject” (Taylor 1994, pp. 72–73). Such legacy of diverse cultural traditions is subject to scrutiny as we engage in their comparative study. Cultural outsiders will be able to judge the worth of different traditions in an objective way once we step back from the biases of our own cultural standards in a comparative cultural study that would displace “our horizons in the resulting fusions” (Taylor 1994, p. 73).
Jurgen Habermas (1994) counters that traditions “normally reproduce themselves by convincing those whose personality structures they shape, that is, by motivating them to appropriate productively and continue the traditions” (Habermas 1994, p. 130). We should only preserve traditions if we remain convinced of their value. Otherwise, we have the right to reject them. We need not guarantee preservation of cultural traditions because doing so would “rob the members of the very freedom to say yes or no that is necessary if they are to appropriate and preserve their cultural heritage” (Habermas 1994, p. 130).
Rejecting cultural traditions (regardless of whether this is from within or from outside a group) may result in conﬂict with those who cling to such traditions. Rejecters may be able to tolerate differences at varying levels, but the less tolerant must be persuaded through reasoned argument that the perceived disruption of their freedom is only apparent. For example, if one does not approve the use of artiﬁcial contraceptives, it may not be a good reason to say that the objector’s freedom is disrupted when others use them. The objector’s freedom is not disrupted because she can still refrain from using contraceptives herself. Insisting that everyone should refrain from using contraceptives on traditional grounds might in fact restrict the freedom of others who have a different belief about the issue.
What Are Culture-Based Reasons?
In modern liberal democracies, proposing public policy that will be funded by taxpayers’ money and imposed on citizens and residents requires legitimation through wide public deliberation and/or democratically delegated debate among representatives or some duly appointed expert panel who will articulate and assess reasons for adopting or rejecting such a public proposal. The kinds of reasons usually included in such deliberations are culture-neutral reasons (or public reasons) that have wide public appeal and which do not favor particular cultural traditions, whether it be Muslim, Christian, atheist, etc. Culture-neutral reasons, because of their impartial nature and general appeal, could not alienate any group in a multicultural society. These reasons are used in arguments designed to be acceptable to all in a public debate (Bohman 1995). Reasons that do not favor any group but simply facilitate the fair interaction of diverse groups and individuals in society are culture-neutral. For example, reasons that invoke Rawls’s two principles of justice are culture-neutral since these principles prescribe basic rights for everyone, regardless of cultural afﬁliation, and equality of opportunity for all.
Culture-based reasons, in contrast, invoke traditional authority for deciding on a public policy, e.g., authority based on a particular religious text (e.g., the Bible). Only those who belong to traditions that recognize the authority of such texts can recognize these types of reasons. A reason is culture-based when the foundation of its correctness or truth rests on a particular worldview or a set of traditional beliefs held only by members of a group. There could be reasons that ﬁnd support in many different cultural traditions, but these reasons are not, as stipulated in this research paper, culture based. For example, reasons that invoke the Golden Rule of reciprocity, although prescribed by many if not all religions or cultures, are not culture-based but culture-neutral. Invoking reciprocity can appeal to the wider public because reciprocity is essential to cooperation and has the potential to facilitate exchanges and compromise between competing groups in a multicultural society. The principle is not culture-based since its correctness does not rest on traditional beliefs held only by members of a particular group. Rather, it is a culture-neutral reason that is also widely accepted by different cultural groups.
Three Normative Approaches
Just social policies attract support from diverse groups that recognize social justice as a fundamental enabling condition for the ﬂourishing of their own distinct ways of life. Cultural conﬂicts could adversely affect common interests. But how should we resolve such conﬂicts when traditions do clash and opposing parties try to persuade their governments to force others to respect their right to practice their own beliefs and traditions using culture-based reasons as justiﬁcation?
