Over the course of its first seven editions, Principles of Biomedical Ethics has proved to be, globally, the most widely used, authored work in biomedical ethics. It is unique in being a book in bioethics used in numerous disciplines for purposes of instruction in bioethics. Its framework of moral principles is authoritative for many professional associations and biomedical institutions-for instruction in both clinical ethics and research ethics. It has been widely used in several disciplines for purposes of teaching in the (...) classroom, during conferences, etc. (shrink)

This book is the result of over 30 years of collaboration among its authors. It uses the systematic account of our common morality developed by one of its authors to provide a useful foundation for dealing with the moral problems and disputes that occur in the practice of medicine. The analyses of impartiality, rationality, and of morality as a public system not only explain why some bioethical questions, such as the moral acceptability of abortion, cannot be resolved, but also provide (...) a method for determining the correct answer for those occasions when a bioethical question has a unique correct answer. This new edition includes an entire chapter that has been added to address the controversial issue of abortion within the authors' distinct framework. This book presents the latest revisions of the authors' orignial analyses of the concepts of death and disease, analyses that have had a significant impact on the field of bioethics. It also includes an added chapter on mental disorders, where the authors' definition influenced what psychiatry classifies as a mental disorder, and so has had an impact that reveals beyond the field of bioethics. In this edition, the authors also offer a new, more developed perspective on the concept of valid or informed consent by considering what information physicians should be required to know before proposing screening, diagnostic testing, prescribing medications, or performing surgery. The book also integrates some of the important insights of the field of clinical epidemiology into its discussion of valid consent. Its account of paternalism and its justification, perhaps the most ubiquitous moral problem in medical ethics, has had considerable influence. Its discussion of euthanasia and physician assisted suicide challenges the standard views that have been put forward by both proponents and opponents of physician assisted suicide and voluntary active euthanasia. (shrink)

The Right and the Good, a classic of twentieth-century philosophy by the eminent scholar Sir David Ross, is now presented in a new edition with a substantial introduction by Philip Stratton-Lake, a leading expert on Ross. Ross's book is the pinnacle of ethical intuitionism, which was the dominant moral theory in British philosophy for much of the nineteenth and early twentieth century. Intuitionism is now enjoying a considerable revival, and Stratton-Lake provides the context for a proper understanding of Ross's great (...) work today. (shrink)

Some of these essays articulate views of justice and liberalism distinct from those found in the two books.

A meta-ethical analysis demonstrates that care ethics is a grounded in a distinct mode of moral reasoning. This is comprised primarily of the rejection of principles such as impartiality, and the endorsement of emotional or moral virtues such as compassion, as well as the notion that the preservation of relations may override the interests of the individuals involved in them. The main conclusion of such a meta-ethical analysis is that such meta-ethical foundations of care ethics are not sound. Reasonable alternatives (...) for care ethics may be its formulation as an additional principle within an established principlist framework, or the move to a dialogical ethics, where the good to be acted upon is not decided in advance but rather critically discussed and established within the encounter of the parties involved. (shrink)

The notion that it is useful to specify norms progressively in order to resolve doubts about what to do, which I developed initially in a 1990 article, has been only partly assimilated by the bioethics literature. The thought is not just that it is helpful to work with relatively specific norms. It is more than that: specification can replace deductive subsumption and balancing. Here I argue against two versions of reliance on balancing that are prominent in recent bioethical discussions. Without (...) meaning to address the substance or the overall merits of either view I criticize, I attack Gert, Culver and Clouser's implicit reliance on some overall dimension of balancing as a basis of resolving conflicts among norms and Beauchamp and Childress's residual acceptance of 'justified balancing'. The former authors' description of resolving conflicts depends upon a type of value commensurability that (as they otherwise seem to admit) does not obtain, while the latter authors' role for justified balancing would be better served by continued specification. (shrink)

: A comparison of casuistry with the strain of particularism developed by John McDowell and David Wiggins suggests that casuistry is susceptible to two very different mistakes. First, as sometimes developed, casuistry tends toward an implausible rigidity and systematization of moral knowledge. Particularism offers a corrective to this error. Second, however, casuistry tends sometimes to present moral knowledge as insufficiently systematized: It often appears to hold that moral deliberation is merely a kind of perception. Such a perceptual model of deliberation (...) cannot offer a convincing account of the possibility of moral progress. This second problem is one to which particularism is itself prone. To redress it, other aspects of casuistry must be exploited: Casuistry contains an account of presumptive generalizations that explains how moral deliberation might be structured by rules while also depending at critical junctures on perception. (shrink)

Introduction to one of the most important, controversial, and suggestive works of moral philosophy ever written.

This book is about the ethical issues that clinicians encounter as they care for patients and is written to assist those who serve on hospital ethics committees as they deliberate about appropriate action in difficult ethical cases.

