Providing a bold and original rethinking of environmental ethics, Ben Minteer's Refounding Environmental Ethics will help ethicists and their allies resolve critical debates in environmental policy and conservation practice. Minteer considers the implications of John Dewey's pragmatist philosophy for environmental ethics, politics, and practice. He provides a new and compelling intellectual foundation for the field - one that supports a more activist, collaborative, and problem-solving philosophical enterprise. Combining environmental ethics, democratic theory, philosophical pragmatism, and the environmental social sciences, (...) Minteer makes the case for a more experimental, interdisciplinary, and democratic style of environmental ethics - one that stands as an alternative to the field's historically dominant "nature-centred" outlook. Minteer also provides examples of his pragmatic approach in action, considering a wide range of application and issues, including invasive species, ecological research, biodiversity loss, protected area management, and conservation under global climate change. (shrink)

Conventional wisdom suggests that environmental pragmatists balk at the mere mention of intrinsic value. Indeed, the leading expositor of the pragmatic position in environmental philosophy, Bryan Norton, has delivered withering criticisms of the concept as it has been employed by nonanthropocentrists in the field. Nevertheless, I believe that Norton has left an opening for a recognition of intrinsic value in his arguments, albeit a version that bears little resemblance to most of its traditional incarnations. Drawing from John Dewey’s contextual approach (...) toward moral inquiry, I offer a reconstructed notion of intrinsic value that avoids the metaphysical pitfalls identified by Norton. I argue that this contextual understanding of noninstrumental claims has the advantage of turning our attention toward, and not away from, the critical realm of practice and policy, and that it is especially compatible with the norms of democratic deliberation. By way of example and in defense of my position, I conclude with a rejoinder to Holmes Rolston’s claims about the role of foundational intrinsic value commitments in settling the human-nature dilemma at Royal Chitwan National Park in Nepal. (shrink)

Providing a bold and original rethinking of environmental ethics, Ben Minteer's Refounding Environmental Ethics will help ethicists and their allies resolve critical debates in environmental policy and conservation practice. Minteer considers the implications of John Dewey's pragmatist philosophy for environmental ethics, politics, and practice. He provides a new and compelling intellectual foundation for the field - one that supports a more activist, collaborative, and problem-solving philosophical enterprise. Combining environmental ethics, democratic theory, philosophical pragmatism, and the environmental social sciences, (...) Minteer makes the case for a more experimental, interdisciplinary, and democratic style of environmental ethics - one that stands as an alternative to the field's historically dominant "nature-centred" outlook. Minteer also provides examples of his pragmatic approach in action, considering a wide range of application and issues, including invasive species, ecological research, biodiversity loss, protected area management, and conservation under global climate change. (shrink)

Conventional wisdom suggests that environmental pragmatists balk at the mere mention of intrinsic value. Indeed, the leading expositor of the pragmatic position in environmental philosophy, Bryan Norton, has delivered withering criticisms of the concept as it has been employed by nonanthropocentrists in the field. Nevertheless, I believe that Norton has left an opening for a recognition of intrinsic value in his arguments, albeit a version that bears little resemblance to most of its traditional incarnations. Drawing from John Dewey’s contextual approach (...) toward moral inquiry, I offer a reconstructed notion of intrinsic value that avoids the metaphysical pitfalls identified by Norton. I argue that this contextual understanding of noninstrumental claims has the advantage of turning our attention toward, and not away from, the critical realm of practice and policy, and that it is especially compatible with the norms of democratic deliberation. By way of example and in defense of my position, I conclude with a rejoinder to Holmes Rolston’s claims about the role of foundational intrinsic value commitments in settling the human-nature dilemma at Royal Chitwan National Park in Nepal. (shrink)

A growing number of contributors to environmental philosophy are beginning to rethink the field’s mission and practice. Noting that the emphasis of protracted conceptual battles over axiology may not get us very far in solving environmental problems, many environmental ethicists have begun to advocate a more pragmatic, pluralistic, and policy-based approach in philosophical discussions abouthuman-nature relationships. In this paper, we argue for the legitimacy of this approach, stressing that public deliberation and debate over alternative environmental ethics is necessary for a (...) culture of democracy to be upheld in decision making and policy formulation. Then we argue for a democratically tempered environmental ethics that is grounded in a practical understanding of the character of moral claims regarding the natural world. We offer the results of an empirical study of environmental ethics held by the public to illustrate the diversity in their moral commitments to nature. Finally, we conclude with a discussion of the implications of this ethical pluralism for policy discussions about the management of American public lands. (shrink)

