This paper explores the relevance of the debate about ethical expertise for the practice of clinical ethics. We present definitions, explain three theories of ethical expertise, and identify arguments that have been brought up to either support the concept of ethical expertise or call it into question. Finally, we discuss four theses: the debate is relevant for the practice of clinical ethics in that it (1) improves and specifies clinical ethicists' perception of their expertise; (2) contributes to improving the perception (...) of moral competence of non-ethicists; (3) gives insight into complementary styles of argumentation of ethicists and non-ethicists; and (4) contributes to the awareness of the problem of profession-building of (clinical) ethicists. (shrink)

Abstract:The present paper focuses on the linkage between two academic paradigms in the enquiry into business ethics: normative philosophy and empirical social sciences. The paper first reviews existing research pertaining to a normative-empirical dialogue. Further empirical data on the relationship between various standards of morality are discussed in relation to the normative frameworks of ethics. Lastly, future directions for such a dialogue in business ethics are suggested.

Abstract:The present paper focuses on the linkage between two academic paradigms in the enquiry into business ethics: normative philosophy and empirical social sciences. The paper first reviews existing research pertaining to a normative-empirical dialogue. Further empirical data on the relationship between various standards of morality are discussed in relation to the normative frameworks of ethics. Lastly, future directions for such a dialogue in business ethics are suggested.

Our aim in this article is to bring some clarity to the clinical ethics expertise debate by critiquing and replacing the taxonomy offered by the Core Competencies report. The orienting question for our taxonomy is: Can clinical ethicists offer justified, normative recommendations for active patient cases? Views that answer “no” are characterized as a “negative” view of clinical ethics expertise and are further differentiated based on (a) why they think ethicists cannot give justified normative recommendations and (b) what they think (...) ethicists can offer, if they cannot offer recommendations. Views that answer “yes” to the orienting question are characterized as a “positive” view of clinical ethics expertise. Positive views are distinguished according to four additional questions. First (P1), how are those recommendations generated? Second (P2), what is the nature of the recommendations? Third (P3), we ask, how are the recommendations justified? And finally (P4), how are the recommendations communicated? (shrink)

Two challenges have faced policymakers during the Covid-19 pandemic: First, they must determine the reliability of expert testimony in the face of uncertainty; second, they must determine the relevance of different kinds of expertise with regard to particular decisions. I argue that both these problems can be fruitfully analyzed through the lens of trust by introducing an in-depth case study of Iceland’s handling of the first wave of the Covid-19 pandemic. I contend that the problem of relevance highlights the limited (...) appeal of a thoroughly technocratic society. Value judgments, best realized through democratic processes, are always lurking in the background. (shrink)

Bioethicists working on national ethics commissions frequently think of themselves as advisors to the government, but distance themselves from any claims to actual authority. Governments however may find it beneficial to appear to defer to the authority of these commissions when designing laws and policies, and might appoint such commissions for exactly this reason. Where does the authority for setting laws and policies come from? This question is best answered from within a normative political philosophy. This paper explains the locus (...) of moral authority as understood within one family of normative political theories—liberal political theories—and argues that most major “liberal” commentators have understood both the source and scope of ethics commissions’ authority in a manner at odds with liberalism, rightly interpreted. The author argues that reexamining the implications of liberalism for bioethics commissions would mean changing what are considered valid criticisms of such commissions and also changing the content of national bioethics commission mandates. The author concludes that bioethicists who participate in such commissions ought to carefully examine their own views about the normative limits of governmental authority because such limits have important implications for the contribution that bioethicists can legitimately make to government commissions. (shrink)

In recent years, there have been growing calls for nurses to have a formal advanced practice role as nurse ethicists in hospital contexts. Initially proposed in the cultural context of the USA where nurse ethicists have long been recognised, the idea is being advocated in other judications outside of the USA such as the UK, Australia and elsewhere. Such calls are not without controversy, however. Underpinning this controversy are ongoing debates about the theoretical, methodological and political dimensions of clinical ethics (...) support services generally, and more recently where nurses might ‘fit’ within such a service. In considering whether nurse ethicists ought to have a place in clinical ethics support services, a number of questions arise such as: Is such a role warranted? If so, what credentials should nurses assuming the title of ‘nurse ethicist’ be required to have? What standards of practice ought nurse ethicists be required to uphold? What is the ultimate role and function of nurse ethicists in hospital contexts? And in what contexts might a nurse ethicist be most useful? In this essay, brief attention will be given to addressing these questions. It will be concluded that, as a minimum, nurses wishing to assume an advanced nursing practice role as a nurse ethicist must have substantive grounding in the foundational knowledge of the disciplines of both moral philosophy and nursing ethics. They must also not lose sight of the ultimate goal of nursing ethics, notably, to promote and advance ethical nursing practice and the provision of ‘good’ nursing care. (shrink)

