Abbreviations for Kierkegaard’s Works
English translations
CA The Concept of Anxiety, R. Thomte in collaboration with A. B. Anderson (trans), Princeton, NJ: Princeton University Press, 1980.
CUP 1 Concluding Unscientific Postscript to ‘Philosophical Fragments,’ vol. 1, H. V. Hong and E. H. Hong (trans), Princeton, NJ: Princeton University Press, 1992.
EO 1 Either/Or, vol. 1, H. V. Hong and E. H. Hong (trans), Princeton, NJ: Princeton University Press, 1987.
EO 2 Either/Or, vol. 2, H. V. Hong and E. H. Hong (trans), Princeton, NJ: Princeton University Press, 1987.
EUD Eighteen Upbuilding Discourses, H. V. Hong and E. H. Hong (trans), Princeton, NJ: Princeton University Press, 1990.
FSE For Self-Examination and Judge for Yourself! H. V. Hong and E. H. Hong (trans), Princeton, NJ: Princeton University Press, 1990.
FT Fear and Trembling and Repetition, H. V. Hong and E. H. Hong (trans), Princeton, NJ: Princeton University Press, 1983.
JP Søren Kierkegaard’s Journals and Papers, seven vols., H. V. Hong and E. H. Hong, assisted by G. Malantschuk (eds and trans), Bloomington, IN: Indiana University Press, 1967 (vol. 1); 1970 (vol. 2); 1975 (vols. 3 and 4); 1978 (vols. 5–7).
KJN 4 Kierkegaard’s Journals and Notebooks: Volume 4, Notebooks NB-NB5, N. J. Cappelørn, A. Hannay, D. Kangas, B. H. Kirmmse, G. Pattison, J. D. S. Rasmussen, V. Rumble, and K. B. Söderquist (eds), Princeton, NJ: Princeton University Press, 2011.
KJN 5 Kierkegaard’s Journals and Notebooks: Volume 5, Journals NB6-NB10, N. J. Cappelørn, A. Hannay, D. Kangas, B. H. Kirmmse, G. Pattison, J. D. S. Rasmussen,
x Abbreviations for Kierkegaard’s Works
V. Rumble, and K. B. Söderquist (eds), Princeton, NJ: Princeton University Press, 2012.
KJN 6 Kierkegaard’s Journals and Notebooks: Volume 6, Journals NB11-NB14, N. J. Cappelørn n, A. Hannay, B. H. Kirmmse, G. Pattison, J. D. S. Rasmussen, V. Rumble, and K. B. Söderquist (eds), Princeton, NJ: Princeton University Press, 2013.
KJN 9 Kierkegaard’s Journals and Notebooks: Volume 9, Journals NB26-NB30, N. J. Cappelørn, A. Hannay, D. Kangas, B. H. Kirmmse, D. D. Possen, J. D. S. Rasmussen, and V. Rumble` (eds), Princeton, NJ: Princeton University Press, 2017.
LFBA The Lily of the Field and the Bird of the Air: Three Godly Discourses, B. Kirmmse (trans), Princeton: Princeton University Press, 2016.
PV The Point of View, including On My Work as an Author, The Point of View for My Work as an Author, and Armed Neutrality, H. V. Hong and E. H. Hong (trans), Princeton, NJ: Princeton University Press, 1998.
R Repetition. See Fear and Trembling.
RPC Repetition and Philosophical Crumbs, E. F. Mooney (ed), M. G. Piety (trans), Oxford: Oxford University Press, 2009.
SLW St ages on Life’s Way, H. V. Hong and E. H. Hong (trans), Princeton, NJ: Princeton University Press, 1988.
SUD The Sickness unto Death, H. V. Hong and E. H. Hong (trans), Princeton, NJ: Princeton University Press, 1980.
TA Two Ages, H. V. Hong and E. H. Hong (trans), Princeton, NJ: Princeton University Press, 1978.
TM The ‘Moment’ and Late Writings, H. V. Hong and E. H. Hong (trans), Princeton, NJ: Princeton University Press, 1998.
UDVS Upbuilding Discourses in Various Spirits, H. V. Hong and E. H. Hong (trans), Princeton, NJ: Princeton University Press, 1993.