This book provides a richly interdisciplinary assessment of the thought and work of Bryan Norton, one of most innovative and influential environmental philosophers of the past thirty years. In landmark works such as Toward Unity Among Environmentalists and Sustainability: A Philosophy of Adaptive Ecosystem Management, Norton charted a new and highly productive course for an applied environmental philosophy, one fully engaged with the natural and social sciences as well as the management professions. A Sustainable Philosophy gathers together a distinguished group (...) of scholars and professionals from a wide array of fields to engage Norton’s work and its legacy for our shared environmental future. A study in the power of intellectual legacy and the real-world influence of philosophy, the book will be of great interest scholars and students in environmental philosophy, public policy and management, and environmental and sustainability studies. By considering the value and impact of Norton’s body of work it will also chart a course for the next generation of pragmatic environmental philosophers and sustainability scholars grappling with questions of environmental value, knowledge, and practice in a rapidly changing world. (shrink)

Many nonanthropocentric environmental ethicists subscribe to a ``principle-ist'''' approach to moral argument, whereby specific natural resource and environmental policy judgments are deduced from the prior articulation of a general moral principle. More often than not, this principle is one requiring the promotion of the intrinsic value of nonhuman nature. Yet there are several problems with this method of moral reasoning, including the short-circuiting of reflective inquiry and the disregard of the complex nature of specific environmental problems and policy arguments. In (...) the present paper, we advance an alternative, pragmatic contextualist approach to environmental ethics, one grounded in the moral theory of John Dewey. We present the results of an empirical study of public environmental ethics and natural resource management attitudes to support our position, and we conclude with a few recommendations for future inquiry in the field of environmental ethics. (shrink)

Many of the leading contributors to the field of environmental ethics demonstrate a preference for foundationalist approaches in their theoretical justifications of environmentalism. In this paper, I criticise this tendency as it figures in the work of Holmes Rolston III, J. Baird Callicott, and Eric Katz. I illustrate how these writers' desire for philosophical absolutes leads them to reject the moral resources present within human culture; a move that carries with it a number of troubling philosophical and political problems. I (...) conclude that environmental theorists would be better served by taking a more contextual, social, and pragmatic approach to justifying their moral projects regarding nature, and that this mode of inquiry will ultimately lead toward a more philosophically sound and democratically authentic environmental ethics. (shrink)

Ecological research and conservation practice frequently raise difficult and varied ethical questions for scientific investigators and managers, including duties to public welfare, nonhuman individuals (i.e., animals and plants), populations, and ecosystems. The field of environmental ethics has contributed much to the understanding of general duties and values to nature, but it has not developed the resources to address the diverse and often unique practical concerns of ecological researchers and managers in the field, lab, and conservation facility. The emerging field of (...) “ecological ethics” is a practical or scientific ethics that offers a superior approach to the ethical dilemmas of the ecologist and conservation manager. Even though ecological ethics necessarily draws from the principles and commitments of mainstream environmental ethics, it is normatively pluralistic, including as well the frameworks of animal, research, and professional ethics. It is also methodologically pragmatic, focused on the practical problems of researchers and managers and informed by these problems in turn. The ecological ethics model offers environmental scientists and practitioners a useful analytical tool for identifying, clarifying, and harmonizing values and positions in challenging ecological research and management situations. Just as bioethics provides a critical intellectual and problem-solving service to the biomedical community, ecological ethics can help inform and improve ethical decision making in the ecology and conservation communities. (shrink)

Bryan Norton 's convergence hypothesis, which predicts that nonanthropocentric and human-based philosophical positions will actually converge on long-sighted, multi-value environmental policy, has drawn a number of criticisms from within environmental philosophy. In particular, nonanthropocentric theorists like J. Baird Callicott and Laura Westra have rejected the accuracy of Norton 's thesis, refusing to believe that his model's contextual appeals to a plurality of human and environmental values will be able adequately to provide for the protection of ecological integrity. These theoretical criticisms (...) of convergence, however, have made no real attempt to engage the empirical validity of the hypothesis, the dimension that Norton clearly takes to be the centerpiece of his project. Accordingly, the present paper attempts to provide an empirical analysis of the convergence argument, by means of a study of the Vermont public's environmental commitments and their attitudes toward national forest policy. Our findings support a generalized version of Norton 's thesis, and lead us to suggest that environmental philosophers should try to be more inclusive and empirically minded in their discussions about public moral claims regarding nature. (shrink)

