In this article I argue for an interpretive approach to bioethics with critically ill children. I begin by highlighting the dominant Anglo-American bioethical framework that defines standards for ethical care in critically ill children and then outline a critique of this framework. Drawing predominantly on the ideas of Charles Taylor, Michael Walzer and Richard Zaner, I call for a reconception of bioethics and propose an interpretive ‘thick’ framework that is centred on culture and context. Finally, I illustrate this interpretive approach (...) through a comparative study of two cases in pediatric intensive care: the narratives of Marc and Larry. These case studies reveal that ethical dilemmas in pediatric critical care can be traced to relational tensions over respect, trust and power rooted in the disparity of moral horizons among the persons involved. (shrink)

At least since Aristotle, phronesis (practical wisdom) and poetics (making or creating) have been understood as essentially different activities, one moral the other (in itself) non-moral. Today, if anything, this distinction is sharpened by a Romantic association of poetics with inner subjective expression. Recent revivals of Aristotelian ethics sometimes allow for poetic dimensions of ethics, but these are still separated from practical wisdom per se. Through a fresh reading of phronesis in the French hermeneutical phenomenologist Paul Ricoeur, I argue that (...) phronesis should be viewed as at least in part poetic at its very core. That is, phronesis deals with the fundamentally tragic human situation of moral incommensurability, and it responds to this by making or creating new moral meaning. Such a poetics of practical wisdom helps phronesis stand up to significant and important critiques made of it by a range of modernists and post-modernists, pointing a way forward for some important contemporary moral debates. (shrink)