Medical ethics' appropriation of moral philosophy: the case of the sympathetic and the unsympathetic physician

Philosophy textbooks typically treat bioethics as a form of "applied ethics"-i.e., an attempt to apply a moral theory, like utilitarianism, to controversial ethical issues in biology and medicine. Historians, however, can find virtually no cases in which applied philosophical moral theory influenced ethical practice in biology or medicine. In light of the absence of historical evidence, the authors of this paper advance an alternative model of the historical relationship between philosophical ethics and medical ethics, the appropriation model. They offer two historical case studies to illustrate the ways in which physicians have "appropriated" concepts and theory fragments from philosophers, and demonstrate how appropriated moral philosophy profoundly influenced the way medical morality was conceived and practiced.     

Interpreting Ecofeminist Environmentalism in African Communitarian Philosophy and Ubuntu: An Alternative to Anthropocentrism

Abstract

The question of what an African ecofeminist environmental ethical view ought to look like remains unanswered in much of philosophical writing on African environmental ethics. I consider what an African ecofeminist environmental ethics ought to look like if values salient in African communitarian philosophy and ubuntu are seriously considered. After considering how African communitarian philosophy and ubuntu foster communitarian living, relational living, harmonious living, interrelatedness and interdependence between human beings and various aspects of nature, I reveal how African communitarian philosophy and ubuntu could be interpreted from an ecofeminist environmental perspective. I suggest that this underexplored ecofeminist environmental ethical view in African philosophical thinking might be reasonably taken as an alternative to anthropocentric environmentalism. I urge other ethical theorists on African environmentalism not to neglect this non-anthropocentric African environmentalism that is salient in African ecofeminist environmentalism.     

The hyperreality of clinical ethics: A unitary theory and hermeneutics

Medical ethics nowadays is dominated by a conception of ethics as the application of moral theories and principles. This conception is criticized for its depreciation of the internal morality of medical practice and its narrow view of external morality. This view reflects both a lack of interest in the empirical realities of medicine and a neglect of the socio-cultural value-contexts of medical ethical issues, including the creative development of a broader philosophical framework for a practicable medical ethics. Several alternative approaches and conceptions have been proposed. The unified clinical ethics theory, developed by Graber and Thomasma, is an interesting attempt to synthesize these alternative approaches. It correctly identifies as the crucial problem the present disconnectedness of medical ethics from theoretical philosophy as well as the practice of medicine. In this paper, however, it is argued that the unitary theory should take more serious attention to the hermeneutic character of medicine as well as ethics. This implies that the unitary theory must in fact transform itself into aninterpretive clinical ethics theory. The theoretical characteristics and practical consequences of an interpretive theory of medical ethics are discussed in the present paper.     

Philosophical parrhesia as aesthetics of existence

According to some interpreters, Foucault's encounter with the Greek and Roman ethics led him to reconsider his earlier work and to turn away from politics. Drawing mostly from Foucault's last and hitherto unpublished lecture course, this paper argues that Foucault's turn to ethics should not be interpreted as a turn away from his previous work, but rather as its logical continuation and an attempt to resolve some of the outstanding questions. I argue that the 1984 lectures on parrhesia should be interpreted as Foucault's philosophical apology, as an attempt to defend himself against the charges of moral and epistemological nihilism, which were raised in response to his earlier work. In his last lectures, the Nietzschean Foucault somewhat surprisingly describes his earlier work as authentic Socratic philosophy and as ethical practice of freedom. In the conclusion, I assess the plausibility of Foucault's apology and speculate in which direction his work might have developed, had it not been cut off by his death.     

Contemporary Environmental Ethics From Metaethics to Public Philosophy

In the past thirty years environmental ethics has emerged as one of the most vibrant and exciting areas of applied philosophy. Several journals and hundreds of books testify to its growing importance inside and outside philosophical circles. But with all of this scholarly output, it is arguably the case that environmental ethics is not living up to its promise of providing a philosophical contribution to the resolution of environmental problems. This article surveys the current state of the field and offers an alternative path for the future development of environmental ethics toward a more publicly engaged model of applied philosophy.     