WA Without Authority, H. V. Hong and E. H. Hong (trans), Princeton, NJ: Princeton University Press, 1997.
WL Works of Love, H. V. Hong and E. H. Hong (trans), Princeton, NJ: Princeton University Press, 1995.
Danish texts (Søren Kierkegaards Skrifter)
SKS 2 Enten–Eller. Første del, N. J. Cappelørn, J. Garff, J. Kondrup, and F. H. Mortensen (eds), Copenhagen: Gads, 1997.
Contributors
Vilhjálmur Árnason is a Professor of Philosophy and chair of the Centre for Ethics at the University of Iceland. He mainly works in the areas of social philosophy and applied ethics, especially bioethics. Recently, his research has focused on the socio-political and the existential dimensions of bioethical discourse. He is an associate editor of the Encyclopedia of Applied Ethics, 2nd ed. (2012).
Hermann Diebel-Fischer is an Ethics Researcher with a specialization in ethics of technology and bioethics and holds a doctorate in Protestant theology. He works at ScaDS.AI at Technische Universität Dresden, where his research is focused on the ethical and social implications of machine-learning-based technologies and relation of anthropology and technological progress.
Marcus Düwell is a Visiting Professor at the Technical University of Darmstadt (Germany). His research topics include foundational questions of moral and political philosophy, philosophical anthropology, bioethics, and climate ethics. He is main editor of the Cambridge Handbook on Human Dignity (2013) and Towards the Ethics of a Green Future (Routledge 2018). He published Bioethics. Methods, Theories, Domains (Routledge 2013).
Mélissa Fox-Muraton is a Professor of Philosophy at the ESC Clermont and tenured member of the Philosophies and Rationalities Research Laboratory at the University Clermont Auvergne (France). Her research focuses on existential and moral philosophy. She is author of Kierkegaard et Wittgenstein: logique, langage, existence (2022) and Ontologie de la chair: Phantasmes philosophiques et médicaux de la conceptualisation narrative (2013), and editor of Kierkegaard and Issues in Contemporary Ethics (2020).
Jonas Hodel is a PhD Researcher at the Chair for Kant and German Idealism at the University of Tübingen. His research focuses mainly on post-idealist philosophy of the nineteenth century (Kierkegaard, Trendelenburg) on which he has published before. His further interests are Fichte’s early theories of self-consciousness and the late medieval metaphysics of Nicholas of Cusa.
Jakub Marek is the head of Department of Philosophy at the Faculty of Humanities, Charles University, Prague. He focuses on research in nineteenth- and twentieth-century philosophy (Kierkegaard, Hegel, Nietzsche, Jaspers, Pato čka) and recently on topics in the field of healthcare ethics. He has authored two books and over 30 articles or chapters. He also works as an Independent Ethics Expert for the European Commission.
Henning Nörenberg is a Postdoctoral Researcher in the Department of Philosophy, University of Rostock, Germany. He has published on various topics in phenomenology, social ontology, political philosophy, and philosophy of religion. His current work focuses on shared normative background orientations and their affective dimension (‘deontological feelings’). He is author of Der Absolutismus des Anderen (2014).
Oliver Norman is a Temporary Research and Teaching Assistant (ATER) at the Université de Poitiers, France. He is currently working on a dissertation considering Kierkegaard’s ethical view of silence and its reprisal in contemporary French philosophy (Levinas, Chrétien, Derrida). He has also presented and published on gender and gender performances including ‘Despair and Gender Identity’ (Kierkegaard and Issues in Contemporary Ethics, ed. Mélissa Fox-Muraton, 2020).
Johann-Christian Põder is a Junior Professor of Ethics (Technology & Medicine) at the Faculty of Theology, University of Rostock, Germany, and Head of Department ‘Ageing of Individuals and Society’ (AGIS), Interdisciplinary Faculty, University of Rostock. He is the co-editor, with John-Stewart Gordon and Holger Burckhart, of Human Rights and Disability: Interdisciplinary Perspectives (Routledge, 2017), and author of Evidenz des Ethischen. Die Fundamentalethik Knud E. Løgstrups (2011).
