The objective of this article is to analyse and compare four methods of ethical case deliberation. These include Clinical Pragmatism, The Nijmegen Method of ethical case deliberation, Hermeneutic dialogue, and Socratic dialogue. The origin of each method will be briefly sketched. Furthermore, the methods as well as the related protocols will be presented. Each method will then be evaluated against the background of those situations in which it is being used. The article aims to show that there is not one (...) ideal method of ethical case deliberation, which fits to all possible kinds of moral problems. Rather, as each of the methods highlights a limited number of morally relevant aspects, each method has its strengths and weaknesses as well. These strengths and weaknesses should be evaluated in relation to different types of situations, for instance moral problems in treatment decisions, moral uneasiness and residue, and the like. The suggestion arrived at on the basis of the findings of this paper is a reasonable methodological plurality. This means that a method can be chosen depending on the type of moral problem to be deliberated upon. At the same time it means, that by means of a method, deliberation should be facilitated. (shrink)

A traditional approach to teaching medical ethics aims to provide knowledge about ethics. This is in line with an epistemological view on ethics in which moral expertise is assumed to be located in theoretical knowledge and not in the moral experience of healthcare professionals. The aim of this paper is to present an alternative, contextual approach to teaching ethics, which is grounded in a pragmatic-hermeneutical and dialogical ethics. This approach is called moral case deliberation. Within moral case deliberation, healthcare professionals (...) bring in their actual moral questions during a structured dialogue. The ethicist facilitates the learning process by using various conversation methods in order to find answers to the case and to develop moral competencies. The case deliberations are not unique events, but are a structural part of the professional training on the work floor within healthcare institutions. This article presents the underlying theory on ethics and illustrates this approach with an example of a moral case deliberation project in a Dutch psychiatric hospital. The project was evaluated using the method of responsive evaluation. This method provided us with rich information about the implementation process and effects the research process itself also lent support to the process of implementation. (shrink)

This is a revised edition of Walker's well-known book in feminist ethics first published in 1997. Walker's book proposes a view of morality and an approach to ethical theory which uses the critical insights of feminism and race theory to rethink the epistemological and moral position of the ethical theorist, and how moral theory is inescapably shaped by culture and history. The main gist of her book is that morality is embodied in "practices of responsibility" that express our identities, values, (...) and connections to others in socially patterned ways. Thus ethical theory needs to be empirically informed and politically critical to avoid reiterating forms of socially entrenched bias. Responsible ethical theory should reveal and question the moral significance of social differences. The book engages with, and challenges, the work of contemporary analytic philosophers in ethics. Moral Understandings has been influential in reaching a global audience in ethics and feminist philosophy, as well as in tangential fields like nursing ethics; research ethics; disability ethics; environmental ethics, and social and political theory. This revised edition contains a new preface, a substantive postscript to Chapter 1 about "the subject of moral philosophy"; the addition of a new chapter on the importance of emotion in practices of responsibility; and the addition of an afterword, which responds to critics of the book. (shrink)

"A fascinating and timely treatment of the objectivism versus relativism debates occurring in philosophy of science, literary theory, the social sciences, ...

First published in 1998. Routledge is an imprint of Taylor & Francis, an informa company.

This article aims at analysing Aristotle’s poetic conception of catharsis to assess whether it may be of help in enlightening the particular didactic challenges involved when training medical students to cope morally with complex or tragic situations of medical decision-making. A further aim of this investigation is to show that Aristotle’s criteria for distinguishing between history and tragedy may be employed to reshape authentic stories of sickness into tragic stories of sickness. Furthermore, the didactic potentials of tragic stories of sickness (...) will be tried out. The ultimate aim is to investigate whether the possibilities of developing a therapeutic conception of medical ethics researched in a previous article on catharsis and moral therapy in Plato may be strengthened through the hermeneutics of the Aristotelian conception of tragic catharsis. (shrink)

This paper aims at analysing the ancient Greek notions of catharsis (clearing up, cleaning), to holon (the whole) and therapeia (therapy, treatment, healing) to assess whether they may be of help in addressing a set of questions concerning the didactics of medical ethics: What do medical students actually experience and learn when they attend classes of medical ethics? How should teachers of medical ethics proceed didactically to make students benefit morally from their teaching? And finally, to what extent and in (...) what forms and formats can the kind of cathartic treatment envisaged by Plato still be considered a necessary preliminary to moral learning? The three questions will be addressed by means of a reconstructive analysis and assessment of the Platonic notions of catharsis and holistic therapy present in the Charmides and the Sophist. Besides, the didactic potential of Plato’s dialogue form and moral regimen will be tried out. The ultimate aim is to investigate the possibilities of developing a therapeutic conception of medical ethics. (shrink)

Research on moral judgment has been dominated by rationalist models, in which moral judgment is thought to be caused by moral reasoning. The author gives 4 reasons for considering the hypothesis that moral reasoning does not cause moral judgment; rather, moral reasoning is usually a post hoc construction, generated after a judgment has been reached. The social intuitionist model is presented as an alternative to rationalist models. The model is a social model in that it deemphasizes the private reasoning done (...) by individuals and emphasizes instead the importance of social and cultural influences. The model is an intuitionist model in that it states that moral judgment is generally the result of quick, automatic evaluations (intuitions). The model is more consistent than rationalist models with recent findings in social, cultural, evolutionary, and biological psychology, as well as in anthropology and primatology. (shrink)

Drawing freely and expertly from Continental and analytic traditions, Richard Bernstein examines a number of debates and controversies exemplified in the works of Gadamer, Habermas, Rorty, and Arendt. He argues that a "new conversation" is emerging about human rationality—a new understanding that emphasizes its practical character and has important ramifications both for thought and action.

Recently, moral deliberation within care institutions is gaining more attention in medical ethics. Ongoing dialogues about ethical issues are considered as a vehicle for quality improvement of health care practices. The rise of ethical conversation methods can be understood against the broader development within medical ethics in which interaction and dialogue are seen as alternatives for both theoretical or individual reflection on ethical questions. In other disciplines, intersubjectivity is also seen as a way to handle practical problems, and methodologies have (...) emerged to deal with dynamic processes of practice improvement. An example is responsive evaluation. In this article we investigate the relationship between moral deliberation and responsive evaluation, describe their common basis in dialogical ethics and pragmatic hermeneutics, and explore the relevance of both for improving the quality of care. The synergy between the approaches is illustrated by a case example in which both play a distinct and complementary role. It concerns the implementation of quality criteria for coercion in Dutch psychiatry. (shrink)

Damasio, an eminent neuroscientist explores the science of human emotion and what the great Dutch philosopher Baruch Spinoza can teach of how and why we feel. Damasio shows how joy and sorrow, those most defining of human feelings, are in fact the cornerstones of our survival and culture.