On the dearth of philosophical contributions to medicine

A recent editorial in this journal calls for more philosophical work in the areas of philosophy of medical science and research methodology [1]. The purpose of the present paper is to bring to light and discuss some obstacles and opportunities for development in these areas. In section I, barriers to increased philosophical work in medicine outside ethics are discussed. In sections II and III, additional areas in medicine ripe for philosophical work are identified and discussed: (a) improving the epistemic fitness of much current clinical reasoning, (b) defining the conditions under which greater epistemic fitness can be achieved, and (c) technology assessment.     

Agrarian Philosophy and Ecological Ethics

Mainstream environmental ethics grew out of an approach to value that was rooted in a particular conception of rationality and rational choice. As weaknesses in this approach have become more evident, environmental philosophers have experimented with both virtue ethics and with pragmatism as alternative starting points for developing a more truly ecological orientation to environmental philosophy. However, it is possible to see both virtue ethics and pragmatism as emerging from older philosophical traditions that are here characterized as “agrarian.” Agrarian philosophy stresses the role of nature, soil and climate in the formation of moral character as well as social and political institutions. As such, reaching back to the agrarian tradition may provide a way to move forward with both virtue oriented themes as well as pragmatist themes in developing ecological ethics.     

What’s philosophically interesting about engineering ethics?

What makes a subject philosophically interesting is hard-to-resolve confusion about fundamental concepts. Engineering ethics suffers from at least three such fundamental confusions. First, there is confusion about what the “ethics” in engineering ethics is (ordinary morality, philosophical ethics, special standards, or something else?) Second, there is confusion about what the profession of engineering is (a function, discipline, occupation, kind of organization, or something else?) Third, there is confusion about what the discipline of engineering is. These fundamental confusions in engineering ethics connect with philosophically interesting work in moral theory, political philosophy, and philosophy of science. Work in these areas may help with the philosophical problems of engineering ethics. But, equally important, work in engineering ethics may help with the philosophical problems in these others fields.     

The Virtues of Metaphysics: A Review of Iris Murdoch's Philosophical Writings

Iris Murdoch's moral philosophy has long influenced contemporary ethics, yet it has not, in general, received the kind of sustained critical attention that it deserves. Existentialists and Mystics and Metaphysics as a Guide to Morals provide new access to most of Murdoch's philosophical writings and make possible a deeper appreciation of her contribution to current thought. After assessing the recent critical reception of Murdoch's thought, this review places her moral philosophy in the context of contemporary trends in ethics by tracing her influence on the work of Charles Taylor, highlights the distinctive features of her moral philosophy (especially her analysis of consciousness), and suggests future directions for Murdochian ethics.     

Soft Libertarianism and Hard Compatibilism

In this paper I discuss two kinds of attempts to qualify incompatibilist and compatibilist conceptions of freedom to avoid what have been thought to be incredible commitments of these rival accounts. One attempt -- which I call soft libertarianism -- is represented by Robert Kane's work. It hopes to defend an incompatibilist conception of freedom without the apparently difficult metaphysical costs traditionally incurred by these views. On the other hand, in response to what I call the robot objection (that if compatibilism is true, human beings could be the products of design), some compatibilists are tempted to soften their position by placing restrictions on the origins of agency. I argue that both of these attempts are misguided. Hard libertarianism and hard compatibilism are the only theoretical options.     

REMOVING VEILS OF IGNORANCE1

For more than two millennia the development of philosophy in what is called the West has been the province of men who trace their intellectual heritage to (some) men in ancient Greece. Within “the development of philosophy” I include the training of philosophers as well as publishing and preserving philosophical work in libraries. Thus I regard philosophy as a very material as well as spiritual enterprise. My focus here is on the spiritual impact, actual and potential, of recent changes in the material base of philosophy and the material impact of recent changes in the spiritual focus of philosophers. Before the Twentieth Century, the most significant transitions in the development of Western philosophy were its coming under the domination of Christian religious institutions and then its becoming relatively freed from such domination. Since the advent of the Twentieth Century, the most significant transitions may come from the increasing access to academic institutions of the middle and working classes, of people of color with histories of oppression by white societies, and of women from all classes and ethnic backgrounds—people who do not always or only trace their intellectual heritages to men of ancient Greece. What differences might these changes make to, and call for in, the development of philosophy? What I have thought about most are differences made by women and differences that have drawn in women to academic philosophy in Western democracies, such as the United States. Twentieth Century women in these contexts have published substantial bodies of philosophical inquiry with feminist agendas (both philosophy of feminism and philosophy manifesting feminist perspectives in ethics, epistemology, etc.). I want to comment on two features of such inquiry that often make it attractive to women less readily engaged by the traditions defined by privileged men. These features are holism and what I call “historical particularism.” I begin with “particularism.”     

