Negotiating the moral order: paradoxes of ethics consultation

Ethics consultation at the bedside has been hailed as a better way than courts and ethics committees to empower patients and make explicit the value components of treatment decisions. But close examination of the practice of ethics consultation reveals that it in fact risks subverting those ends by interpolating a third (expert) party into the doctor-patient encounter. In addition, the practice of bioethics through consultation does the broader cultural work of fashioning a shared moral order in the face of manifestly plural individual commitments. In doing so, however, bioethics furthers medicine's position as a privileged domain of public moral discourse in contemporary American society.     

A Substantivist Construal of Discourse Ethics

Abstract

This paper presents a substantivist construal of discourse ethics, which claims that we should see our engagement in public deliberation as expressing and elaborating a substantive commitment to basic moral ideas of solidarity, equality, and freedom. This view is different from Habermas’s standard formalist defence of discourse ethics, which attempts to derive the principle of discursive moral justification from primarily non‐moral presuppositions of rational argumentation as such. After explicating the difference between the substantivist and the formalist construal, I defend the former by showing that it is not only intuitively compelling, but also particularly well equipped for addressing four important objections recently levelled against discourse ethics and its political applications (Rawls’s concern that it lacks substantive guidelines, Gunnarsson’s challenge that it has not been proven to be superior to alternative moral conceptions such as utilitarianism, Scanlon’s complaint that it lacks an account of moral motivation, and Galston’s and Young’s worries that it could lead to political practices of cultural imposition). I conclude by pointing out some consequences of the previous discussion for the future of Critical Theory.     

Re‐embedding Moral Agency

The connection between ethics and theological vision has become increasingly important for ethics as we better appreciate how the moral agent is embedded in a framework that affectively and intellectually shapes her moral reasoning. Moral reasoning is always reasoning within (that is, within a moral framework, a religious worldview, and/or a set of ideological commitments). A similar framing occurs in literature, which I refer to as its “horizon.” A literary text's horizon comprises the theological and metaphysical commitments that are implied by the text and that the reader relies on to make sense of it. I suggest that there is a parallel between how moral frameworks and literary horizons operate in that both shape moral judgment. I argue that in using literature as a resource for ethics, the same contemporary currents that have led us to appreciate the embeddedness of moral reasoning should also encourage us to give more careful attention to the theological or metaphysical vision implied by a text. Such a “theo‐ethical” reading of literature provides a richer understanding of particular moral goods and the interplay between those goods and ethical themes like agency, hope, and redemption. I substantiate this claim with a reading of William Blake's Jerusalem: The Emanation of the Giant Albion.     

THE ROLE OF PERCEPTION IN JONATHAN EDWARDS'S MORAL THOUGHT: The Nature of True Virtue Reconsidered

This essay provides an interpretation of Jonathan Edwards's moral thought that calls attention to the motif of perception in his conception of true virtue. The aim is to illumine the extent to which Edwards's virtue ethics can be included in and contribute to prevailing approaches to virtue in contemporary theological ethics. To advance this proposal, this essay attends to the question of moral agency that Edwards's reflections on charity, the new spiritual sense, and religious affections raise. This procedure offers an acute sense of the significance of perception for Edwards's virtue ethics, which in turn allows for a constructive Edwardsean entry into current theological discussions on the narrative character of virtue.     

Theological Ethics, Moral Philosophy, and Natural Law

The article deals with the relationship between theological ethics and moral philosophy. The former is seen as a theoretical reflection on Christian ethics, the latter as one on secular ethics. The main questions asked are: (1) Is there one and only one pre-theoretical knowledge about acting rightly? (2) Does philosophy provide us with the theoretical framework for understanding both Christian and secular ethics? Both questions are answered in the negative. In the course of argument, four positions are presented: theological ‘unificationism’, philosophical ‘unificationism’, theological ‘separationism’ and Lutheran ‘dualism’. It is argued that the latter position is most convincing. It is dual in the sense of being both a theory of Christian ethics and of including a recognition of natural law. Hence, it unites a particularistic and a universalistic point of view. In the last section a reformulation of the Lutheran position is attempted in making use of the ethical theory of Knud E. Løgstrup's The Ethical Demand.     

