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At least 1,225 records · Page 68Linked to original sources
PubMed1990

Philosophical integrity and policy development in bioethics.

Critically examining what most people take for granted is central to philosophical inquiry. Philosophers who accept positions on policy making commissions, tasks forces, or committees cannot, however, play the same uncompromisingly critical role in this capacity as they do in the classroom or in their personal research or writing. Still, philosophers have much to contribute to such bodies, and they can do so without compromising their integrity or betraying themselves as philosophers.

Advisory Committees↗
PubMed1990

Philosophers and the public policy process: inside, outside, or nowhere at all?

Three standard tasks undertaken by applied ethicists engaged in the public policy process are identifying value issues, clarifying concepts and meanings, and analyzing arguments. I urge that these should be expanded to include making specific moral judgments and advocating positions and policies. Three objections to philosophers/ethicists' engagement in the formation of public policy are advanced and evaluated: philosophers necessarily do public policy badly, doing it at all compromises one's integrity as a seeker after truth, and frequently participation is in the service of a repressive status quo that is structured simultaneously to preclude radical change and to co-opt ethicists. Finally, however, I argue that those who would be 'applied ethicists' cannot avoid all participation in some form of a public policy process; that engagement holds the hope as well for improved ethical theory; that the preferred form of participation is frequently from outside of establishment bodies; and that wherever philosophers do involve themselves in policy formulation, this is best done in the expanded sense urged at the outset.

Advisory Committees↗
PubMed1990

Public philosophy: distinction without authority.

An assumed core of normative ethical principles may constitute a philosophically proper framework within which public policy should be formulated, but it seldom provides any substantive solutions. To generate public policy on bioethical issues, participants still need to confront underlying philosophical controversies. Professional philosophers' proper role in that process is to clarify major philosophical options, to press wider-ranging consistency questions, and to bring more parties into the philosophical debate itself by arguing for particular substantive claims. Though questions of fact that mediate final policy conclusions frequently fall outside philosophical competence, one sort of fact, lack of political support, should seldom cause philosophers to stand aside; philosophers still have an important role as critics of culture, politics, and profession. They have no authority, however, on even the philosophical presuppositions of public policy.

Advisory Committees↗
PubMed1991

The 'voice of care': implications for bioethical education.

This paper examines the 'justice' and 'care' orientations in ethical theory as characterized in Carol Gilligan's research on moral development and the philosophical work it has inspired. Focus is placed on challenges to the justice orientation--in particular, to the construal of impartiality as the mark of the moral point of view, to the conception of moral judgment as essentially principle-driven and dispassionate, and to models of moral responsibility emphasizing norms of formal equality and reciprocity. Suggestions are made about the implications of these challenges, and of the care orientation in ethics, for the ethical theory taught, the issues addressed, and the skills and sensitivities encouraged through bioethical education.

Beneficence↗
PubMed1991

Clinical judgment and bioethics: the decision making link.

The literature on bioethics is diverse and confusing in its treatment of appropriate components for decision making. As a result, the literature on teaching bioethics is also confusing, even contradictory, in presenting an 'appropriate' framework within which learners may come to understand the nature and process of bioethics. The article sets out five decision components which are seen as common to all decision making. These components are then shown to have a significant influence both on bioethics decision making and on bioethics teaching. They are also shown to play a role in breaking down the separatism evidenced in contemporary bioethics literature aimed at individual professions.

Beneficence↗
PubMed1991

Conceptual issues in nursing ethics research.

Empirical studies that have attempted to describe nurses' ethical practice have used conceptual frameworks derived primarily from the disciplines of bioethics and psychology. These frameworks have not incorporated important concepts developed by nursing theorists over the past two decades. This article points out flaws in the past research frameworks and proposes a synthesis of ethical theory, nursing practice contexts, and empirical research methods to enrich theoretical development in nursing ethics.

Ethical Analysis↗
PubMed1991

Committees and consensus: how many heads are better than one?

The first section of this paper asks why the notion of consensus has recently come to the fore in the medical humanities, and suggests that the answer is a function of growing technological and professional complexity. The next two sections examine the concept of consensus analytically, citing some of the recent philosophical literature. The fourth section looks at committee deliberations and their desirable outcomes, and questions the degree to which consensus serves those outcomes. In the fifth and last section it is suggested that if I am to subscribe to a consensual outcome responsibly I must be personally committed to it, and that this requires a form of knowledge I call 'fiduciary', in this case knowledge of the competence and trustworthiness of other participants in deliberation whose expertise may have influenced my agreement.