René Rosfort is an Associate Professor of Ethics and Philosophy of Religion at the Søren Kierkegaard Research Centre, Faculty of Theology, University of Copenhagen. Besides Kierkegaard, he works primarily with philosophy of psychiatry, ethics, and philosophy of gender. Among his recent publications are the Oxford Handbook of Phenomenological Psychopathology (2019, co-editor) and the article ‘Challenging Identity: Kierkegaard, Bias, and Intersectionality’ (2022).
Anna Westin lectures in Philosophy and Ethics at St. Mellitus College and is a Visiting Lecturer and Honorary Research Fellow at The Bakhita Centre for Research on Slavery, Exploitation and Abuse at St. Mary’s University. She has most recently released Embodied Healing and Trauma with Routledge (2022).
or less manifestly, inspired a wide variety of existential and other anti-reductionist approaches to reality (cf. Stewart 2011; Grøn et al. 2017), not least in the context of both medicine and medical ethics.
As Kierkegaard scholars Arne Grøn and René Rosfort have rightfully observed, there has been a renewal of interest of late in both existential questions and the key or founding figures of existential thought (Grøn and Rosfort 2017, 1). They view this not in terms of a coincidence but instead as a ‘critical reaction’ to the present ‘emphasis on science and pragmatism’ in understanding human beings, a situation that seems to resemble the ‘scientific enthusiasm’ encountered at the beginning of the twentieth century and existential thinking’s subsequent heyday (in which Kierkegaard played a major role).
Modern medical culture, dominated by scientific and technical approaches, has also provoked existential and other more holistic approaches to medicine and to medical ethics, both in the previous century and in the present one (cf. Greaves and Evans 2000, 1; Ghilardi et al. 2016). While Kierkegaard’s influence on such approaches or, as they have been characterized, ‘critical reactions’ (e.g., that of phenomenological bioethics, narrative bioethics, or medical humanities) cannot be underestimated, it is yet to be explored. Two significant examples from the previous century of Kierkegaardian or (at least implicitly) Kierkegaard-inspired approaches to medicine and medical ethics can be found in the fields of existential psychology and psychopathology and in Martin Heidegger’s Zollikon Seminars.
One of the clearest instances of Kierkegaard’s influence on medicine and medical ethics from the twentieth century occurs in the fields of existential psychology and psychopathology, best known through such figures as the German psychiatrist Karl Jaspers and the Swiss psychiatrist Ludwig Binswanger (Podmore 2015; Rosfort 2015), both of whom were deeply indebted to Kierkegaard for their existential and phenomenological understanding of human psychopathological conditions (Basso 2011; Czakó 2011). Important Kierkegaardian traces that can be found in their treatment of issues of mental illness concern concepts such as subjectivity, negativity, freedom, alienation, affectivity, and suffering (cf. Rosfort 2015, 456). Because the ethical questions of ‘becoming oneself’, of freedom, and of suffering touch the very core of mental illness and are crucial for our understanding of psychiatry (cf. Rosfort 2020, 211 f.), such an existential understanding of psychopathological conditions also bears on genuinely ethical issues.
A second notable instance of Kierkegaard’s influence on medicine and bioethics is clearly indirect and appears in Heidegger’s late Zollikon Seminars (1959–1969). Heidegger repeatedly rejected Kierkegaardian existentialist interpretations of his own thought. Nevertheless, Heidegger ‘appropriated’ Kierkegaard in his existential analytic. For Kierkegaard attempts ‘to grasp the selfhood of the human being essentially, on the
Johann-Christian Põder
basis of subjectivity’, as Heidegger clearly states in his note ‘My relation to Kierkegaard’ (Heidegger 2017, 169; cf. Thonhauser 2017; Cimino 2019).
In the Zollikon Seminars, Heidegger applies his existential approach –and this includes its Kierkegaardian debt or inspiration – explicitly to issues in medicine and medical practice. He criticizes modern medicine’s quantifying and reifying outlook as tending to overlook or ‘annihilate’ the existing subject (e.g., the patient in pain and sorrow), and stresses the importance of the ‘existential relation’ between human beings (which ‘does not consist of molecules’, Heidegger 2001, 200; cf. Svenaeus 2017, 80 ff.; Aho 2018).