Reissued here in its corrected second edition of 1864, this essay by John Stuart Mill argues for a utilitarian theory of morality. Originally printed as a series of three articles in Fraser's Magazine in 1861, the work sought to refine the 'greatest happiness' principle that had been championed by Jeremy Bentham, defending it from common criticisms, and offering a justification of its validity. Following Bentham, Mill holds that actions can be judged as right or wrong depending on whether they promote (...) happiness or 'the reverse of happiness'. Although attracted by Bentham's consequentialist framework based on empirical evidence rather than intuition, Mill separates happiness into 'higher' and 'lower' pleasures, arguing for a weighted system of measurement when making and judging decisions. Dissected and debated since its first appearance, the essay is Mill's key discussion on the topic and remains a fundamental text in the study of ethics. (shrink)

Henry Richardson argues that we can determine our ends rationally. He constructs a rich and original theory of how we can reason about our final goals. Richardson defuses the counter-arguments for the limits of rational deliberation, and develops interesting ideas about how his model might be extended to interpersonal deliberation of ends, taking him to the borders of political theory. Along the way Richardson offers illuminating discussions of, inter alia, Aristotle, Aquinas, Sidgwick, and Dewey, as well as the work of (...) several contemporary philosophers. (shrink)

The field of bioethics has deployed different models of justification for particular moral judgments. The best known models are those of deductivism, casuistry, and principlism (under one, rather limited interpretation). Each of these models, however, has significant difficulties that are explored in this essay. An alternative model, suggested by the work of Henry Richardson, is presented. It is argued that specified principlism is the most promising model of justification in bioethics. Keywords: casuistry, deductivism, ethical theories, intuition principlism, specified principlism, specification (...) CiteULike Connotea Del.icio.us What's this? (shrink)

Expounds on the relationship between theory and practice as applied, adjusted, and inaugurated in health care.

Casuistic methods of reasoning in medical ethics have been criticized by a number of authors. At least five main objections to casuistry have been put forward: (1) it requires a uniformity of views that is not present in contemporary pluralistic society; (2) it cannot achieve consensus on controversial issues; (3) it is unable to examine critically intuitions about cases; (4) it yields different conclusions about cases when alternative paradigms are chosen; and (5) it cannot articulate the grounds of its conclusions. (...) Two main versions of casuistry have been put forward, and the responses to these objections depend in part on which version one is defending. Jonsen has advocated a version modeled on the approach to casuistry used by moral theologians in the 15th and 16th century, involving comparison of the case at hand with a single paradigm and a lineup of cases. The present author has advocated another version, drawn from experience with cases in clinical ethics, which involves comparing the case at hand with two or more paradigms. Four of the five objections are unsuccessful when directed against Jonsen'sapproach, and all of them are unsuccessful when directed against the approach involving comparison with two or more paradigms. (shrink)

After criticizing three common conceptions of therelationship between practical ethics and ethical theory, analternative modeled on Aristotle's conception of the relationshipbetween rhetoric and philosophical ethics is explored. Thisaccount is unique in that it neither denigrates the project ofsearching for an adequate comprehensive ethical theory norsubordinates practical ethics to that project. Because the purpose of practical ethics, on this view, is tosecure the cooperation of other persons in a way that respectstheir status as free and equal, it seeks to influence thejudgments (...) of others by providing them with reasons that areaccessible to their own understanding. On this account, theindependence of practical ethics is rooted in an appreciation ofthe constraints that non-ideal circumstances place on the rolethat the philosophically refined premises of moral theory canplay in such public deliberations. Practical and philosophicalethics are united, not by shared theoretical frameworks orprinciples, but by the need to exercise intelligently the sameintellectual and affective capacities. They are separated, notby the particularity or generality of their starting points, butby their responsiveness to the practical problem of facilitatingsound normative deliberations among persons as we find them,under non-ideal circumstances. (shrink)

After presenting the current version of principlism, in the process repudiating a widespread deductivist misinterpretation, a fundamental metaethical disagreement is developed by outlining the deductivistic critique of principlism. Once the grounds for this critique have been understood, the dispute between casuistry, deductivism and principlism can be restructured, and the model of "application" proven to be the central difference. In the concluding section it is argued that principlism is the most attractive position, if the perceptual model of weak intuitionism is made (...) more explicit. (shrink)

Casuistry is a traditional method of interpreting and resolving moral problems. It focuses on the circumstances of particular cases rather than on the application of ethical theories and principles. After a brief history of casuistry, the method is explained and its relation to theory and principles is discussed.

This is an important work for those studying the concept of utilitarianism, or those who are interested in the writings of John Stuart Mill.

Principlism has been advocated as an approach to resolving concrete cases and issues in bioethics, but critics have pointed out that a main problem for principlism is its lack of a method for assigning priorities to conflicting ethical principles. A version of principlism referred to as 'specified principlism' has been put forward in an attempt to overcome this problem. However, none of the advocates of specified principlism have attempted to demonstrate that the method actually works in resolving detailed clinical cases. (...) This paper shows that when one tries to use it, specified principlism fails to provide practical assistance in deciding how to resolve concrete cases. Proponents of specified principlism have attempted to defend it by arguing that it is superior to casuistry, but it can be shown that their arguments are faulty. Because of these reasons, specified principlism should not be considered a leading contender in the search for methods of making justifiable decisions in clinical cases. (shrink)

The chapter discusses the various ways in which ethical theory and moral practice relate to one another. Various proposals are discussed and evaluated, such as that the relation is a deductive one, that the relation is one of norm-specification, or that the theory provides multiple moral principles that must be balanced against one another. The author makes some suggestions on how the relation between theory and practice should be understood.