BackgroundMedical ethics has recently seen a drive away from multiple prescriptive approaches, where physicians are inundated with guidelines and principles, towards alternative, less deontological perspectives. This represents a clear call for theory building that does not produce more guidelines. Phronesis (practical wisdom) offers an alternative approach for ethical decision-making based on an application of accumulated wisdom gained through previous practice dilemmas and decisions experienced by practitioners. Phronesis, as an ‘executive virtue’, offers a way to navigate the practice virtues for any (...) given case to reach a final decision on the way forward. However, very limited empirical data exist to support the theory of phronesis-based medical decision-making, and what does exist tends to focus on individual practitioners rather than practice-based communities of physicians.MethodsThe primary research question was: What does it mean to medical practitioners to make ethically wise decisions for patients and their communities? A three-year ethnographic study explored the practical wisdom of doctors (n = 131) and used their narratives to develop theoretical understanding of the concepts of ethical decision-making. Data collection included narrative interviews and observations with hospital doctors and General Practitioners at all stages in career progression. The analysis draws on neo-Aristotelian, MacIntyrean concepts of practice- based virtue ethics and was supported by an arts-based film production process.ResultsWe found that individually doctors conveyed many different practice virtues and those were consolidated into fifteen virtue continua that convey the participants’ ‘collective practical wisdom’, including the phronesis virtue. This study advances the existing theory and practice on phronesis as a decision-making approach due to the availability of these continua.ConclusionGiven the arguments that doctors feel professionally and personally vulnerable in the context of ethical decision-making, the continua in the form of a video series and app based moral debating resource can support before, during and after decision-making reflection. The potential implications are that these theoretical findings can be used by educators and practitioners as a non-prescriptive alternative to improve ethical decision-making, thereby addressing the call in the literature, and benefit patients and their communities, as well. (shrink)

The overall aim of this paper is to explore the role of knowledge and truth in the practical deliberation of candidate virtuous agents. To this end, the paper considers three criticisms of Julia Driver’s recent defence of the prospect of ‘virtues of ignorance’ or virtues for which knowledge may be considered unnecessary or untoward. While the present essay agrees with the general drift of Driver’s critics that we should reject such virtues construed as traits that deliberately embrace ignorance, it is (...) more sympathetic to the suggestion that virtue and virtues may need to accommodate some absence or deficit of knowledge and proceeds to further scrutiny of this possibility. More radically, however, the paper concludes by arguing that while knowledge is an overall desideratum of virtue and virtuous conduct, there are circumstances in which even complete knowledge may be insufficient to identify or determine the precise course and direction of such conduct. (shrink)

ABSTRACTAs neo-Aristotelian character education approaches have become more popular, the list of objections has increased too. This paper focuses on the objection that while character education proponents claim to be ‘progressive’ and ‘reformative’ they seem to maintain the educational status quo. This paper examines what happens to neo-Aristotelian character education approaches when they are implemented in schools. First, a range of authors is consulted that has critically followed character education approaches, in particular the one advocated by the Jubilee Centre for (...) Character and Virtues. Second, the Bildung tradition is discussed, which was also intended as a progressive and cosmopolitan project, but was used by German governments in the 19th century to fashion the nation state. Finally, a comparison between the two approaches is made, raising the question whether it is possible for states to run an education system that does not distort ideals of what it means to be human. (shrink)