Still, Kierkegaard’s influence on ethical issues in medicine is not restricted to the past, but also concerns our present-day research and discussions. His indirect influence on today’s phenomenological or narrative bioethics has been mentioned previously. Perhaps the most prominent contemporary example of a direct influence or inspiration from Kierkegaard can be found in Jürgen Habermas’ critique of genetic enhancement in his book The Future of Human Nature (2003; orig. in German 2001). Habermas turns to Kierkegaard in order to criticize the existential self-forgetfulness and self-instrumentalization which, in his view, are characteristic of genetic enhancement and which constitute a serious threat to our ethical self-understanding (cf. Diebel-Fischer’s contribution in this volume).
More recently, a few other scholars have resorted directly to Kierkegaard in their conviction that existential matters and aspects (a person’s lived, first-person situation, and experience) cannot be ignored, but instead belong at the very heart of both medicine and bioethics. In her book Kierkegaard after the Genome, Ada S. Jaarsma, for example, notably puts Kierkegaard into dialogue with ‘post-genomic’ science studies in order to explore their ‘existential stakes’ (Jaarsma 2017).
With the aid of Kierkegaardian motifs, Jaarsma criticizes biomedicine for what she refers to as its ‘quantifying siren song’, i.e., the levelling tendency to replace ‘the singular, exceptional dynamics of becoming’ with abstracted, statistical aggregates, proxies, or predictions (Jaarsma 2017, 88).
In addition, the rather limited number of papers published on the subject of Kierkegaard and bioethics includes, for example, topics like human enhancement (examining Habermas’ use of Kierkegaard; cf. Christiansen 2009; Fox-Muraton 2016; Árnason 2017), selfhood and suffering in cancer survivorship (Knox 2020), clinical thinking in psychology (Protasio 2022), mental health and illness (Rosfort 2020), gender dysphoria and trans identities (Norman 2020), methods in bioethics (Westin 2018), irony and medical practice (Curlin 2016), and bioethics and love (Hall 2008).
It is possible that the rare use of Kierkegaard in contemporary bioethics has, at least partly, to do with two common (mis)interpretations of
Kierkegaard, which are either increasingly contested or in decline now, however. A previously popular interpretation, prominently represented by Alasdair Macintyre in his After Virtue (1981), depicted Kierkegaard as an ‘irrationalist’ or as a blind fideist requiring ‘the rejection of all ordinary ethical norms’, and advocating for an ‘empty and purely formal notion’ of choice or authenticity (Davenport and Rudd 2001, XVII f.). Such a reading, which does justice neither to the depth nor to the complexity of Kierkegaard’s thought, quite possibly hindered its reception in bioethics.
A second, similarly hindering interpretation claims that there is a wide, non-bridgeable gulf between the Christian thinker Kierkegaard and contemporary bioethics. Referring to Kierkegaard’s faith-related thinking and morality, Hugo T. Engelhardt pointedly states in his The Foundations of Christian Bioethics that: ‘Kierkegaard’s morality is not the morality that can guide our contemporary societies’ (Engelhardt 2000, 109). Likewise, Aaron E. Hinkley argues for a wide and ‘infinite gulf’ between Kierkegaard’s Christian thought and secular bioethics (Hinkley 2011, 55).
In contrast to such interpretations, the chapters in this volume seek to demonstrate that ‘Kierkegaard’s morality’ still speaks to us and that even has the potential to offer orientation and inspiration for our contemporary societies, and for our (mostly) non-religious or philosophical bioethical research and debates in specific. The chapters also contribute to a more sophisticated and adequate (e.g., non-irrationalist, non-fideist) understanding of Kierkegaard’s ethical thinking, encouraging, and exemplifying its use in bioethics and thereby mirroring today’s international Kierkegaard research.
Kierkegaardian Concepts in Bioethics
Whereas the previous sections contained allusions to a number of Kierkegaard’s ideas, this section explicitly highlights a few central Kierkegaardian concepts or motifs that are relevant to bioethical research and, in so doing, indicates the benefits of putting the two into dialogue.
First, Kierkegaard was deeply driven and troubled by the question of existence and criticized the oblivion of existence in abstractions of modern philosophy, in objectifying knowledge of science, and in the levelling and depersonalizing dynamics of modern society. In the oblivion of existence, we ignore the idea that we are fundamentally ‘situated in existence’, we disregard the ‘existing person’, and we pay no mind to the concrete and temporal ‘becoming of existence’ (CUP 1, 301/SKS 7, 274; cf. Grøn 2017, 72 ff.). Kierkegaard’s reflections on the oblivion of human existence can inspire and help us to critically ask about existence’s place and meaning in today’s medical system as well as in the bioethical discourse.