Consumerism as a moral attitude

In this theoretical and explorative essay, from an analysis of Pope Francis’, Cornel West's, and William T. Cavanaugh's works, it is argued that it is possible to construe a specific understanding of the concept of consumerism within the political theological discourse. From the analysis, consumerism is imagined as a fundamental attitude of remaining morally indifferent towards suffering. Accordingly, the proposed definition for consumerism is understood as the act of trivializing the good and remaining indifferent towards suffering. Furthermore, the article highlights how this definition of consumerism challenges the idea of consumerism as an “ersatz” religion, which is an understanding of consumerism that is often used within a Christian theological context.     

Ethics, theism and metaphysics: An analysis of the theocentric ethics of James Gustafson

Modern ethics has been shaped by two dominant philosophical assumptions: (1) that there can be no theoretical knowledge of God, i.e., denial of metaphysics, and (2) that moral claims can be redeemed independently of theistic affirmations, i.e., morality does not require theism. These assumptions have influenced much of modern theological ethics. Yet, insofar as theological ethics accepts that morality does not require any explicit or implicit religious beliefs, it affirms that a secularistic morality is possible. But this affirmation is directly at odds with the essence of theism, namely, that God is the source and end of all things, including the moral life. By accepting the dominant consensus, therefore, theological ethics undermines its fundamental theistic claim. Focusing on James Gustafson's theocentric ethics, I seek to show the price that theological ethics pays for subscribing to the dominant consensus. I argue that: (1) Gustafson embraces an inconsistent self-understanding, which undermines his theocentric claim, (2) this is due to his dismissal of metaphysics, and (3) his theocentric ethic would be more compelling if formulated in terms of Whitehead's process metaphysics.     

Taking Sin Seriously

Contemporary Roman Catholic ethics endeavors to take sin seriously by offering theologies of sin that emphasize it as a force and as a basic, personal orientation. Such efforts rightly counter the Catholic tradition's earlier reduction of sin to sins, and sins to external acts and moral culpability. But perhaps they go too far in this regard. By engaging Charles Curran, this study argues that inattention to sins undermines the theological referent of sin as a discourse that concerns more than moral culpability, obscures God as the source of freedom and value, and neglects the way in which acts express and sustain sin and fashion a personal orientation. Drawing on the work of Jean Porter, the essay shows that attention to sins highlights the historicity, particularity, and provisionality of human acts because of the theological referent and analogical character of sin and sins.     

Dialogue among Friends: Toward a Discourse Ethic of Interpersonal Relationships

Despite clear parallels between Jürgen Habermas's discourse ethics and recent scholarship in feminist ethics, feminists are often suspicious of discourse ethics and have kept themselves mostly separate from the field. By developing a sustained application of Habermas's discourse ethics to friendship, Keller demonstrates that feminist misgivings of discourse ethics are largely misplaced and that Habermas's theory can be used to develop a compelling moral phenomenology of interpersonal relations.     

Theme Articles: Mujerismo and The Two Kin‐doms: Distinction and Reconciliation

Abstract : The theological ethics underlining mujeristas' theological praxis and Luther's Two Kingdoms doctrine may seem to be contradictory to some. Mujerista theology calls for active engagement in the public sphere. Despite its utilization to the contrary, Luther's Two Kingdoms doctrine calls for that same active engagement of the Christian in civic matters. As a Lutheran Latina, I posit that the theological ethics of mujeristas and Luther's Two Kingdoms are distinct but reconcilable.     

