Sterilization, Catholic health care, and the legitimate autonomy of culture.

Disagreement over the legitimacy of direct sterilization continues within Catholic moral debate, with painful and at times confusing ramifications for Catholic healthcare systems. This paper argues that the medical profession should be construed as a key moral authority in this debate, on two grounds. First, the recent revival of neo-Aristotelianism in moral philosophy as applied to medical ethics has brought out the inherently moral dimensions of the history and current practice of medicine. Second, this recognition can be linked to Catholic morality through Vatican II's affirmation of the legitimate autonomy of culture, including the sciences. A partial precedent for understanding the moral authority of medicine can be found in the recent history of Catholic medical morality, and we further argue that a full contemporary recognition of that authority would weigh against an absolute prohibition of direct sterilizations. Institutionally, we propose the allowance of direct sterilizations in cases where the clinically perceived biomedical good of the patient is at stake.     

THE UNIVERSALITY OF JEWISH ETHICS: A Rejoinder to Secularist Critics

Jewish ethics like Judaism itself has often been charged with being "particularistic," and in modernity it has been unfavorably compared with the universality of secular ethics. This charge has become acute philosophically when the comparison is made with the ethics of Kant. However, at this level, much of the ethical rejection of Jewish particularism, especially its being beholden to a God who is above the universe to whom this God prescribes moral norms and judges according to them, is also a rejection of Christian (or any other monotheistic) ethics, no matter how otherwise universal. Yet this essay argues that Jewish ethics that prescribes norms for all humans, and that is knowable by all humans, actually constitutes a wider moral universe than does Kantian ethics, because it can include non-rational human objects and even non-human objects altogether. This essay also argues that a totally egalitarian moral universe, encompassing all human relations, becomes an infinite, totalizing universe, which can easily become the ideological justification ( ratio essendi ) of a totalitarian regime.     

现代社会伦理秩序的发生路径

“自发生成论”和“理性创设论”是传统道德哲学关于社会伦理秩序生成的两种理论模式。“自发生成论”认为,伦理道德不是纯粹人类理性设计的产物,而是人类行为实践的自然结果;“理性创设论”认为,伦理道德是人类自觉建构的结果,是人类理性创设的产物。这两种理论模式都以抽象的人性为其理论基础,无法合理解释个体与类之间的伦理关系。基于现实伦理实体的“创生拓展”应成为现代社会伦理秩序的发生路径。     

THE VALIDITY OF MORAL THEORIES

Abstract. We can usefully draw an analogy between ethics and science, despite the significant differences between them. We can then see the ways in which moral theories can indeed be "tested," not by empirical experience but by moral experience. This can be expected to lead to rival moral theories, but in science also we have rival theories. I argue that we should demand more than coherence of our moral theories, as we do of our scientific theories. I try to show how the "testing" of moral theories can be carried out and how this can allow us to accept some moral theories as valid.     

In defense of caring

I hope to persuade Hilde L. Nelson that she is wrong about an ethics of caring....In conclusion, caring is an "ethics of attention," but it includes more than attention. 'Carers' must respond as well as attend. Much more needs to be done in describing caring responses, especially when social problems are involved. I agree with Nelson that an ethics or a moral orientation must deal with social problems. I also agree that, to date, most of us working on caring have written little on the subject. However, I do not agree that an ethics of caring is unable to address social problems. We have to work at showing that it can.     

孔子的忠德观探析

“忠”是孔子道德学说的一个重要范畴。孔子对“忠”的论述非常全面和系统,其中既包括对“忠”的学理性探讨,也包括对忠德的培育、践行等的方法论指导,构成了一个理论性与实践性兼备的完整体系。孔子的“忠”具有泛伦理特征,在他看来,“忠”是一切人都应具备的道德品格,不存在主体上的选择性;“忠”的美德不仅应当施于主体以外的所有人,而且应当施于主体所从事的工作和事业,施于自己的祖国。     

Why we need a theory of suffering, and lots of other theories as well: commentary

In the first section of his article, "The Role of Suffering and Community in Clinical Ethics," Erich Loewy sketches a theory of suffering. His conviction is that clinical medical ethics is not clearly rooted in theory and is inadequately grounded because of this. While acknowledging the merits of virtue ethics and casuistry, Loewy quickly dispenses with them, as contenders for this theoretical basis. Kantianism and utilitarianism are likewise rejected as "a universally acceptable grounding for ethics." In their place, Loewy proposes that "a deeper and more universal grounding can be found in the capacity of sentient beings to suffer." It is on this capacity to suffer that he builds his hierarchies of moral value, including primary, secondary, and symbolic worth. This theory of suffering should be welcomed. It promises to expand our awareness of clinical experience, and moral life generally, away from autonomy, utility, or virtue orientations toward attention to suffering and our response to it. Such a theory can give us a revitalized language to probe the issues of medical ethics. This should lead us to a careful reading of Loewy's larger work on which this article is based. Yet my enthusiasm is tempered by Loewy's noncritical acceptance of a peculiar, yet pervasive, understanding of the role and use of theory in ethics....     