Exclusive Approach: Set Aside Cultural Differences And Adopt Culture-Neutral Principles
According to Rawls, a just society should be organized according to principles selected using a culture-blind perspective, i.e., members of a just society should set aside and exclude culture-based reasons when choosing principles of justice. Culture is not a relevant consideration in choosing principles of justice. The basic structure of society should be arranged on the basis of “a constitution.. .which all [free and equal] citizens.. .may be reasonably expected to endorse.. .in the light of principle.. .acceptable to their common human reason” (Rawls 1993, p. 137). Such culture neutral common human reason enables people that disagree on substantive matters (or cultural beliefs) to live together and cooperate despite their differences. Intractable disagreement on substantive issues should be methodically avoided (aka “method of avoidance” in Rawls 1985, pp. 230–231, 240 cf. Bohman 1995, pp. 254–255). Conﬂicting parties should agree on procedures instead. Nonpublic reasons, since these are based on “comprehensive religious and philosophical doctrines,” are not useful in fostering cooperation and stability in society, so we must employ public reasons instead (Rawls 1993, p. 217). Rawls’s public reasons are similar to what I call culture-neutral reasons, and his nonpublic reasons (Rawls 1993, p. 220) are equivalent to what I call culture-based reasons. Cultureneutral principles include (1) equal right to basic liberty and (2) permitting social and economic inequality only when it maximizes the welfare of the worse-off and only if social and economic positions are open to all under conditions of fair equality of opportunity (1999, p. 60). Culturebased reasons are not useful in deliberating how we may establish social cooperation and therefore should be excluded in public debate.
Jurgen Habermas, while not directly advocating culture neutrality as Rawls does, seems to agree with Rawls in assuming that individuals have a built-in rational capacity to evaluate for themselves which elements of their culture are worth keeping and rejecting. He implies this when he explains that “Cultural heritages and the forms of life articulated in them normally reproduce themselves by convincing those whose personality structures they shape, that is, by motivating them to appropriate productively and continue the traditions” (Habermas 1994, p. 130). For the same reason, society cannot guarantee survival of cultural traditions “For to guarantee survival would necessarily rob the members of the very freedom to say yes or no that is necessary if they are to appropriate and preserve their cultural heritage” (Habermas 1994, p. 130). In other words, the freedom to say yes or no to a cultural practice is not negotiable and cannot be trumped by the need to preserve tradition. Individual freedom must be respected. For Habermas, culturebased reasons can be set aside or must be set aside when these reasons undermine the freedom to say yes or no. Culture-based reasons must have the quality to convince and must appeal to human reason if they deserve to be preserved. But this very same freedom seems to fuel the kind of conﬂict that emerges from rejecting cultural traditions from within a group or between different groups.
Conﬂict does not merely ensue at the level of clashing traditional beliefs and practices (Bohman 1995). Conﬂict may run deep when it is produced by clashing standards for evaluating the merits of beliefs and practices themselves. How can we properly evaluate reasons if the standards for evaluating these reasons are themselves subject to deeply conﬂicting interpretations? Bohman criticizes Rawls’s failure to resolve the problem of deep conﬂict in irreconcilable standards of evaluation. He argues that neither overlapping consensus nor the method of avoidance is sufﬁcient in ﬁnding the public basis of justiﬁcation for solutions to deep cultural conﬂicts. Bohman proposes that deep conﬂict can be resolved if we revise Rawls and Habermas’s liberal approach to public deliberation in two ways: (1) make the political conception of justice more dynamic (not ﬁxed as Rawls seems to advocate) and (2) make public reason “plural” and not “singular.” Rather than endorsing one singular public reason (overlapping consensus), we must make public reason plural and require all groups to be open to compromise and to changing their own views and beliefs to avoid persistent political inequalities between them. Despite Bohman’s criticism of the Rawlsian approach, Bohman’s compromise approach and Rawlsian culture neutrality seem to have similar practical implications. The Rawlsian requirement to exclude cultural traditions and be neutral may in some sense imply making a compromise with regard to these traditions such that political cooperation could be achieved. To compromise means one still holds a distinct view based on one’s culture but sets this view aside (or changes it) to enable cooperation with others who hold a conﬂicting view. The same thing is done by being neutral about substantive cultural beliefs or comprehensive worldviews. One can still hold distinct cultural views while not counting them as reasons for not cooperating with others. What is different in Bohman’s approach is his requirement to openness to changing even one’s own cultural views (Bohman 1995, p. 270) in order to attain political equality between conﬂicting cultures. This demand to be willing to revise cultural views is not part of liberal neutrality since cultural beliefs and practices are excluded in public deliberation. Cultural beliefs and practices that are set aside could remain unchanged and continue to be practiced by a believer in private. These unchanged private beliefs and practices may still clash with other traditions when practitioners later invoke them in public deliberations.