康德“目的王国”与阿佩尔“理想交往共同体”之比较——从阿佩尔视角解读康德的尝试

阿佩尔对话伦理学对康德道德哲学的改造预设了对后者的两个基本判断,即康德的道德哲学受限于主体性哲学,并且是一种严格的原则伦理或意向伦理。但从阿佩尔的视角反观康德则不难发现,阿佩尔先验语用学终极奠基的努力,以及他所强调的对话伦理学的责任伦理之维,在康德道德哲学的很多思想环节中都已有所体现。康德有关目的王国的思想就是其中一例。康德的目的王国与阿佩尔的理想交往共同体概念在内涵上非常相似,目的王国的法则与理想交往共同体之规范性前提以及目的王国的首领和理想对话的共识之间也存在对应性。这种比较最终得出,康德的定言命令式和阿佩尔对话伦理学的对话原则之间具有同构性,两者既包含了基本的道德原则,也是检验具体规范的程序性原则。这些都表明了康德与阿佩尔相似的思想洞见。     

Religious Claims in Public: Lutheran Resources

Abstract : A cacophony of religious voices seeking to influence public culture, opinion, and policy pervades the public discourse in the United States today. Some publicly‐oriented religious claims are appropriate while others are not. Sorely needed are criteria for making that distinction. This essay asks: What are criteria for appropriate and valid use of religious claims, language, and symbols in deliberation about public policy? What particular gifts do Lutheran traditions bring to shaping those criteria? The essay then draws upon Lutheran theological resources to propose theologically grounded criteria for appropriate and valid use of religious language, claims, and symbols in public discourse.     

Spanning our differences: moral psychology,physician beliefs,and the practice of medicine

Moral pluralism is the norm in contemporary society. Even the best philosophical arguments rarely persuade moral opponents who differ at a foundational level. This has been vividly illustrated in contemporary debates in bioethics surrounding contentious issues such as abortion and euthanasia. It is readily apparent that bioethics discourse lacks an empirical explanation for the broad differences about various topics in bioethics and health policy. In recent years, social and cognitive psychology has generated novel approaches for defining basic differences in moral intuitions generally. We propose that if empirical research using social intuitionist theory explains why people disagree with one another over moral issues, then the results of such research might help people debate their moral differences in a more constructive and civil manner. We illustrate the utility of social intuitionism with data from a national physician survey.     

A Methodologically Pragmatist Approach to Development Ethics

This paper suggests that lessons from the field of environmental ethics and sociological perspectives on knowledge are important tools for rethinking what type of ethical analysis is needed for building up further the field of development ethics and, more generally, for addressing some of the most fundamental ethical problems related to global poverty and development. The paper argues for a methodologically pragmatist approach to development ethics that focuses on the interplay between facts, values, concepts and practices. It views development ethics as a hybrid between a public moral–political philosophy and a public conception of social science. Ethical analyses of poverty and development must lead to fundamental changes in the ways knowledge is produced and justified and must challenge the dominance of global institutions and orthodox economics as the single sources of expert knowledge for development. Two of the main tasks of ethical analysis is to provide tools for the formulation of alternative knowledge for development centred on the equal moral worth of all human beings, and to influence global policy making as well as multilateral institutions' goals and policies. The last section of the paper argues that Amartya Sen's version of the Capability Approach is already methodologically pragmatist and points to some convergence between Sen's work and John Dewey's. Further sociological and methodologically pragmatist analysis of the approach is needed to assess the ways in which it is influencing debates on human development and leading to policy changes, and the possible distortions it suffers when adopted by multilateral agencies and policy makers.     

Indulging anxiety: human enhancement from a Protestant perspective.

At the heart of any ethics of human enhancement must be some normative assumptions about human nature. The purpose of this essay is to draw on themes from a Protestant theological anthropology to provide a basis for understanding and evaluating the tension between maintaining our humanity and enhancing it. Drawing primarily on the work of theologian Reinhold Niebuhr, I interpret enhancement as proceeding from the anxiety that characterizes human experience at the juncture of freedom and finiteness. Religious and moral dimensions of human sinfulness are considered in relation to cultural values that motivate human enhancement generally. I employ these dimensions in a series of benchmarks to suggest a background of theological, anthropological, and moral considerations against which enhancement is not to be condemmed but rather critically evaluated.     