Law and Force: 20th Century radical legal philosophy,post-modernism and the foundations of law

The foundations of law have been the object ofintense philosophical scrutiny since antiquity.Most importantly, it has been asked whetherthere are really any foundations other thansheer force to be found once more comfortingillusions are abandoned. This paperinvestigates four influential theorists ofradical legal philosophy and postmodern thought(Benjamin, Schmitt, Luhmann, Derrida) who dealwith this problem in comparable ways despitetheir different theoretical outlooks. Themerits of these theories having been assessed,mentalism in ethics and law is introduced as apossible alternative to both the widespreadfoundationalism of the past and theanti-foundationalism of the postmodern present.     

The Virtues of Metaphysics: A Review of Iris Murdoch's Philosophical Writings

Iris Murdoch's moral philosophy has long influenced contemporary ethics, yet it has not, in general, received the kind of sustained critical attention that it deserves. Existentialists and Mystics and Metaphysics as a Guide to Morals provide new access to most of Murdoch's philosophical writings and make possible a deeper appreciation of her contribution to current thought. After assessing the recent critical reception of Murdoch's thought, this review places her moral philosophy in the context of contemporary trends in ethics by tracing her influence on the work of Charles Taylor, highlights the distinctive features of her moral philosophy (especially her analysis of consciousness), and suggests future directions for Murdochian ethics.     

Moralism and Anti-Moralism: Aspects of Bonhoeffer’s Christian Ethic

Dietrich Bonhoeffer's thinking about ethics and Christianity is a fascinating attempt to combine different, and often conflicting, strands in the Christian intellectual tradition. In this article, I outline his thinking, analyse the advantages and disadvantages in his approach, and relate it to developments in contemporary philosophy. His critique of an excessive stress upon principles and abstraction in opposition to a concern for concrete circumstances is, I argue, best seen as a necessary critique of what I call moralism rather than morality. It is also related to recent philosophical theories of particularism and the debates about ‘emergency ethics’ in current philosophy. On the negative side, Bonhoeffer has a tendency to treat non-Christian ethics as necessarily relativist and at times is excessively influenced by the elements in Christian theological tradition that are hostile to the natural and to non-Christian philosophy. In addition, his invocation of ‘the Divine mandates’ seems to have undesirable implications for some genuine values in liberal democratic theory and practice.     

DARWINISM: STILL A CHALLENGE TO PHILOSOPHY

Charles Darwin died in 1882—more than a hundred years ago. His doctrine, however, is still alive. Recently there has been particular interest in his ideas among philosophers. These ideas are indeed a challenge to (traditional) philosophy: To take Darwin seriously means to revise—or even to destroy—some positions in (traditional) philosophy. Among the philosophical disciplines which have been affected by Darwin's ideas are epistemology and moral philosophy (ethics). In the present paper I shall discuss the epistemological and ethical consequences of Darwin's doctrine from the point of view of contemporary philosophy of biology; I shall give a brief outline of evolutionary epistemology and evolutionary ethics which both have caused many controversies.     

BRICOLAGE AND THE PURITY OF TRADITIONS: Engaging the Stoics for Contemporary Christian Ethics

This essay is a response to C. Kavin Rowe's critique of my 2011 argument that certain dimensions of Roman Stoic ethics are at work in Jonathan Edwards's moral thought. Rowe raises questions about the act of selectively retrieving ideas from a philosophical tradition to support constructive work in another tradition. I argue for the importance of acknowledging how Christian thought has been shaped by what Jeffrey Stout describes as moral bricolage, the selective retrieval of ideas from various traditions, and I contend that this bricolage can continue to be a fruitful means through which Christian ethics engages external traditions. Moreover, the importance of Stoicism's retrieval in early modern philosophy makes the work of eighteenth‐century theologians such as Edwards a particularly valuable resource for exploring the plausibility of Christian engagement with the Stoics.     

