As I have been saying in recent blogs, most of what we do in
clinical ethics, but also in most areas of bioethics, is procedural ethics.
That is when we are faced with an ethical dilemma, our approach, whether
consciously or unconsciously is usually to try to reach a reasonable compromise
or consensus among the key participants that are in conflict consistent with
well-established values and principles. This tendency reflects an obvious
reality about the nature of contemporary ethics that we often ignore: in the
current Western moral setting, our only viable methodology for resolving value
laden disputes, whether at the micro level in clinical ethics or macro level in
healthcare policy, is to attempt to craft an agreement or consensus among those
with a say. Whether we are dealing with patients and families at odds with
their physician on how to define the goals of care in the hospital setting or
trying to build a consensus of opinion among voters in the political arena, we
assume there are no final, authoritative moral answers that avail themselves to
us. Whether we like it or not, we humans must figure out ethical dilemmas for
ourselves and learn to get along.
Yet the idea of procedural ethics remains very worrisome for
many people, including such bioethicists and Tristram Engelhardt, Jr. He believes
that procedural ethics, such much of what we do in clinical ethics, is not
really ethics in because it is based on convention and legalistic type
standards. For him ethics worthy of the name must flow from a content-rich,
canonical moral tradition that provides moral authority to our everyday ethical
and moral judgments.
The views, opinions and positions expressed by these authors and blogs are theirs and do not necessarily represent that of the Bioethics Research Library and Kennedy Institute of Ethics or Georgetown University.