States and Moral Pluralism

Bioethicists can be fairly accused of wanting to solve complex problems with single standards and national institutions. Both liberal and conservative bioethicist, have pressed for national standards administered by federal agencies across a wide variety of issues, ranging from research ethics and assisted reproduction the governance and financing of stem cell research. Despite this national focus, states have been and will continue to be principal players in bioethical decision-making. As a consequence, the discipline has not adequately understood how federalism affects the development of policy and the rights of individuals.The premise of this paper is that bioethicists' neglect of federalism is a mistake on two levels: it gets the facts wrong, and it downplays the important benefits of the division of power between the states and the federal government. Rather than being peripheral actors, state legislatures and courts have been and continue to be major participants in the establishment and implementation of bioethics policy. Moreover, state activism in bioethics is not a bad thing. A federalist system - a system that distinguishes between the limited but supreme powers of a central government on the one hand and the broad sovereign powers of each of the states on the other--offers considerable advantages in managing the political conflicts that inevitably arise from moral pluralism, particularly around questions where there is no clear national consensus. Attention to federalism is especially critical now, given the many current and emerging issues that either much areas where states are already major actors or seem likely to produce the divided views among both policy-makers and the public that have driven recent state activism.