The institutionalization of ethics and the direct influence of politics on how ethics bodies frame their opinions have been widely recognized and explored in the last few years. Less attention has been paid to what kind of normative instrument ethics as an institutional phenomenon has become in the State under the rule of law, and which institutional powers it has depended on. This paper analyzes the rise of ethics in the European Union context, where ethics, constructed as an isolated set (...) of values, has been exploited for its symbolic capacity to evoke citizenship, has become quite formalized as to certain features, and has acquired the potential to redefine the traditional divisions of powers in the State under the rule of law. (shrink)

The National Institute for Health and Clinical Excellence (hereafter NICE) was created in 1998 to give guidance on which treatments should be provided by the British National Health Service, and to whom. So it has a crucial role as an agent of distributive justice. In this paper I argue that it is failing to adequately explain and justify its decisions in the public arena, particularly in terms of distributive justice; and that this weakens its legitimacy, to the detriment of the (...) National Health Service as a whole. I argue that this failure arises from the fact that NICE works within the frameworks of positivist science and liberal ethics, largely to the exclusion of other perspectives. This narrowness of view prevents NICE from properly connecting with the range of moral concerns represented in the population. I argue for NICE’s deliberations to become more inclusive, both in terms of epistemology, and also in terms of ethical perspectives. And I suggest a range of perspectives that could usefully be included. Finally I offer a framework of structures, philosophies and discussion process that will enable competing perspectives to be debated fairly and productively in this process. (shrink)