The nature, possibility, and implications of ethics expertise in general and of bioethics expertise in particular has been the focus of extensive debate for over thirty years. What is ethics expertise and what does it enable experts to do? Knowing what ethics expertise is can help answer another important question: What, if anything, makes a claim of expertise legitimate? In other words, how does someone earn the appellation “ethics expert?” There remains deep disagreement on whether ethics expertise is possible, and (...) if so, what constitutes such expertise and what it entails and legitimates. Discussion of bioethics expertise has become particularly important given the growing presence of bioethicists in the clinical setting as well as efforts to professionalize bioethics through codes of ethics and certification efforts. Unlike in the law or in engineering, where there may be a body of knowledge that professional organizations or others have articulated as important for education and training of experts, ethics expertise admits of no such body of knowledge or required experience. Nor is there an entity seen as having the authority to articulate the necessary scope of knowledge. Questions about whether there is such a body of knowledge for particular areas within bioethics have emerged and played a central role in professionalization efforts in recent years, especially in the area of clinical ethics. (shrink)

BackgroundBariatric surgery for children and adolescents is becoming widespread. However, the evidence is still scarce and of poor quality, and many of the patients are too young to consent. This poses a series of moral challenges, which have to be addressed both when considering bariatric surgery introduced as a health care service and when deciding for treatment for young individuals. A question based (Socratic) approach is applied to reveal underlying moral issues that can be relevant to an open and transparent (...) decision making process.DiscussionA wide range of moral issues with bariatric surgery for children and adolescents is identified in the literature. There is a moral imperative to help obese minors avoiding serious health problems, but there is little high quality evidence on safety, outcomes, and cost-effectiveness for bariatric surgery in this group. Lack of maturity and family relations poses a series of challenges with autonomy, informed consent, assent, and assessing the best interest of children and adolescents. Social aspects of obesity, such as medicalization, prejudice, and discrimination, raise problems with justice and trust in health professionals. Conceptual issues, such as definition of obesity and treatment end-points, present moral problems. Hidden interests of patients, parents, professionals, industry, and society need to be revealed.SummaryPerforming bariatric surgery for obese children and adolescents in order to discipline their behavior warrants reflection and caution. More evidence on outcomes is needed to be able to balance benefits and risks, to provide information for a valid consent or assent, and to advise minors and parents. (shrink)

We examined the effects of order of presentation on the moral judgments of professional philosophers and two comparison groups. All groups showed similar-sized order effects on their judgments about hypothetical moral scenarios targeting the doctrine of the double effect, the action-omission distinction, and the principle of moral luck. Philosophers' endorsements of related general moral principles were also substantially influenced by the order in which the hypothetical scenarios had previously been presented. Thus, philosophical expertise does not appear to enhance the stability (...) of moral judgments against this presumably unwanted source of bias, even given familiar types of cases and principles. (shrink)

The past 15 years occasioned an extraordinary blossoming of research into the cognitive and affective mechanisms that support moral judgment and behavior. This growth in our understanding of moral mechanisms overshadowed a crucial and complementary question, however: How are they learned? As this special issue of the journal Cognition attests, a new crop of research into moral learning has now firmly taken root. This new literature draws on recent advances in formal methods developed in other domains, such as Bayesian inference, (...) reinforcement learning and other machine learning techniques. Meanwhile, it also demonstrates how learning and deciding in a social domain—and especially in the moral domain—sometimes involves specialized cognitive systems. We review the contributions to this special issue and situate them within the broader contemporary literature. Our review focuses on how we learn moral values and moral rules, how we learn about personal moral character and relationships, and the philosophical implications of these emerging models. (shrink)

In this paper I investigate the theory-practice relationship in ethics by using the lens of theorist-practitioner relationships. In particular I discuss the contrasts between theorist-practitioner relationship inside and outside the classroom, the ‘extra-mural’ expertise of theorists, and the ethical issues which arise when theorists act as co-practitioners. I argue that understanding these social and ethical issues is essential to understanding the relationship between theory and practice in ethics, and shows the need for more emphasis on practice-oriented forms of ethical theorising.