Egocentrism in moral development: Gibbs, Piaget, Kohlberg

In Gibb’s theory of moral development Piagetian ideas concerning egocentrism play an important role. Based on these ideas Gibbs offers a detailed analysis of transitions in moral development. However, Gibbs still fails to utilize the full potential offered by Piaget’s equilibration theory, because he does not generalize the idea of overcoming egocentrism, as an important mechanism, to all stage transitions. Gibbs seeks a non-relativistic theoretical/ethical justification for his claims about moral development in a difficult to substantiate notion of an underlying reality. Moreover, such objectivist claims are difficult to reconcile with his endorsement of Piaget’s constructivism.Following Piaget’s equilibration theory development can be seen as the march to an ever widening perspective, possible through reflecting abstraction, and implying overcoming egocentric biases that recur at all levels of development. Assuming the widest level in the case of moral development is the moral point of view, an impartial procedure that should guarantee that everybody involved can freely agree as the result of considering arguments reflecting all viewpoints, fits in with a tradition in ethics from Kant, to Rawls, to Habermas which takes the moral point of view as the ultimate moral principle. These so called ‘Procedural Ethics’ theories are not relativistic, but not objectivist either, because they ultimately depend on the characteristics of the procedure.     

The relationship of moral maturity and ethical attitude1

Two issues related to Hogan's Survey of Ethical Attitudes (SEA) were investigated. First, the adequacy of Hogan's theoretical characterizations of the two poles of the SEA was tested. The results supported his characterization of the ethics of conscience, but only partially supported his characterization of the ethics of responsibility. Our second focus was on Hogan's prediction that “moral maturity” should be curvilinearly related to the SEA. As predicted, when moral maturity was measured in Hogan's sense, subjects scoring in the middle of the SEA dimension showed higher levels of moral maturity than those at either the ethics of conscience end or the ethics of responsibility end. In contrast, moral maturity in Kohlberg's sense was linearly related to the SEA with the most mature individuals scoring at the ethics of conscience end of the dimension. The total pattern of results highlights the importance of conceptual clarity and conceptual pluralism in research on morality.     

The relationship between moral philosophy and medical ethics reconsidered

Medical ethics often is treated as applied ethics, that is, the application of moral philosophy to ethical issues in medicine. In an earlier paper, we examined instances of moral philosophy's influence on medical ethics. We found the applied ethics model inadequate and sketched an alternative model. On this model, practitioners seeking to change morality "appropriate" concepts and theory fragments from moral philosophy to valorize and justify their innovations. Goldilocks-like, five commentators tasted our offerings. Some found them too cold, since they had already abandoned applied ethics; others too hot, since they still find the applied ethics model to their taste. We reply that the appropriation model offers an empirically testable account of the historical relationship between moral philosophy and medical ethics that explains why practitioners appropriate concepts and fragments from moral philosophy. In contrast, the now fashionable common morality theory neither explains moral change nor why practitioners turn to moral philosophy.     

The Rationality of Ultimate Concern: Moral Exemplars,Theological Ethics,and the Science of Moral Cognition

This paper argues that consideration of moral exemplars may provide a means for integrating insights across philosophical ethics, theological ethics, and the scientific study of moral cognition. Key to this endeavor is an understanding of the relation of cognition and emotion in ethical decision-making, a relation that is usually understood to be oppositional but which in proper circumstances may be understood to be quite the opposite. Indeed, a distinctive feature of moral exemplarity may consist in the ability to properly integrate the emotions into the moral life, and reference to and imitation of exemplars may involve a referencing and imitating of the emotions of the exemplar.     

THE THEOLOGICAL ETHICS OF HERBERT McCABE, OP: A REVIEW ESSAY

Herbert Mc Cabe, OP (d. 2001), was a significant theological figure in England in the last century. A scholar of Aquinas, he was also influenced by Wittgenstein and Marx, his reading of whom helped him articulate a distinctive Thomistic account of human embodiment that serves as a critique of other dominant approaches in ethics. This article shows McCabe's contribution to moral theology by placing his work in conversation with other important approaches, namely, situation ethics, proportionalism, and the New Natural Law Theory.