Inclusive Approach: Mutually Recognize Cultural Differences By Including Culture-Based Reasons
Bohman’s argument to include culture-based reasons in forging compromise in public deliberation between conﬂicting parties seems to agree with Taylor’s approach. Taylor argues that multicultural conﬂicts can be solved by mutually recognizing cultural differences through “fusion of horizons,” an idea he borrowed from Hans Georg Gadamer (Taylor 1994, pp. 66–73). Taylor builds his case by presenting a critique of liberalism’s failure to account for modern pluriform societies’ lack of solidarity which is essential if liberalism’s politics of equal dignity is to work. He argues that the politics of recognition he proposes is better than liberal neutrality because it allows the preservation and survival of cultural identity of minorities through mutual recognition that results from “willingness to be open to comparative cultural study of the kind that must displace our horizons in the resulting fusions” (Taylor 1994, p. 73). The idea of including multiple standards of reason is supported by Young’s (2002) proposal that we become truly inclusive by employing subjective elements (as opposed to liberal emphasis on objectivity) in political communication. Dryzek (2000) argues that we should prevent hierarchies between those who have different cultural views. We do this by engaging in deliberation that is free and inclusive (i.e., deliberation that connects the particular to the general). Addis (1997) argues that we should develop public reason that emerges out of dialogue among various communities as they employ their own reasons to justify their views. Pluralistic public reason should be a product of dialogue and should bring together differing views and cultural traditions in their revised or adjusted forms if it is to attract support from diverse groups. Kymlicka (1995) argues that we should reject the idea that people’s differences (varying/conﬂicting ends) are ﬁxed and beyond rational revision. One could only preserve difference (as a way of respecting community rights) in a group if that group (wishing to preserve its cultural identity) also allows and respects being different within their group. Tolerating differences within a cultural group is the criterion for that group to deserve tolerance from other groups (also see Okin 1999).
There are different dimensions of inclusiveness related to cultural diversity: (1) inclusion by recognition between cultures (Taylor 1994), (2) tolerance of differences within cultural groups (Kymlicka 1995), (3) making public reason plural and inclusive in public deliberation (Bohman 1995), and (4) legitimately forcing cultural groups to offer reasons to justify their controversial practices in public (Thorseth 2001). It is legitimate to paternalistically force conﬂicting parties to communicate and justify their cultural norms and practices in open public debate if doing so allows parties to evaluate their views through the use of argumentation. This view is compatible with Habermas’s (1994) argument for legitimate legislation of recognition of difference (as mutual respect) which requires judgment of acceptance or rejection of such difference as a result of using “reason” in public deliberation. The autonomy enabling paternalistic coercion required in Thorseth’s view could provide an institutional avenue for enforcing both Bohman’s multiplereasons-compromise approach and inclusive versions of liberal neutrality in resolving multicultural conﬂict. This enables autonomous revision of wills by helping conﬂicting parties to recognize (rather than reject or ignore) their differences. It enables (rather than limits) autonomy because engaging in deliberation gives voice to the agent and gives her discursive space to freely revise her norms and practices. It allows participants to be free agents and makes possible a community of moral persons and moral practice. Parties should (1) not censor views from being presented in the deliberation and (2) not refuse to revise (or change) their views if there are good reasons to do so.
