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At least 919 records · Page 51Linked to original sources
PubMed1995

The principlism debate: a critical overview.

Clouser and Gert's 'A Critique of Principlism' (1990) has ignited debate over the adequacy of substituting principlism for moral theory as a means for dealing with biomedical dilemmas. Clouser and Gert argue that this sort of substitution is not adequate to the task. I examine their argument in light of recent defences of principlism on this score, those of B. Andrew Lustig (1992), David Degrazia (1992), and Beauchamp and Childress (1994). I argue that both sides in the debate have assumed differing conceptions of a moral theory that virtually guarantee their respective conclusions. These differing conceptions are motivated by antecedent epistemological commitments. The present debate over principlism is therefore inconclusive. Future discussion should focus on the underlying epistemological issues.

Bioethics↗
PubMed1995

Virtue and truth in clinical science.

Since the time of Hippocrates, medical science sought to develop a practice based on "knowledge rather than opinion". However, in the light of recent alternative approaches to healing and a philosophy of science that, through thinkers like Kuhn, Rorty, and Foucault, is critical of claims to objective truth, we must reappraise the way in which medical interventions can be based on proven pathophysiological knowledge rather than opinion. Developing insights in Foucault, Lacan, and Wittgenstein, this essay argues for a recovery of the Aristotelian idea of a techne, where there is a dynamic interplay between praxis and conceptualization. The result is a post-Kuhnian epistemology for medical science that recognizes the evaluative dimension of knowledge, but that also looks to a Platonic conception of the good as the ultimate constraint on human thought, thus avoiding the radically self-contained accounts of truth found in some post-modern thinkers.

Biomedical Research↗
PubMed1983

Ambiguities in 'killing' and 'letting die'.

In a recent article Carla Kary (1980) attempts to show that there can be a significant moral difference between instances of killing and letting die. I shall maintain in Section I that Kary's argument is somewhat weakened by her failure to note an important ambiguity in the notion of killing a person. I shall also argue in Section II that a similar ambiguity affects the notion of letting someone die, and that failure to note this latter ambiguity also weakens the position developed by Robert Coburn (1980) with regard to defective newborns.

Congenital Abnormalities↗
PubMed1983

Experimentalism in bioethics research.

Basson's commentary on my proposals regarding the structure and function of research in bioethics provides a welcome opportunity for extended comparison of standard approaches with the suggestions made in 'What Bioethics Should Be.' I begin by noting a common assumption underlying our respective views. I then address points of fundamental difference, indicating why the experimental method proposed in my original essay presents a potentially more productive strategy for examining moral issues in biomedicine. In the latter respect, I certainly disagree with Basson's contention that "we are unable to test" metaethical hypotheses "against reality" (Basson, p. 185) - a proposition which seems no more defensible than the equally untenable claim that we cannot refine methods of natural science research through examination of their usefulness in advancing our understanding of the correlation of events in nature.

Bioethics↗
PubMed1983

Bioethical decision-making: a reply to Ackerman.

Terrence Ackerman has suggested that we ought to view general bioethical principles as generalizations which summarize our previous bioethical decisions rather than as moral rules. He would have us derive our ethical views instead principally from the facts of the cases in question and our intuitions about them. The proposal is attractive because of its similarity to medical decision-making, but it fails because it allows for no higher order standard of reference against which conflicting ethical intuitions may be judged.

Bioethics↗
PubMed1988

Covenantal relationships: grounding for the nursing ethic.

This article is in reaction to recent articles in Advances In Nursing Science by Yarling and McElmurry and Bishop and Scudder, which interpret the nursing ethic as grounded in the social reform of the institution or in the role of the nurse on the health care team. It is argued here that covenantal relationships between the nurse and the patient provide a more substantial foundation for the nursing ethic. Arising from the moral principle of fidelity, this model furnishes guidance for the nurse, a link for the nursing ethic with traditional moral theory, and, most important, a grounding in the unique experience of the nurse-patient relationship.

Contracts↗
PubMed1989

Ethical inquiry and the concept of research.