T his assessment bears on, for instance, the basic concepts of health and disease: Can they be described solely on the basis of scientific knowledge (biology, statistics) or are they also genuinely existential and et hical terms, involving existential self-relation (selfhood) and relations to ot hers? The same can be said concerning other concepts that are central to bioethics such as suffering and pain (cf. Marek, Hodel, and Rosfort in this volume). The critical assessment also bears on the often depersonalized and alienating dynamics of medical institutions and practice, and our existential engagement (or disengagement) in health care. Furthermore, the existential self-forgetfulness can even reach into the very core of bioethical discourse and methodology. Kierkegaard’s critique of modern philosophy for abstracting from concrete existence also pertains to the narrowly normative, foundationalist, theoretical, and abstract approaches in bioethics (see the following section).
Second, and as a ‘counter move to oblivion’ (Grøn 2017, 89), Kierkegaard stresses the importance of existential thinking or knowledge. For Kierkegaard, existential thinking comes to know existence not from an objectifying distance, but while enmeshed in and in relationship to existence. It involves, on the one hand, as Clare Carlisle pointedly puts it, the task of having to ‘work out who we are, and how to live, right in the middle of life itself’ (Carlisle 2019, xiii), and on the other, the duty of taking up this task rather than seeking refuge from it in philosophical abstractions or scientific objectifications. Existential thinking discovers, describes, and examines existence while maintaining a relationship with it.
Kierkegaard points to the importance of existential knowledge of ou rselves, of our ethical life, and engagement in the world in different situations of alienation, loss of meaning, and self-forgetfulness. This task of existential self-understanding is anything but trivial. For Kierkegaard, the most difficult part of being ourselves is knowing who we really are, and what kind of life we want to live. Indeed, this is a task that involves ‘great courage’ and a commitment to the truth: ‘to see oneself is to die, to die to all illusions and hypocrisy – it takes great courage to dare look at oneself’ (FSE supplement, 234/SKS 24, 425, NB 24:159). Importantly, however, the ethical task of being a true and authentic self is not solipsistic. Rather, it is essentially relational, inseparable from others and the world, including its social institutions. For Kierkegaard, to be truly oneself is, in its essence, to be lovingly concerned for others (Fox-Muraton 2020, 4 ff.; cf. also her contribution to this volume).
Kierkegaard’s existential reflections on ‘How to be a human being in the world?’ (cf. Carlisle 2017, 113–130) can inspire and encourage bioethical investigations into asking: ‘How to be a patient or physician in today’s medical situations and system?’ This can concern, for example, existential questions of authenticity, freedom, suffering, and compassion in healthcare. The patient or physician engaged in existential
a complete, hierarchical, or foundational ‘ethical theory’ (cf. Roberts 2008). Rather, it is a hermeneutic, ‘conceptual exploration’ that takes the lived, first-person perspective seriously, and ‘expresses, seeks, and seeks to engender wisdom’ (ibid., 73, italic in original). The latter means that it is itself existentially engaged, all the while trying to enact ethical change and transformation.
Kierkegaard’s approach has similarities with the tradition of vi rtue ethics, due to its focus on the existential attitudes or characteristics (‘existential phenomena’) that qualify our existence as a whole (Fremstedal 2015, 114). Indeed, virtue ethics in medicine also criticizes the ‘over-reliance on abstraction’ and emphasizes the ‘concrete interactions in being sick and in healing’ (Thomasma 2004, 89). In fact, many of Kierkegaard’s existential phenomena have been interpreted as ‘vi rtues’ (e.g., hope, love, gratitude, humility, patience, and courage; see Lippitt 2017; Roberts 2019; and, critically, Walsh 2018).
Similarities to a number of other critical alternatives to principle-driven bioethics can also be detected. Included among those alternatives are, for instance, phenomenological bioethics, narrative bioethics, care ethics, and feminist ethics – all of which defend a more holistic, relational, affective, and embodied approach to medical ethics that takes seriously situated, lived experience. Given that phenomenological bioethics, and so also traditions close to phenomenology such as narrative bioethics or care ethics, has been indirectly influenced by Kierkegaard, this does not come as a surprise.