“How dare you sport thus with life?”: Frankensteinian fictions as case studies in scientific ethics

Fictional scenarios involving "hard" science offer what are in effect case studies of scientific ethics. From his analysis of Shelley's novel, biologist Leonard Isaacs constructed a model of a "Frankenstein scenario," applicable to the dilemmas posed by the advancement of science in our time, as well as to fiction about science by such contemporary writers as Robin Cook and Michael Crichton. The special contribution of fiction to the study of ethics is that it both reflects and evaluates reality's infinite permutations. In reflecting and judging, the fictional scenarios engage our moral imagination and compel us to confront our personal ethos in relation to the evolving ethos of science.     

ADAM SMITH AND THE POSSIBILITY OF SYMPATHY WITH NATURE

Abstract:  As J. Baird Callicott has argued, Adam Smith's moral theory is a philosophical ancestor of recent work in environmental ethics. However, Smith's "all important emotion of sympathy" (Callicott, 2001, p. 209) seems incapable of extension to entities that lack emotions with which one can sympathize. Drawing on the distinctive account of sympathy developed in Smith's Theory of Moral Sentiments , as well as his account of anthropomorphizing nature in "History of Astronomy and Physics," I show that sympathy with non-sentient nature is possible within a Smithian ethics. This provides the possibility of extending sympathy, and thereby benevolence and justice, to nature.     

Health Care Ethics Consultation: 'Training in Virtue'

In philosophy, intelligence is less important than character, or so Wittgenstein once argued. In this paper, in a similar vein, I suggest that in health care ethics consultation character is of preeminent importance. I suggest that the activity of ethics consultation can be understood as "training in virtue," and what distinguishes the good health care ethics consultant from his/her average colleague are differences in traits of character. The underlying assumption is that one's use of knowledge and abilities are ultimately a function of who one is and how one perceives and confronts situations of moral uncertainty and conflict. In discussing the original case presented by Mark Bliton, I focus on the virtues of wisdom, justice, courage, compassion and humility.     

Integrating justice and care in animal ethics

In this paper I argue that the standoff between justice and care approaches to animal ethics presents us with a false dilemma. We should take justice's focus on reasoning from principles, and care's use of sympathetic awareness, as two integrated deliberative capacities necessary for the consideration of arguments for extending moral concern to animals. Such an integrated approach rests on a plausible account of the psychology of moral deliberation. I develop my argument as follows. Section I summarizes the nature of the debate between justice and care approaches to animal ethics, focusing on Brian Luke's arguments against justice approaches. Section II provides pro-justice rebuttals to Luke's objections. These rebuttals, while largely successful against Luke's objections, do not account for the intuition that sympathy does play a central epistemological role in animal ethics. Section III explains how sympathy cognitively simulates the perspective of the other, and thus can play an epistemological role in animal ethics. I argue that the abilities to simulate the perspective of the other and to reason from moral principles can complement each other. In section IV, I argue that though it may not be desirable to use both sympathy and reasoning from principles in all moral deliberation, it is a desirable aim when offering, and considering, moral arguments for what I will term the "extensionist project" of extending over moral concern to animals. I make this idea plausible by elucidating the claim that arguments for this project are best thought of as second-order deliberations about our first-order deliberative life.     

Killing and Letting Die: the Similarity Criterion

abstract   Applied ethics engages with concrete moral issues. This engagement involves the application of philosophical tools. When the philosophical tools used in applied ethics are problematic, conclusions about applied problems can become skewed. In this paper, I focus on problems with the idea that comparison cases must be exactly alike, except for the moral issue at hand. I argue that this idea has skewed the debate regarding the moral distinction between killing and letting die.
I begin with problems that can arise from attempts to produce comparison cases that are exactly alike, except for the moral issue at hand. I then argue that attempts to produce such examples are doomed to failure. Finally, I argue that abandoning concerns about similarity advances the debate regarding the moral distinction between killing and letting die.     

Reproductive Technologies of the Self: Michel Foucault and Meta-Narrative-Ethics

This paper presents a direction for narrative ethics based on ethical ideas found in the works of Michel Foucault. Narrative ethics is understood here at the meta-level of cultural discourse to see how the moral subject is constituted by the discursive practices that structure the contemporary debate on reproductive technologies. At this level it becomes meta-narrative-ethics. After a theoretical discussion, this paper uses two literary narratives representing the polarized views in the debate to show how the moral subject may be compelled to relate to its self. Ethics is redefined as Foucauldian rapport à soi, and ethical analysis, at this meta-level, shows how the moral self is intimately connected to cultural discourse.     