Critical-Inclusive Approach: Include Culture-based Reasons But Critically Evaluate Their Merits
There are arguments, for and against, including culture-based reasons in public debate. The distinctions I make between the approaches proposed by different authors are not hard and fast but indicate tendencies within the exclusion–inclusion divide. Categorizing them this way serves as a heuristic device to analyze the three tendencies: exclusive, inclusive, and critical inclusive. This does not entail commitment to strictly demarcate boundaries between these views. The crucial point is the case for inclusion of culture-based reasons in public debates and the emphasis on critical evaluation of such reasons which is the key distinctive of the critical-inclusive approach. An example of the critical-inclusive approach is Friedman’s (2008) argument for critical inclusion of private reasons (or nonpublic reasons) in public debate. Most approaches to inclusion of private reason do not emphasize the need for critical evaluation of these reasons. Bohman (1995, pp. 255–256) implied priority of inclusion over revision by emphasizing having more than one “public standpoint” of what culture-neutral reason (or public reason) should be. Addis (1997) prescribes utilizing each cultural group’s own reasons in justifying their respective views when they engage in public dialogue. But such a maneuver in pluralizing norms of reasonableness weakens the ability of conﬂicting parties to scrutinize their favorite views since their own culture-based standards would tend to afﬁrm their own views instead of seriously criticizing them. Priority of inclusion is also present in Taylor’s (1994, pp. 66–67) emphasis on presumption of equal worth that will guide our comparison of our different cultural practices which includes culture-based reasons for defending these traditions and beliefs.
What emerges from the “exclusion–inclusion divide” discussed above is a “qualiﬁed approach” to inclusion. The need to qualify what it is required to properly include multiple types of reasons in public deliberation is implied both in liberal neutrality and in communitarian and deliberative inclusive approaches. To qualify for inclusion, we basically need to add (or emphasize) one more step in the deliberative process, i.e., critical evaluation of reasons (using both subjective and objective standards). We need to evaluate the worth of culture-based reasons in forging the compromise we need in resolving conﬂict in cultural diversity. The elements that clash need to be adjusted. Such adjustments (revisions, fusions of horizon, compromises) can only be afforded if we apply critical scrutiny to the reasons we include in justifying claims in public deliberation. Critical scrutiny is explicit in Friedman’s (2008) account of an inclusive approach. Both Friedman and Bohman argue that justiﬁcation for public decisions should include a plurality of reasons (as opposed to liberal insistence on public “reason” only). But Friedman adds that we also need to evaluate the merits of private reasons to be included in public deliberation. He does this by criticizing the liberal procedural approach that excludes religious reasons because of its nonpublic source of authority. Instead, Friedman advocates hearing reasons out without regard to their source (religious or secular), in order to assess their merits (evaluated based on the ideals of consistency, plausibility, reasonableness).
The background of Friedman’s inclusivist proposal is his criticism of Norman Daniels and James Sabin’s (2002) exclusivist solution to resolving (or avoiding) intractable disagreements in healthcare rationing through fair deliberative procedures that fulﬁll four conditions: transparency, relevance, revisability, and enforcement. Intractable disagreement in healthcare rationing is analogous to multicultural disagreements in the sense that the fundamental basis of conﬂicting positions also includes value judgments (e.g., Kantian vs. utilitarian). Friedman objects to the relevance condition for procedural fairness and its insistence on including public reasons only while excluding nonpublic reasons because it will not make deliberation fair and legitimate. Insisting that deliberation should only include public reasons is a mistake because disagreements in healthcare rationing are not merely about the relative weight of considerations but the importance of life-or-death implications of the decision to losers as well. Losers will not be able to support rationing outcomes that could adversely affect them. Even reasonable people would ﬁnd it difﬁcult to agree about which type of reasons should count as relevant public reasons and which are private reasons that should be excluded. Friedman instead proposes that we should hear out even reasons that seem private because doing so allows the possibility of having those private reasons reconsidered and revised (Friedman 2008, p. 108, fn. 38). Making the relevance condition too strict by excluding private reasons would be too demanding for lay deliberators because only political philosophers normally employ coherent, clear, consistent, and compelling-enough reasons that could satisfy such a strict exclusive standard that tend to set aside reasons because of their private source of authority. To insist on such a strict standard of relevance is to limit democratic participation only to those who employ a type of public reasoning akin to Utilitarians, Kantians, or Liberals. Since there is no clear way to distinguish bad reasons from good reasons a priori, we cannot exclude faith-based reasons without hearing them out. We cannot dismiss such reasons as divisive, controversial, or unlikely to produce consensus unless we actually examine them in public debate. Friedman suggests including private reasons (e.g., faith-based reasons) in the deliberation process so that we can fairly evaluate them for consistency, reasonableness, and plausibility in the same way as public reasons are evaluated. Doing so could help deliberators to be aware of the details of the values and beliefs of those who hold such reasons and give deliberators the chance to ﬁnd out what may be wrong or right about these reasons. Having these private reasons critically included in the deliberation process also increases the chances of inviting support (from those whose private reasons are included) for whatever outcome the deliberation produces than it would if private reasons are excluded. This also makes imposing the deliberation outcome legitimate for losers since their own private reasons are heard in making such decision. It is not legitimate to impose a policy on those whose views have been excluded in the deliberation.