Advisory Committees↗
PubMed1991

Consensus, contracts, and committees.

Following a brief account of the puzzle that ethics committees present for the Western Philosophical tradition, I will examine the possibility that social contract theory can contribute to a philosophical account of these committees. Passing through classical as well as contemporary theories, particularly Rawls' recent constructivist approach, I will argue that social contract theory places severe constraints on the authority that may legitimately be granted to ethics committees. This, I conclude, speaks more about the suitability of the theory to this level of analysis than about the ethics committee phenomenon itself.

Bioethical Issues↗
PubMed1991

The epistemology and ethics of consensus: uses and misuses of 'ethical' expertise.

In this paper I examine the epistemology and ethics of consensus, focusing on the ways in which decision makers use/misuse ethical expertise. The major questions I raise and tentative answers I give are the following: First, are the 'experts' really experts? My tentative answer is that they are bona fide experts who often represent specific interest groups. Second, is the experts' authority merely epistemological or is it also ethical? My tentative answer is that the experts' authority consists not only in their command over specific matters of fact and/or value, but also in their ability to achieve 'consensus' about what is 'true'/'false', or 'right'/'wrong'. Third, should the authority of expertise be limited? My tentative answer is that it should be limited in the area of facts but especially in the area of values. Persons who are ethics 'experts' must be particularly careful to practice an ethics of persuasion rather than an ethics of compulsion. Their role is not to force their group consensus upon decision makers' individual moral perceptions and deliberations; rather it is to help decision makers come to their own conclusions about what they ought to do.

Advisory Committees↗
PubMed1991

Consensus of expertise: the role of consensus of experts in formulating public policy and estimating facts.

For years analysts have recognized the error of assuming that experts in medical science are also experts in deciding the clinically correct course for patients. This paper extends the analysis of the use of the consensus of experts to their use in public policy groups such as NIH Consensus Development panels. After arguing that technical experts cannot be expected to be expert on public policy decisions, the author extends the criticism to the use of the consensus of experts in estimating facts to provide a basis for policy decisions. It is argued that to the extent that (a) experts' views regarding a body of facts can be expected to correlate with their values relevant to those facts; and (b) the values of experts differ from the values of lay people, even the estimates of the facts given by the consensus of expert panels can be expected to differ from the estimates lay people would have given had they had the relevant scientific expertise.

Advisory Committees↗
PubMed1992

Religion, theology, church, and bioethics.

Modern medical ethics developed in America after mid-century chiefly at theological schools, but discourse on bioethics soon moved to the pluralist-secular settings of the academy and the clinic, where it acquired a philosophical and intentionally non-religious cast. An effort was made, on the grounds of 'liberal culture' and 'late Enlightenment rationality' to find a framework for inquiry which aspired to the universal. Today, while that language persists, it coexists with, challenges, and is challenged by forms of ethical analysis and advocacy which take into consideration the 'thickness' of complicating narrative and reasoning based in the many religious traditions. It has become incumbent upon advocates of those traditions to propose 'publicly accessible' argument.

Bioethics↗
PubMed1992

Policy arguments in a public church: Catholic social ethics and bioethics.

This paper is an analysis of the relationship of social ethics and bioethics in Roman Catholic theology. The argument of the paper is that the character of both Catholic moral theology and ecclesiology shape the broadly defined interest of the church in bioethics. The paper examines the common elements of social ethics and bioethics in Catholic teaching, describes how ecclesiology shapes Catholic public policy and uses the examples of abortion and health care to illustrate the relationship of Catholic social thought and bioethics. In developing the relationship of these two dimensions of Catholic moral argument the article highlights how the appeal to natural law categories differs in social ethics and bioethics and how the two topics are received differently in the theological community. It also seeks to illustrate how the premises of Catholic social ethics remain central to public positions taken on bioethics.

Abortion, Induced↗
PubMed1993

Voices and time: the venture of clinical ethics.

Four prominent views of the nature and methods of clinical ethics (especially in consultation forums) are reviewed; each is then submitted to a criticism intended to show both weaknesses and strengths. It is argued that clinical ethics needs to be responsive to the specific complexities of clinical situations. For this, the need for an expanded notion of practical reason within unique situations is emphasized, one whose aim is to facilitate decision-making on the part of those directly responsible for them and consonant with their own respective moral frameworks and conceptions of what is most worthwhile.

Casuistry↗