The authority of bioethics as a field of inquiry and of bioethicists as scholars with a distinctive expertise is being questioned on various fronts. Sarah Franklin’s 2019 Nature commentary ‘Ethical research – the long and bumpy road from shirked to shared’ is the latest example. In this paper, we respond to these challenges by focusing on two key issues. First, we discuss the theory and practice of bioethics. We argue that both of these endeavours are fundamental components of this field (...) of inquiry and that bioethics cannot be reduced to the contribution that it makes to the production of biopolicy, as Franklin suggests. Second, we contend that bioethicists have distinctive skills and knowledge that place them at an epistemic advantage in discussing normative questions. Hence, we reject views that deny the specific contribution that bioethicists can bring to assessing the ethics and governance of science and technology. We conclude by arguing that—despite formal and substantive differences between disciplines—philosophers, social scientists and other scholars should join forces and engage in critical friendships rather than turf wars to move towards the just governance of science and technology. (shrink)

This article describes and rejects three standard views of reason in secular clinical ethics. The first, instrumental reason view, affirms that reason may be used to draw conceptual distinctions, map moral geography, and identify invalid forms of argumentation, but prohibits recommendations because reason cannot justify any content-full moral or metaphysical commitments. The second, public reason view, affirms instrumental reason, and claims ethicists may make recommendations grounded in the moral and metaphysical commitments of bioethical consensus. The third, comprehensive reason view, also (...) affirms instrumental reason, but encourages ethicists to make recommendations grounded in the moral and metaphysical commitments of their private worldviews. A compatibilist view of public reason is then defended, which holds that each standard view captures an important role for reason in different aspects of secular clinical ethics. The article ends by identifying three implications for enduring theoretical debates in clinical ethics. (shrink)

This paper explores the concept of moral expertise in the contemporary philosophical debate, with a focus on three accounts discussed across moral epistemology, bioethics, and virtue ethics: an epistemic authority account, a skilled agent account, and a hybrid model sharing key features of the two. It is argued that there are no convincing reasons to defend a monistic approach that reduces moral expertise to only one of these models. A pluralist view is outlined in the attempt to reorient the discussion (...) about moral expertise. (shrink)

As a relational concept, responsible innovation can be made more tangible by asking innovation of what and responsibility of whom for what? Arranging the scattered field of responsible innovation comprehensively, starting from an anthropological point of view, into five fields of tension and five categories of spearheads, may be theoretically and practically helpful while offering suggestions for both research and management.

We review recent developments in ethical pluralism, ethical particularism, Kantian intuitionism, rights theory, and climate change ethics, and show the relevance of these developments in ethical theory to contemporary business ethics. This paper explains why pluralists think that ethical decisions should be guided by multiple standards and why particularists emphasize the crucial role of context in determining sound moral judgments. We explain why Kantian intuitionism emphasizes the discerning power of intuitive reason and seek to integrate that with the comprehensiveness of (...) Kant’s moral framework. And we show how human rights can be grounded in human agency, and explain the connections between human rights and climate change. (shrink)

In most domains of human life, we are willing to accept that there are experts with greater knowledge and competencies that distinguish them from non-experts or laypeople. Despite this fact, the very recognition of expertise curiously becomes more controversial in the case of “moral experts”. Do moral experts exist? And, if they indeed do, are there ethical reasons for us to follow their advice? Likewise, can emerging technological developments broaden our very concept of moral expertise? In this article, we begin (...) by arguing that the objections that have tried to deny the existence (and convenience) of moral expertise are unsatisfactory. After that, we show that people have ethical reasons to ask for a piece of moral advice in daily life situations. Then, we argue that some Artificial Intelligence (AI) systems can play an increasing role in human morality by becoming moral experts. Some AI-based moral assistants can qualify as artificial moral experts and we would have good ethical reasons to use them. (shrink)

According to G. E. Moore, moral expertise requires abilities of several kinds: the ability to factor judgments of right and wrong into (a) judgments of good and bad and (b) judgments of cause and effect, (2) the ability to use intuition to make the requisite judgments of good and bad, and (3) the ability to use empirical investigation to make the requisite judgments of cause and effect. Moore’s conception of moral expertise is thus extremely demanding, but he supplements it with (...) some very simple practical guidance. (shrink)