This volume is a revised, enlarged, and broadened version of Gert's classic 1970 book, The Moral Rules. Advocating an approach he terms "morality as impartial rationality," Gert here presents a full discussion of his moral theory, adding a wealth of new illuminating detail to his analysis of the concepts--rationality/irrationality, good/evil, and impartiality--by which he defines morality. He constructs a "moral system" that includes rules prohibiting the kinds of actions that cause evil, procedures for determining when violation of the rules is (...) permitted, and ideals which encourage actions that prevent or relieve suffering. To be valid, Gert argues, any such system must be "a public system that applies to all rational persons." The book concludes with a discussion of medical ethics, demonstrating the link between moral theory and its application to real moral problems. (shrink)

Context: Although ethics consultation is commonplace in United States (U.S.) hospitals, descriptive data about this health service are lacking. Objective: To describe the prevalence, practitioners, and processes of ethics consultation in U.S. hospitals. Design: A 56-item phone or questionnaire survey of the "best informant" within each hospital. Participants: Random sample of 600 U.S. general hospitals, stratified by bed size. Results: The response rate was 87.4%. Ethics consultation services (ECSs) were found in 81% of all general hospitals in the U.S., and (...) in 100% of hospitals with more than 400 beds. The median number of consults performed by ECSs in the year prior to survey was 3. Most individuals performing ethics consultation were physicians (34%), nurses (31%), social workers (11%), or chaplains (10%). Only 41% had formal supervised training in ethics consultation. Consultation practices varied widely both within and between ECSs. For example, 65% of ECSs always made recommendations, whereas 6% never did. These findings highlight a need to clarify standards for ethics consultation practices. (shrink)

As groups around the country begin to craft standards for clinical ethics consultations, one focus of that work is the proper procedure for conducting ethics consults. From a recent empirical look into the workings of ethics consult services (ECSs), one worrisome finding is that some ECSs rely on a committee vote when making a recommendation. This article examines the practice of voting and its moral standing as a procedural strategy for arriving at a clinical ethics recommendation. I focus here on (...) the type of clinical ethics conflicts that are most likely to lead an ECS to vote, namely, conflicts involving ethical uncertainty—or, in the Greek, aporia. I argue that in cases of aporia, voting on an ethics conflict is not a morally justifiable procedure. Then on the same grounds that I use to show that voting is ethically problematic, I raise broader concerns about the common practice of making recommendations by other procedures. In contrast to the standard approach of adjudicating between moral claims, I argue that ECSs can best resolve aporetic conflict through the process of clinical ethics mediation. (shrink)

Professional philosophers are members of bioethical committees and regulatory bodies in areas of interest to bioethicists. This suggests they possess moral expertise even if they do not exercise it directly and without constraint. Moral expertise is defined, and four arguments given in support of scepticism about their possession of such expertise are considered and rejected: the existence of extreme disagreement between moral philosophers about moral matters; the lack of a means clearly to identify moral experts; that expertise cannot be claimed (...) in that which lacks objectivity; and that ordinary people do not follow the advice of moral experts.I offer a better reason for scepticism grounded in the relation between moral philosophy and common-sense morality: namely that modern moral philosophy views even a developed moral theory as ultimately anchored in common-sense morality, that set of basic moral precepts which ordinary individuals have command of and use to regulate their own lives.Even if moral philosophers do nevertheless have a limited moral expertise, in that they alone can fully develop a set of moral judgments, I sketch reasons – grounded in the values of autonomy and of democracy – why moral philosophers should not wish non-philosophers to defer to their putative expertise. (shrink)

What does it mean to be an expert? What sort of authority do experts really have? And what role should they play in today's society? Addressing why ever larger segments of society are skeptical of what experts say, Expertise: A Philosophical Introduction reviews contemporary philosophical debates and introduces what an account of expertise needs to accomplish in order to be believed. Drawing on research from philosophers and sociologists, chapters explore widely held accounts of expertise and uncover their limitations, outlining a (...) set of conceptual criteria a successful account of expertise should meet. By providing suggestions for how a philosophy of expertise can inform practical disciplines such as politics, religion, and applied ethics, this timely introduction to a topic of pressing importance reveals what philosophical thinking about expertise can contribute to growing concerns about experts in the 21st century. (shrink)