Comments on Guyer

Paul Guyer's paper “Naturalistic and Transcendental Moments in Kant's Moral Philosophy” raises a set of issues about how Kantian ethics should be understood in relation to present day “philosophical naturalism” that are very much in need of discussion. The paper itself is challenging, even in some respects iconoclastic, and provides a highly welcome provocation to raise in new ways some basic questions about what Kantian ethics is and what it ought to be. Guyer offers us an admirably informed and complex argument, both historical and philosophical, that tangles with some of the most difficult problems in Kant's moral philosophy. It begins with some ambitious and controversial claims about Kant's moral philosophy prior to the Groundwork of 1785. It then offers an interpretation, and also a fundamental criticism, of the Groundwork's attempt to establish the moral law based on the idea of freedom of the will. And finally, it raises – and expresses some opinions on – the large and vexed questions of the relationship between transcendental philosophy and philosophical naturalism, and whether Kantian ethics can be made consistent with a naturalistic philosophical outlook. In these comments I will have something to say on each of these three topics, without pretending (any more than Guyer does) to have exhausted what might be said about them.     

Free will and the Genome Project

...I want to argue that the Human Genome Project itself poses no special problem for human freedom, understood in relation to the philosophical issue of free will versus determinism. It seems to pose a problem only if one muddles the interpretation of the issue or of the project that is supposed to bear on it. There is a need for conceptual clarification to point this out, perhaps, but I see no need for "research" in the sense that implies original investigation. However, I also want to probe a bit deeper to identify a distinct set of philosophical worries about freedom that seem to have been misplaced onto the standard issue, the issue of freedom versus determinism, in this discussion and elsewhere. After arguing that the genome project has no real bearing on free will versus determinism, I shall attempt to identify the threat it poses to freedom partly by detaching it from this standard version of the free will question. I shall argue that the worrisome forms of genetic influence that the project might uncover do not really presuppose determinism. But what they do presuppose -- some form of internal or psychological constraint on behavior -- suggests an alternative version of the free will question as the source of popular fears about scientific explanation of human behavior. What is under threat on this version of the question is the Aristotelian notion of character formation and self-control.     

Consciousness and Conscience: Mamardašvili on the Common Point of Departure for Epistemological and Moral Reflection

Mamardašvili did not develop a systematic philosophy that treats separately the various traditional disciplines of philosophy such as epistemology, logic, ethics, aesthetics etc. On the contrary, isolated from the direct influences of other currents of thought that might otherwise have given his own a different direction, Mamardašvili concentrated his attention on the very act of thought, the vitality of which had been undermined in philosophical understandings, including both Hegelian-Marxist attempts to situate the subject in history and re-appropriations of the Cartesian cogito. In this paper I will outline the most pertinent elements of Mamardašvili’s attempt to find a unified subject of knowledge and action and attempt to show how in his view consciousness and conscience are indissoluble. I would like to express my sincere thanks to Tapani Laine who generously shared both his acumen as a philosopher and his vast knowledge of the work of Mamardašvili in comments on a draft of this paper.     

Moral philosophy and moral psychology in Mencius

This paper defends both an interpretation of Mencius’ moral theory and that theory itself against alternative interpretive defences. I argue that the ‘virtue ethics’ reading of Mencius wrongly sees him as denying the distinction between moral philosophy and moral psychology. Virtue ethics is flawed, because it makes such a denial. But Mencius’ moral theory, in spite of Mencius’ obvious interest in moral psychology, does not have that flaw. However, I argue that Mencius is no rationalist. Instead, I show that he upholds a coherentist moral theory, in which reason and psychology both have a role. The final third of the paper compares my interpretation with the work of various important Mencius scholars. I point out that the issue of the difference between moral philosophy and moral psychology is quite important in contemporary Western moral theory.