A growing number of contributors to environmental philosophy are beginning to rethink the field’s mission and practice. Noting that the emphasis of protracted conceptual battles over axiology may not get us very far in solving environmental problems, many environmental ethicists have begun to advocate a more pragmatic, pluralistic, and policy-based approach in philosophical discussions abouthuman-nature relationships. In this paper, we argue for the legitimacy of this approach, stressing that public deliberation and debate over alternative environmental ethics is necessary for a (...) culture of democracy to be upheld in decision making and policy formulation. Then we argue for a democratically tempered environmental ethics that is grounded in a practical understanding of the character of moral claims regarding the natural world. We offer the results of an empirical study of environmental ethics held by the public to illustrate the diversity in their moral commitments to nature. Finally, we conclude with a discussion of the implications of this ethical pluralism for policy discussions about the management of American public lands. (shrink)

Bryan Norton's convergence hypothesis, which predicts that nonan‐thropocentric and human‐based philosophical positions will actually converge on long‐sighted, multi‐value environmental policy, has drawn a number of criticisms from within environmental philosophy. In particular, nonanthropocentric theorists like J. Baird Callicott and Laura Westra have rejected the accuracy of Norton's thesis, refusing to believe that his model's contextual appeals to a plurality of human and environmental values will be able adequately to provide for the protection of ecological integrity. These theoretical criticisms of convergence, (...) however, have made no real attempt to engage the empirical validity of the hypothesis, the dimension that Norton clearly takes to be the centerpiece of his project. Accordingly, the present paper attempts to provide an empirical analysis of the convergence argument, by means of a study of the Vermont public's environmental commitments and their attitudes toward national forest policy. Our findings support a generalized version of Norton's thesis, and lead us to suggest that environmental philosophers should try to be more inclusive and empirically minded in their discussions about public moral claims regarding nature. (shrink)

Most environmental ethicists adhere to a standard intellectual history of the field, one that explains and justifies the dominant commitments to nonanthropocentrism, moral dualism, and wilderness/wildlife preservation. Yet this narrative—which finds strong support in the work of first generation environmental historians—is at best incomplete. It has tended to ignore those philosophical projects and thinkers in the American environmental tradition that challenge the received history and the established conceptual categories and arguments of environmental ethics. One such figure is the agrarian thinker, (...) conservationist, and rural reformer, Liberty Hyde Bailey. A writer whose environmental philosophy combined biocentric attitudes toward nature with more humanistic concerns about intergenerational fairness and civic responsibility, Bailey remains an invisible figure in environmental ethics, despite his clear influence on the later work of such conservation luminaries as Aldo Leopold, Wendell Berry, Wes Jackson, and others. We would benefit from a recovery of Bailey’s environmental philosophy, especially his articulation of a pluralistic ethical outlook defined by the melding of anthropocentric moral and civic concerns with biocentric commitments regarding the beauty and resilience of the properly cultivated landscape. (shrink)

Most environmental philosophers have had little use for 'conventional' philosophical and political thought. This is unfortunate, because these traditions can greatly contribute to environmental ethics and policy discussions. One mainstream concept of potential value for environmental philosophy is the notion of the public interest. Yet even though the public interest is widely acknowledged to be a powerful ethical standard in public affairs and public policy, there has been little agreement on its descriptive meaning. A particularly intriguing account of the concept (...) in the literature, however, may be found in the work of the American pragmatist John Dewey. Dewey argued that the public interest was to be continuously constructed through the process of free, cooperative inquiry into the shared good of the democratic community. This Deweyan model of the public interest has much to offer environmental philosophers who are interested in making connections between normative arguments and environmental policy discourse, and it holds great promise for enhancing environmental philosophy's role and impact in public life. (shrink)

Few disputes in the annals of US environmentalism enjoy the pedigree of the conservation-preservation debate. Yet, although many scholars have written extensively on the meaning and history of conservation and preservation in American environmental thought and practice, the resonance of these concepts outside the academic literature has not been sufficiently examined. Given the significance of the ideals of conservation and preservation in the justification of environmental policy and management, however, we believe that a more detailed analysis of the real-world use (...) and understanding of these ideas is needed. In this paper, we describe the results of a qualitative, semantic study of the concepts of conservation and preservation undertaken in the context of the Chattahoochee National Forest (CNF), located in northern Georgia (USA). Thirty in-depth interviews were conducted with scientists and north Georgia residents either interested or involved in the future management of the forest. Respondents were asked to define conservation and preservation in their own words and to indicate which approach they felt was more appropriate for the management of the CNF. Qualitative content analysis was used to elicit a set of recurring themes for each foundational concept. Taken together, these themes help to flesh out the meaning of conservation and preservation for citizens and scientists today, and illustrate the evolving nature of two of the more significant and venerable ideas animating US environmental policy and management. (shrink)

