=== Open Peer Commentary forthcoming in the American Journal of Bioethics ===
The Disconnection That Wasn’t:
Philosophy in Modern Bioethics from a
Piotr Bystranowski1*, Vilius Dranseika*, Tomasz Żuradzki*
*Interdisciplinary Centre for Ethics & Institute of Philosophy, Jagiellonian University, Kraków,
Blumenthal-Barby and her colleagues (2022) situate their discussion of philosophy and
bioethics in the context of (reportedly) widely held assumption that, when compared to the early
days of bioethics, the role of philosophy is now diminished across the field – the assumption we
call the Disconnection Thesis. This assumption can be summarized, to use the authors’ own
words, by the phrase “philosophy’s glory days in bioethics are over“. While in no place of the
article they explicitly endorse the Disconnection Thesis, at least some of the authors had
previously endorsed it in print (Savulescu 2015).
Such expressions of collective expert wisdom might be a valuable source of information
on the discipline's history, but they should not be accepted uncritically. Given the explosion in
the size and scope of bioethical research in recent decades, any scholar’s familiarity with the
area is necessarily based on selective reading and might be biased. Hence, in this commentary,
we examine what kind of more rigorous evidence could corroborate the Disconnection Thesis.
In other words, if the role of philosophy in bioethics has been indeed diminishing, what kind of
observable patterns should we expect to see?
Drawing on our previous research (Bystranowski, Dranseika, Żuradzki 2022), here we
focus on two useful perspectives: citation analysis and topic modeling. While the first approach
allows us to indirectly measure the level of engagement of bioethicists with philosophical
literature (by measuring the proportion of references from articles published in journals in
bioethics that cite philosophy journals), the latter provides a window into the content and
argumentative style of bioethical texts.
We do not claim that these two perspectives are the only, or even the most appropriate
ones to study empirically the presence of philosophy in bioethics. Other potential approaches
would be, for example, analyzing the share of authors affiliated at philosophy departments in
bioethics journals and/or the share of philosophy degree-holders among scholars employed at
1Correspondence to: Piotr Bystranowski, Interdisciplinary Centre for Ethics, ul. Grodzka 52, 31-044
Kraków, Poland. firstname.lastname@example.org
bioethics centers. Hence, we hope that this commentary can help inspire further empirical
research in this area.
Let us look at the available evidence. Analyses that follow are based on the corpus of
about 20,000 texts published in the 7 leading journals in bioethics (American Journal of
Bioethics,Bioethics,Hastings Center Report,Journal of Medical Ethics) and philosophy of
medicine (Journal of Medicine and Philosophy,Medicine, Health Care, and Philosophy,
Theoretical Medicine and Bioethics).2
The citation analysis is based on Web of Science citation data. For all references in our target
journals in a given year, we were able to identify the proportion that cited articles published in
Philosophy journals (as defined by the National Science Foundation (NSF) journals
classification3). As clearly visible in Figure 1, the proportion of citations to philosophy in the four
leading bioethics journals has been relatively low (consistently less than 5% of all citations to
journals and consistently below the analogical proportion for the three analyzed philosophy of
medicine journals)4over the last decades but, on the other hand, it has remained very stable,
not demonstrating any clear diachronic trend5. Hence, to the extent that the Disconnection
Thesis implies that the engagement of bioethicists with philosophical literature used to be high
in the early days of bioethics and has diminished since then, our citation analysis provides
evidence against it.
Topic modeling analysis: Content-based topics
In our topic model (Bystranowski, Dranseika, Żuradzki 2022), we identified 91 content-based
topics which we interpreted as denoting distinct areas of research present in the target journals.
While one perhaps cannot define philosophy in terms of specific contents – any question is a
fair game to philosophy – nonetheless some philosophers would find it plausible that some
themes – such as metaphysical issues of human identity or the very nature of moral obligations
– are paradigmatically “philosophical”. This could be another approach to testing the
Disconnection Thesis. One would select a set of paradigmatically philosophical topics and then
trace their diachronic development. Measuring correlations between topics’ prominence in a text
5With the linear model providing a null effect of time on the proportion: B= -0.0001, t(46) = -0.93, p= .36.
4Philosophy is only the fifth most frequently cited NSF category in the four bioethics journals, coming
after General & Internal Medicine, Health Policy & Services, Social Sciences, Biomedical, and General
Biomedical Research. Philosophy journals most frequently cited in the four bioethics journals are:
Philosophy & Public Affairs,Ethics,Journal of Philosophy,Journal of Applied Philosophy, and Social
Philosophy & Policy.
3With some manual corrections (we moved Ethics,Philosophy & Public Affairs, and Social Philosophy &
Policy from the category Miscellaneous Social Science to Philosophy, and Kennedy Institute of Ethics
Journal and Christian Bioethics from Philosophy to Health Policy & Services). One should also remember
that NSF classifies most philosophy of science journals not in Philosophy, but in the category ‘Science
2See (Bystranowski, Dranseika, Żuradzki 2022) for an explanation of how these journals were selected.
The partition of the set of journals into bioethics and philosophy of medicine is grounded in
topic-correlation-based clustering, for details see
and the proportion of citations from such a text to Philosophy journals provides6a relatively
rigorous way of identifying such topics (see Figure 2). The content-based topics most
associated with Philosophy in this sense are: Abortion: philosophical issues (r= .25), Doctrine of
double effect and act/omission distinction (or Omissions;r= .20), Metaphysics of beginning of
life (or Embryos: identitiy;r= .18), Health and wellbeing (r= .15), Justice and equality (r= .12),
Principlism debate (r= .11).
As shown in Figure 3, there is no sign of decline7of relative prominence of these topics
in the subset of the four Bioethics journals (Figure 3b).
