History and theory in "applied ethics"

Robert Baker and Laurence McCullough argue that the "applied ethics model" is deficient and in need of a replacement model. However, they supply no clear meaning to "applied ethics" and miss most of what is important in the literature on methodology that treats this question. The Baker-McCullough account of medical and applied ethics is a straw man that has had no influence in these fields or in philosophical ethics. The authors are also on shaky historical grounds in dealing with two problems: (1) the historical source of the notion of "practical ethics" and (2) the historical source of and the assimilation of the term "autonomy" into applied philosophy and professional ethics. They mistakenly hold (1) that the expression "practical ethics" was first used in a publication by Thomas Percival and (2) that Kant is the primary historical source of the notion of autonomy as that notion is used in contemporary applied ethics.     

Inside baseball and ethics consultation: a comment on "ethics been very good to us"

In response to the article by Scofield, I consider the that, how, and why of ethics consultation, moral expertise, and the rules of the game. The question still to be engaged is, how does all of this work out for patients and families?     

"Facilitated consensus," "ethics facilitation," and unsettled cases

In "Consensus, Clinical Decision Making, and Unsettled Cases:' David M. Adams and William J.Winslade' make multiple references to both editions of the American Society of Bioethics and Humanities (ASBH) Core Competencies for Healthcare Ethics Consultation in their discussion of two assumptions that are supposed to be at the heart of the facilitated consensus model's inability to handle unsettled cases; that is, that: 1. Consultants "should maintain a kind of moral impartiality or neutrality throughout the process," "explicitly condemn[ing] anything resembling a substantive 'ethics' recommendation, and 2. "What counts as the proper set of allowable options among which the parties are to deliberate will itself always be clearly discernible' Herein, I argue that neither of these assumptions is required by ASBH's ethics facilitation approach. I then conclude by suggesting that, despite their fundamentally mistaken interpretation of the ASBH approach-perhaps even because of it-Adams and Winslade have made two important contributions to the ethics consultation literature.     

The politics, economics, and ethics of "appropriateness"

The terms "appropriate" and "necessary" are crucial determinants in decisions regarding the use and reimbursement of medical treatments. This paper encourages greater awareness of the political, economic, and normative assumptions that give meaning to these concepts.     

The role of the clinical ethics consultant in "unsettled" cases

In this article I take up a central question posed by the article jointly authored with Bill Winslade in this issue of JCE: What should be the role of clinical ethics consultants (CECs) in (what we call) an unsettled case: that is, a situation in which the range of allowable choices, among which the parties to a bioethical disagreement must select, cannot be clearly or completely specified? I argue here that CECs should, in such cases, guide the parties by presenting their own reasoned conclusions about what the scope of allowable choices should be taken to include. Since this position challenges the received view that CECs must not express their own moral positions or conclusions in their role as ethicists, I try to defend my view of the CEC's role in unsettled cases against several objections.     

"Lost in a shopping mall" -- a breach of professional ethics

The "lost in a shopping mall" study has been cited to support claims that psychotherapists can implant memories of false autobiographical information of childhood trauma in their patients. The mall study originated in 1991 as 5 pilot experiments involving 3 children and 2 adult participants. The University of Washington Human Subjects Committee granted approval for the mall study on August 10, 1992. The preliminary results with the 5 pilot subjects were announced 4 days laters. An analysis of the mall study shows that beyond the external misrepresentions, internal scientific methodological errors cast doubt on the validity of the claims that have been attributed to the mall study within scholarly and legal arenas. The minimal involvement -- or, in some cases, negative impact -- of collegial consultation, acadmic supervision, and peer review throughout the evolution of the mall study are reviewed.     

1959年“曹操论战”与儒家伦理史学

儒家伦理与传统史学,首先表现为经与史的关系。历代政治的兴衰是传统史学书写的主要内容,儒家政治与伦理一体,使得史学成为儒家伦理的载体。"经世致用"的特点和"历史审判"的功用也是伦理史学的重要成因。史学的伦理化导致了传统史学中事实判断与价值判断的矛盾,二者相互交融。1959年之"替曹操翻案"运动,使历史评价的标准由"道德评价"转向"事功评价",是新中国成立后挑战儒家伦理的典型事例。这一运动导致了历史与伦理的决裂,对儒家伦理史学的解构带来重要影响。今天,应当重视"史学伦理"的研究,重建历史与伦理的联系。     

Cultivating ethics consultation: commentary on "The development of a clinical ethics consultation service in a community hospital

Conclusion: Simpson's article [in this issue, p. 124-130] provides us with needed data about the development and utilization of an ethics consultation service in a community hospital. It makes clear, however, how much further we have to go in developing guiding standards for practitioners and institutions. We need to learn much more about the effectiveness of ethics consultation in meeting well-defined goals and producing desired processes and outcomes before standards for credentials and accountability have a sound empirical basis.