从伦理的视角看“三个代表”

“三个代表”重要思想,从伦理学上进行分析,饱含着深刻的伦理智慧,浸润着美善和正义的光华,它既可以理解为一种全新的政治伦理,又可以指谓一种进步的社会伦理,还可以从经济伦理、科技伦理和文化伦理等角度加以阐释与论证。因此,我们有理由认为,“三个代表”的伦理精神和伦理目标将构成当代中国社会的主流伦理,成为指导我国当前公民道德建设的伟大旗帜和促成中华伦理文化伟大复兴的理论指南。     

Response to Erich Loewy: commentary

The capacity to suffer, the vulnerability with respect to suffering, confers on all animals with that capacity (not just human beings) a prima facie right not to be caused suffering. Nurturing in order to stave off such suffering is the first act of the community toward the individual, primarily in infancy. Hence for Loewy, autonomy, the gradual growth of self-determination in individuals, is grounded in a broader moral commitment of the community, that of beneficence. This is the critical point in his argument, for it represents a wholesale critique of modern libertarianism. Libertarians, in contrast to Loewy's argument, seem to ground the nature of the community in the prima facie right of autonomy. For Loewy, the community not only has an obligation to refrain from harming individuals (nonmaleficence), but it also has an active duty to ameliorate and prevent, as far as possible, the suffering of its members. Thus, if there is a social contract, it is one of nurturing one another to overcome the vulnerability of suffering, not primarily one of protecting autonomy. This is most significant for clinical ethics as well. Once the primary obligation to ameliorate suffering is no longer necessary, when the individual loses or does not have the primary moral worth prompted by the capacity to suffer, then secondary and symbolic obligations emerge. Loewy is thereby able to suggest a "calculus" of moral worth, wherein our obligations to individuals in a permanent vegetative state or to anencephalics (almost always the individual will have lost the capacity to suffer through some cerebral event) must be weighed against other primary obligations. Although Loewy admits that grounding clinical ethics in the capacity to suffer might be "thin," it nevertheless prompts serious discussion about the nature of the "good" in good clinical ethics decisions.     

"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.     

What Must We Mean By “Community”? A Processive Account

The term "community" in ethics and bioethics traditionally has been used to designate either a specific kind of moral relationship available to rational agents or, in contrast, the context in which any sense of rational agency can even be understood. I argue that bioethics is better served when both "selves" and "community" are expressed through a more processive language that highlights the functional character of such concepts. In particular, I see the turn to "processive" community in bioethics as a turn towards method, contextualization, and narrative. In clinical practice, such a processive account demands that bioethics concentrate on methods of developing healthy dialogue and deeper understanding from within the problematic situation rather than trying to "fix" problems using ethical tools developed from outside the present situation. "Community," I argue, is in and of the interactive processes of inquiry itself. Such inquiry, such "communitying," requires that we engage individual patients in context; it demands more than simply gaining their permission or mere consent; it demands developing a supportive environment for participation.     

"Moralism" and the Gender Gap: Judgments of Political Ethics in Japan

This article investigates whether women are, as many claim, "moralists"—that is, moral and ethical standard-setters who seek clean politics and have strict standards for public officials. An analysis of data from the 1996 Japanese Elections and Democracy Study survey and from 18 focus groups conducted in 1996 indicates that women in Japan are not moralists. As elsewhere, there is a gender gap in Japan on "issue preference sets," with women favoring a "care" agenda, but women assign political ethics less importance than do men, even though women are more likely to see adverse effects from political corruption. Studying people's judgments of four ethics scenarios reveals minimal gender gaps; controlling for education and age, women's judgments overall are less, not more, strict than men's. Among women, age is a better predictor of moralism than education; older women are stricter than younger women on political ethics. This is attributed to gender-based differences in moral reasoning: Japanese women and men both rely heavily on a "relation-based" frame (which is situation-specific and requires extensive social information), but gender stratification patterns create information inequalities. Younger women lack social information necessary for judging political misconduct, whereas older women overcome the information deficit through life experience.     

A theory of international bioethics: the negotiable and the non-negotiable

The preceding article in this issue of the Kennedy Institute of Ethics Journal presents the argument that "moral fundamentalism," the position that international bioethics rests on "basic" or "fundamental" moral prinicples that are universally accepted in all eras and cultures, collapses under a variety of multicultural and postmodern critiques. The present article looks to the contractarian tradition of Hobbes and Locke -- as reinterpreted by David Gauthier, Robert Nozick, and John Rawls -- for an alternative justification for international bioethics. Drawing on the central themes of this tradition, it is argued that international bioethics can be rationally reconstructed as a negotiated moral order that respects culturally and individually defined areas of nonnegotiability. Further, the theory of a negotiated moral order is consistent with traditional ideals about human rights, is flexible enough to absorb the genuine insights of multiculturalism and postmodernism, and yet is strong enough to justify transcultural and transtemporal moral judgments, including the condemnation of the Nazi doctors at Nuremberg. This theory also is consistent with the history of the ethics of human subjects experimentation and offers insights into current controversies such as the controversy over changing the consent rule for experiments in emergency medicine and the controversy over exempting certain clinical trials of inexpensive treatments for preventing the perinatal transmission of AIDS from the ethical standards of the sponsoring country.