Topic modeling analysis: Framing topics
In our topic model, we were also able to identify 7 framing topics (Priva & Austerweil 2015) that
correspond to distinct methodological perspectives and forms of discourse employed in
bioethics and philosophy of medicine. Two of those ‘framing topics,’ Definitions of concepts and
Moral philosophy discourse appear to represent philosophically-loaded perspectives.8The data
presented in Figure 2 provide additional support for the association of these framing topics with
philosophy. For both Moral philosophy discourse and Definitions of concepts correlations
between the probability that a given text expresses a given framing topic and the proportion of
citations to articles published in journals classified as Philosophy are pronounced (Pearson’s r =
.21 and .12, respectively), making them the second and the sixth topics (out of all the 97
content-based and framing topics) most associated with Philosophy in this respect (See Figure
As can be seen in Figure 4b, the prominence of Definitions of concepts has been
relatively stable in the four analyzed bioethics journals in the last decades, while Moral
philosophy discourse has enjoyed a consistent growth.9This suggests some temporal dynamics
– but it is the opposite of what the Disconnection Thesis would assume.
9With the linear model providing a significant effect of time on the topic’s prominence: B= 0.0055, t(7) =
12.8, p= .006.
8Priva and Austerweil describe framing topics as topics that “frame content, rather than present the
content itself” (2015: 4). Definitions of concepts is characterized by the following keywords: ‘concept’,
‘definition’, ‘kind’, ‘define’, ‘notion’, ‘nature’, ‘criterion’, ‘ account’, ‘distinction’, ‘refer’. It seems to be
expressive of conceptual analysis and definitional work in philosophy. Moral philosophy discourse is
characterized by ‘objection’, ‘morally’, ‘relevant’, ‘kind’, ‘justify’, ‘account’, ‘thing’, ‘position’, ‘conclusion’.
Given that keywords like 'argumentative strategy', 'assume', 'reject', 'counterargument', 'assumption',
'premise', ‘justify’, ‘justified’, ‘impermissible’, ‘permissible’, ‘wrong’ are notably associated with this framing
topic, we think it is justified to interpet it as expressive of a sort of explict argumentation from premises to
conclusions typical of much of philosophical discourse. While both of these modes of reasoning are
familiar from philosophy, perhaps they are not limited to it exclusively.
7What we actually find is evidence of a moderately positive linear trend for each of the five topics: 0.0009
<Bs < 0.0019, .001 < ps < .003.
6To conduct such an analysis, we had to match our topic modeling data set with Web of Science records.
We managed to match 14,213 records, which represents 73% of the corpus analyzed in Bystranowski,
Dranseika, Żuradzki (2022).
We have attempted to look at the Disconnection Thesis (i.e., the claim that when compared to
the early days of bioethics, the role of philosophy is now diminished across the field) in three
different ways: citation analysis, content-based topics, and framing topics in topic modeling. In
all three cases, there was no evidence of the Disconnection Thesis. However, perhaps there are
better ways to operationalize the claim, such that the operationalization is both empirically
tractable and more faithful to the way the claim is generally understood–we believe that the ball
is now on the court of the proponents of the Disconnection Thesis.
Figure 1 The proportion of the number of references to Philosophy journals to the number of all
references to journals in a given year for (a) 4 crucial journals in Bioethics (American Journal of
Bioethics,Bioethics,Hastings Center Report,Journal of Medical Ethics) and (b) 3 crucial
journals in Philosophy of Medicine (Journal of Medicine and Philosophy,Medicine, Health Care,
and Philosophy,Theoretical Medicine and Bioethics), as identified in Bystranowski, Dranseika &
Żuradzki (2022). Lines represent locally estimated scatterplot smoothing with 95% confidence
intervals. Based on Web of Science citation data and NSF/CHI journal classification.
Figure 2 Pearson’s coefficients for correlations between the prominence of a given topic in a
document (published in one of the 7 leading journals in bioethics and philosophy of medicine)
and the proportion of citations from that document to Philosophy journals. Highlighted rows
correspond to the 6 ‘framing topics’. Error bars represent 95% confidence intervals. Opaque
dots correspond to coefficients that do not significantly differ from zero. For descriptions of
individual topics see Bystranowski, Dranseika & Żuradzki (2022).
Figure 3 The mean prevalence of the six content-based topics most strongly associated with
citing Philosophy journals, across 5-year periods (from 1976 to 2020) in (a) the entire corpus
analyzed by Bystranowski, Dranseika, & Żuradzki (2022); (b) the subset of bioethics journals; (c)
the subset of philosophy of medicine journals.
Figure 4 The mean prevalence of four framing topics across 5-year periods (from 1976 to 2020)
in (a) the entire corpus analyzed by Bystranowski, Dranseika, & Żuradzki (2022); (b) the subset
of bioethics journals; (c) the subset of philosophy of medicine journals.
Blumenthal-Barby, J., S. Aas, D. Brudney, J. Flanigan, M. Liao, A. London, W. Sumner, and J.
Savulescu. 2022. The Place of Philosophy in Bioethics Today. American Journal of Bioethics .
Bystranowski, P., V. Dranseika, T. Żuradzki. 2022. Half a Century of Bioethics and Philosophy of
Medicine. A Topic-Modeling Study. Bioethics.https://doi.org/10.1111/bioe.13087.
Cohen Priva, U.; J.L. Austerweil. 2015. Analyzing the history of Cognition using Topic Models.
Cognition 135: 4-9. http://dx.doi.org/10.1016/j.cognition.2014.11.006.
Savulescu, J. 2015. Bioethics: Why Philosophy Is Essential for Progress. Journal of Medical
Ethics 41(1): 28–33. https://doi.org/10.1136/medethics-2014-102284.