Towards Convergence Via Critical Inclusion
Culture-based reasons can inform public debates about details of diverse cultures so that parties who are willing to compromise know what is at stake. Culture-based reasons are internally justiﬁed within the worldview of groups that invoke them so agreement between different groups holding different worldviews cannot rely on such reasons to persuade others. Agreement on substantive claims argued on the basis of diverse culture-based reasons originating from different cultural sources of authority is very difﬁcult if not impossible to achieve. For example, those who argue against the use of artiﬁcial contraceptives on the basis of arguments sourced from the authority of religious doctrine that states that the divine purpose for sex is procreation cannot agree with those who defend the use of contraceptives and who do not recognize the authority of religious doctrine. The disagreement between holders of the two conﬂicting positions is intractable precisely because the conﬂicting groups have different and sometimes contradicting sources of authority. If citizens disagree on substantive issues, such issues cannot be the basis of public policy that will be implemented through political coercion of citizens. Instead, ground rules or procedures that can be accepted as fair by contending parties must be established. Dealing with intractable disagreement on substantive issues can be avoided by focusing instead, as Rawlsian proceduralists propose, on procedures that parties can agree on (Rawls 1985, pp. 230–231, 240). Since people disagree about “comprehensive religious and philosophical doctrines,” we cannot base our claims to public policy on these reasons based on these doctrines. But agreement on procedures may not be enough in forging compromise and cooperation. When proponents of competing policies use their own culture-based reasons to justify their claims in public debate, these reasons should not be presented to members of other groups in their original partisan form. Culture-based reasons must be communicated in a manner that connects the particular to the general (Dryzek 2000, pp. 68–69). Proponents must try their best to connect the features of their cultural worldview to more universal values, for example, relating appeals to religious authority in rejecting genetic modiﬁcation of crops to the more universal concerns that religious authority asserts, such as dangers of interfering with natural processes that we do not fully understand. Doing so can translate concerns particular only to a group to more universal concerns that other groups share and which overlap with diverse values. Another example is that the concern for the value of the fetus in stem cell research as expressed by Christian groups may overlap with concern for human dignity that other groups recognize which can then be negotiated at the level of general principles recognized by a public body such as a bioethics committee. Alternative sources of stem cells could then be proposed as a compromise between the valued goals of science and the concerns of a particular religious or faith-based group.
A critical-inclusive approach to public debate can be implemented through the intentional use of various communication tools, especially online, to engage the public and to invite the articulation, deliberation, and evaluation of all sorts of views and reasons. Fishkin’s deliberative polling initiative is an example of intentional communication (Fishkin 1991). These deliberative exercises expose arguments to open scrutiny and give participants opportunity to rethink and revise their views after considering the views of others and acquiring more information. Deliberative exercises are compatible with the proposal to require members of diverse groups to communicate their justiﬁcation of a controversial practice (Thorseth 2001). Using online communication media has the advantage of reaching more people without being limited by time and space while simultaneously documenting the deliberation for transparency and public review. Requiring deliberative engagement assumes that the enabling conditions (e.g., literacy, sufﬁcient mental and physical health) for participation are already in place, but some minority groups may not be able to participate in deliberation due to poverty and political exclusion. It is therefore crucial to remedy their deprivation and empower them politically if they are required to participate, to communicate their culture-based reasons in public debate (Alvarez 2014).