It should be noted, however, that a Kierkegaardian bioethics need not replace or even be exclusively antagonistic to principle-based approaches. In providing a richer and more adequate understanding of the situation to which the principles are to be applied, it might also complement, e.g., the principlism of Beauchamp and Childress. In this way, existential bioethics can deliver valuable input to the bottom-up scale of ‘reflexive equilibrium’, an ethical method that Beauchamp and Childress embraced in the late 1980s in order to balance top-down principles with, for example, moral intuitions (Arras 2017, 204; cf. Rawls 1971). In addition, and more critically, a Kierkegaardian approach to bioethics can also be used to modify and to improve principlism by working out alternative or additional principles (cf. Svenaeus 2017, 10).
However, there is an even more radical or far-reaching way to relate Kierkegaardian existential ethics constructively to the principle-based bioethics of Beauchamp and Childress. This approach would involve seeing ‘existential bioethics’ not only as complementing principlism, but also as providing an existential-anthropological foundation for it. That means, it would provide an anthropological framing or foundation in which the popular prima facie principles can be ‘embedded in’, and critically ‘transformed into’ richer and existentially substantiated concepts (Svenaeus 2017, 16; cf. Düwell in this volume).
I n this way, Kierkegaardian bioethics can make principles like autonomy, non-maleficence, beneficence, and justice more intelligible, both anthropologically and ethically. It would investigate their meaning, validity, and presuppositions by relating them to basic ‘existential phenomena’ that are involved in our ethical task of ‘becoming a self’ (such as suffering, anxiety, despair, love, and hope). The task of existential bioethics, then, is to make things explicit, that is, to explore and to articulate the ‘thick’ anthropology that is implicit in contemporary ‘thin’, principle-driven bioethics.
Kierkegaard and Bioethics – An Inspiring Encounter
Bioethics is widely researched and taught around the globe. There is also a growing body of literature on Kierkegaard which has been a lively and productive research field in recent decades. Nevertheless, their relation to one another has not yet been collaboratively addressed. This volume, with contributions from both leading and emerging scholars in the fields of Kierkegaard research and bioethics, is the first to do so. It explores and critically discusses the significance (meaning his limitations as well) of Kierkegaard’s work for bioethics, with both direct reference to Kierkegaard’s writings and reference to his more indirect influence. In this way, it aims to be an encouraging and timely reminder of the significance of existential issues in bioethics.
The book divides into five parts. Part I is concerned with methodological issues, and, in particular, with the possibility of an existential frame or foundation for bioethics. Part II attempts to substantiate existentially the basic bioethical concepts of health, disease, and disability. Part III addresses two dominant emerging fields in contemporary medicine: predictive medicine and medical enhancement. Part IV examines ethical issues present in psychiatry and trauma studies. Part V applies Kierkegaard’s existential approach to the topics of COVID-19 and gender identity, demonstrating its significance for current controversies.
Part I includes chapters by Vilhjálmur Árnason and Marcus Düwell. In Árnason’s view, ‘bioethics in the spirit of Kierkegaard’ requires engagement with experience, a mood of earnestness, and a dialogical ‘art of helping’. Árnason maintains that existential engagement requires a type of engagement with experience that is different to that of the prevailing bioethical discourse. In exploring the Kierkegaardian ‘art of helping’, he argues that the Christian virtues of hope and love can complement the dominant values or principles of biomedical ethics in an existentially anchored bioethics.
Düwell’s chapter explores the significance of Kierkegaard’s thought for developing an anthropological foundation for bioethics. For Düwell, anthropological reluctance of today’s bioethics makes convincing normative responses to novel ethical challenges increasingly difficult. In his
contemporary bioethical debates while also offering an important contribution to Kierkegaard scholarship. Motivated by the ‘existential’ need for such an encounter in today’s rapidly changing medicine, this volume serves as a reminder that we are not merely to be found in the objectifications of bioscience, the often levelling dynamics of public health, or the abstractions of bioethics. Rather, above all, and in a radical sense, we are ‘situated in existence’ (Kierkegaard).
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