A clinical ethics fit for the Anthropocene—our current geological era in which human activity is the primary determinant of environmental change—needs to incorporate environmental ethics to be fit for clinical practice. Conservationist Aldo Leopold’s essay ‘The Land Ethic’ is probably the most widely-cited source in environmental philosophy; but Leopold’s work, and environmental ethics generally, has made little impression on clinical ethics. The Land Ethic holds that “A thing is right when it tends to preserve the integrity, stability, and beauty of (...) the biotic community. It is wrong when it tends otherwise.” I argue that a Land Ethic helps to re-frame problems in clinical ethics that more common philosophical approaches struggle to handle, and that it can be incorporated into clinical ethics without succumbing to “environmental fascism”. I motivate viewing problems in clinical ethics from the perspective of the ‘integrity of the biotic community’, then illustrate how this perspective can offer guidance where more commonly-invoked theories—such as consequentialism and Kantian-inspired approaches—struggle, using antimicrobial resistance in nosocomial infection as a case study. The Land Ethic equips us to understand human values as arising within and inseparable from a social-ecological context, and by treating communities as valuable in themselves rather than just through the aggregate welfare of their individual participants, we can avoid problems with the ‘repugnant conclusion’ and utility monster that plague utilitarian accounts. (shrink)

The developers of ecological ethics claim that the rationale of anthropocentrism is false. Its main message is that natural complexes and resources exist to be useful to the human being who sees them only from the perspective of using them and does not take into account their intrinsic value. Kant’s anthropocentric teaching argues that the instrumental attitude to nature has its limits. These limits are hard to determine because the anthropocentrists claim that the human being is above nature. Indeed, the (...) “human exclusiveness thesis” (J.- M. Schaeffer) assumes that its advocates underestimate nature’s impact on humans and their connection to other living beings. Constructing a dialogue between Kant and Schaeffer helps to solve two problems. First, to determine whether Kant’s ethical and teleological concept is immune to Schaeffer’s critique. Second, to clarify the German philosopher’s contribution to environmental ethics. I come to the conclusion that it is premature to claim that consciousness and free will exist only in the framework of their being conditioned by nature. I also demonstrate that in his teleological teaching Kant sees the mechanism of nature as the dependence of living things on forces that act in an unpremeditated manner. Recognition of these forces sets limits to humans’ instrumental attitude to nature and paves the way for them to become moral subjects. Thus, Kant’s teaching combines “the human exclusiveness thesis” and the intuitions of the representatives of deep ecology and the opponents of anthropocentrism as such. (shrink)