Non-patient decision-making in medicine: the eclipse of altruism.
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The sort of ethical theory derived from Aristotle, variously described as virtue ethics, virtue-based ethics, or neo-Aristotelianism, is becoming better known, and is now quite widely recognized as at least a possible rival to deontological and utilitarian theories. With recognition has come criticism, of varying quality. In this article I shall discuss nine separate criticisms that I have frequently encountered, most of which seem to me to betray an inadequate grasp either of the structure of virtue theory or of what would be involved in thinking about a real moral issue in its terms. In the first half I aim particularly to secure an understanding that will reveal that many of these criticisms are simply misplaced, and to articulate what I take to be the major criticism of virtue theory. I reject this criticism, but do not claim that it is necessarily misplaced. In the second half I aim to deepen that understanding and highlight the issues raised by the criticisms by illustrating what the theory looks like when it is applied to a particular issue, in this case, abortion.
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The principle of respect for autonomy has come under increasing attack both within health care ethics, specifically, and as part of the more general communitarian challenge to predominantly liberal values. This paper will demonstrate the importance of respect for autonomy for the social practice of assigning moral responsibility and for the development of moral responsibility as a virtue. Guided by this virtue, the responsible exercise of autonomy may provide a much-needed connection between the individual and the community.
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Those who deny that general principles are important for moral deliberation have mostly misunderstood how principles work. Principles do not give us algorithms for living. They identify broad requirements we must live up to, but they do not actually tell us what to do. We are left instead to craft responses that honor our general commitments using the materials of the case at hand.
Moral deliberation involves a constant interplay among specific judgments, general moral values and principles, and background beliefs about the world. We may also construct broad moral theories to explain how our judgments and general commitments hang together, but there is little hope of settling on any one comprehensive moral theory.