The place of scholarly research in nursing has not been well studied. Ethical inquiry, as scholarly research, has been included in this neglect. The concept of ethics research is defended and new research approaches to ethics are outlined. Forms of ethics research identified are scholarly, empirical, and dual mode. Questions considered are: Is ethics research research? What are the forms of ethics research? What is the role of empiricism in ethics research? And what is the relationship of ethics research to the moral concerns of nursing? Ethics research explores the basic moral norms undergirding nursing research, practice, and education.

Behavioral Research↗
PubMed1989

Toward a theory of nursing ethics.

The development of nursing ethics as a field of inquiry has largely paralleled developments within the field of biomedical ethics. However, there is growing evidence that the development of a theory of nursing ethics might not necessarily follow a similar pattern. The value foundations of nursing ethics are derived from the nature of the nurse-patient relationship instead of from models of patient good, rights-based notions of autonomy, or the social contract of professional practice as articulated in prominent theories of medical ethics. The value foundations of nursing are analyzed, and a moral-point-of-view theory with caring as a fundamental value is proposed for the development of a theory of nursing ethics.

Empathy↗
PubMed2000

Guidance and justification in particularistic ethics.

This paper argues that, contrary to a common line of criticism followed by scholars such as Helga Kuhse, a particularistic version of virtue ethics properly elaborated, can provide sound moral guidance and a satisfactory account for moral justification of our opinions regarding, for instance, health care practice. In the first part of the paper, three criteria for comparing normative theories with respect to action-guiding power are outlined, and it is argued that the presented particularistic version of virtue ethics actually can provide more guidance than the universalistic theories followed by Kuhse and others. In the second part of the paper it is claimed that universalist normative theories have serious problems accounting for the role that moral principles are supposed to play in the justification, of moral opinions, whereas the present version of virtue ethics accommodates a plausible alternative idea of justification without invoking moral principles or eschewing objectivity.

Empathy↗
PubMed1991

Ethics consultation as moral engagement.

I will begin by presenting some doubts about what might be called the "received view" of the role of the moral expert as a health care consultant. Then I will review the literature on moral experts and moral expertise and proceed to apply the results of that review to the notion that there are some who are expert in ethical decision making in health care. I will try to show that certain conclusions that can be drawn from this rather circumscribed topic have implications for the very conception of the relationship between moral theory and clinical ethics.

Bioethical Issues↗
PubMed2006

Restricted treatments, inducements, and research participation.

In this paper, I support the claim that placing certain restrictions on public access to possible new treatments is morally problematic under some exceptional circumstances. Very ill patients may find that all available standard treatments are unacceptable, either because they are ineffective or have serious adverse effects, and these patients may understandably be desperate to try something new even if this means stepping into the unknown. Faced with certain death, it is rational to want to try something new and to chance a dire outcome. Restricting possible new treatments to research trials may put these treatments scientifically, geographically or economically out of reach of these patients. For those who can get access, research restrictions could weaken, though not necessarily eliminate, the value of consent participants of such trials are able to give. Some participants may therefore be exploited for scientific purposes in the name of public interest. There are nonetheless compelling reasons for keeping some restrictive regulation in this area.

Clinical Trials as Topic↗
PubMed1995

Util-izing animals.

Biomedical experimentation on animals is justified, researchers say, because of its enormous benefits to human beings. Sure, animals suffer and die, but that is morally insignificant since the benefits of research incalculably outweigh the evils. Although this utilitarian claim appears straightforward and relatively uncontroversial, it is neither straightforward nor uncontroversial. This defence of animal experimentation is likely to succeed only by rejecting three widely held moral presumptions. We identify these assumptions and explain their relevance to the justification of animal experimentation. We argue that, even if non-human animals have considerably less moral worth than humans, experimentation is justified only if the benefits are overwhelming. By building on and expanding on arguments offered in earlier papers, we show that researchers cannot substantiate their claims on behalf of animal research. We conclude that there is currently no acceptable utilitarian defence of animal experimentation. Moreover, it is unlikely that there could be one. Since most apologists of animal experimentation rely on utilitarian justifications of their practice, it appears that biomedical experimentation on animals is not morally justified.

Animal Experimentation↗