Critically Including Culture-Based Reasons In The Stem Cell Debate
The public debate about stem cell research illustrates the difﬁculty of using culture-based reasons in persuading opponents and adjudicators about the correctness of contending policy proposals. Earlier technology allowed human embryonic stem cells (hESC) to be harvested from embryos, but the embryos had to be discarded afterwards. Many groups oppose this technique because they object to embryos being discarded in the process. Proponents defend hESC research as a promising way to develop lifesaving treatments for the many who suffer from debilitating diseases such as Parkinson’s disease. Proponents also reject partisan culture-based reasons as unfairly privileging conservative cultural viewpoints. Opponents can connect their particular traditional concerns about the moral status of embryos to the general widely held intuition about the value of early human life (Denker 2006). Many countries seem to restrict hESC research on the basis of such intuition. The alternative technology for harvesting stem cells from adults (instead of embryos) or so-called induced pluripotent stem cells (iPSC) seems promising at ﬁrst, but similar objections have been raised in relation to the cells’ potential to develop into a human embryo in addition to the need to keep using hESCs as controls for “stemness” in experiments (Denker 2006). Objectors to iPSC invoke culture-based reasons about the moral status of stem cells or the potential of these cells to develop into something with moral status. An exclusive approach to cultural diversity would simply set aside such culture-based reasons in favor of fair decision procedures that everyone could reasonably accept. The losing minority, however, would ﬁnd it difﬁcult to support the results of such procedures. An inclusive approach could hold back deliberators from criticizing any culture-based reasons out of respect or tolerance. A critically inclusive approach would not exclude culture-based reasons, even faith-based ones, in the debate but would encourage their authors to try to relate these reasons to more general concerns that can be shared by opponents. For example, particular concerns for the embryo could be related to the more general concern for caution in manipulating the building blocks of life in view of possible unintended adverse environmental, social, economic, or political effects of the technology. Concern for the embryo (or even the potentiality objection) may not necessarily appeal to everyone, but an appeal to precaution may have more universal appeal. If this communication strategy of relating culture-based reasons to more universal concerns works, then each side could take such reasons into consideration and critically evaluate their merits in public debate.
This research paper examined three approaches to social conﬂicts arising from cultural diversity and the place of culture-based reasons in public deliberation: an exclusive approach, an inclusive approach, and a critical-inclusive approach. The exclusive approach avoids disagreements by focusing on fair procedures and culture-neutral reasons that people from different traditions could recognize. The inclusive approach values giving recognition to cultural traditions under the assumption that these traditions will continue to function for groups as they have been developed by earlier generations. Exclusion is intended to maintain a culture-neutral public standpoint. Inclusion is meant to afﬁrm (rather than ignore) cultural differences as bases for forging “compromise” between conﬂicting beliefs. A critical inclusive approach combines elements of the two contending approaches. If excluding culture based reasons is meant to prevent cultural differences from becoming hindrances to compromise and if including these same reasons in public debate is meant to ensure that conﬂicting parties will be able to support any compromise that could come out of public debate, then it is not exclusion or inclusion of culture-based reasons per se that is crucial in dealing with social conﬂict arising from cultural diversity. What is important, rather, is the evaluation of particular culture-based reasons as to whether these could contribute or hinder compromise in public deliberation. If particular culture-based reasons facilitate compromise, allow other culture-based reasons to be heard, and contribute to resolving conﬂicts, these reasons deserve inclusion in public debate. The claim that the judgment to include or exclude certain culture based reasons should be based on evaluating these reasons as to whether they could contribute to compromise is more of a practical ideal, i.e., everyone who is concerned with resolving political conﬂict between cultures would be interested in looking for ways to achieve compromise. Thus, so long as the inclusion of culture-based reasons beneﬁts the goal of resolving conﬂict, then the culture-based reasons to be included must have qualities that are consistent with this goal or ideal. The evaluation of culture-based reasons cannot be based merely on the substantive norms that each culture recognizes (as Bohman’s plurality of public reasons seems to suggest) but also on the practical quality these reasons contribute to compromise between conﬂicting parties. Cultural traditions are dynamic and changing, and new traditions can be created within and outside groups. Respect for these traditions in global bioethics discourse requires approaches that allow society to face the challenges and enjoy the opportunities cultural diversity present.
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