In Democracy and the Claims of Nature, the leading thinkers in the fields of environmental, political, and social theory come together to discuss the tensions and sympathies of democratic ideals and environmental values. The prominent contributors reflect upon where we stand in our understanding of the relationship between democracy and the claims of nature. Democracy and the Claims of Nature bridges the gap between the often competing ideals of the two fields, leading to a greater understanding of each for the (...) other. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:The Future of Environmental PhilosophyBen A. Minteer (bio)I think we should be deeply concerned about the future of environmental philosophy. It is the most marginalized of the applied ethics fields (which are often marginalized as a whole within traditional philosophy departments) and with few exceptions, it still has not made significant inroads into neighboring territories—including schools of public policy, natural resources/environment, planning, life sciences, and so on. In (...) my opinion, this is partly due to the general ideological pitch of the field and its narrow methodological orientation, at least historically. The neglect of alternative methods of inquiry, especially qualitative and quantitative work in the social sciences, is particularly troubling.Environmental ethics also has an image problem. In my experience, most natural resource professionals, policy scholars, engineers, and life scientists view our field with considerable skepticism, shaking their heads at what they see as arcane debates that do not touch upon the issues and challenges that motivate their own work. Many of our colleagues in the natural and environmental social sciences, for example, have little patience for the kind of metaethical discussions about intrinsic value, moral pluralism, etc., that have captured much of our attention in the past. They do not see what these kinds of arguments contribute to the scientific, policy, and management curricula, or what they add to their graduate students' training, or to their own research proposals. Typically, if a role for an environmental ethicist is recognized in such settings, it is often just to plug a personnel hole in an National Science Foundation proposal or to serve as a third or fourth reader on a graduate studies committee. Environmental ethics is at best an elective pursuit, it is not seen as essential.I'll be the first to admit that I have blood on my hands here (as do all of us, at least to the extent we have spent time and energy on debates over metaphilosophical issues in the field). And, of course, just because our environmental science and policy colleagues often do not see the true value of the field does not mean that it has no value. Still, I worry that the field seems to be falling into the chasm between traditional philosophy departments and environmental science, policy, and management programs. It is frequently deemed too applied and practical by many [End Page 132] philosophy departments, and too esoteric for schools of public policy, life sciences, and so on. This is not a good situation.How can we fix the image problem? Perhaps one approach would be to develop more solid links with our bioethics cousins (both philosophically and institutionally). There is a revealing story here about the different fortunes of bio- and environmental ethics, and I think we might learn from the success of the former. There will be barriers to such an alliance, however, some of which are intellectual (e.g., the rejection of conventional ethical categories and theories by many environmental ethicists is not shared by most bioethicists) while others are institutional (e.g., What practical shape would a "clinical" model of environmental ethics take? What is the market for this service? and so on).Another route would be to provide more organized and systematic attention to emerging, large-scale environmental science and policy issues—climate change, sustainability, poverty alleviation, and biodiversity loss, to name a few—that are (unfortunately, given their seriousness) viewed as "growth areas" in environmental science and policy studies. At my own institution (Arizona State University) we are moving away from an older departmental and disciplinary model to a more integrative institutional form and a transdisciplinary research culture. So, for example, we have a new school of global studies, a new school of sustainability, and so on. These are composed of a range of disciplines cutting across the natural, technical, and social sciences. There is certainly room in these initiatives and programs for a practical and progressive environmental ethics, but it must be conversant in subjects such as intergenerational equity, conservation science, economic valuation, environmental justice, and the normative dimensions of environmental science policy. I think there is an important role for us to play in these sorts of endeavors (which are popping... (shrink)

Benton MacKaye's name is rarely evoked in the fields of environmental history and philosophy. The author of the Appalachian Trail in the early 1920s and a co-founder of the Wilderness Society with Aldo Leopold and Bob Marshall in the 1930s, MacKaye's unique contribution to American environmental thought is seldom recognized. This neglect is particularly egregious in the current debate over the intellectual foundations of the American wilderness idea, a discussion to which I believe MacKaye has much to contribute. Specifically, I (...) believe that his pragmatic vision for wilderness conservation, a project supported through an appeal to the values of a reconstructed "indigenous" communal environment, owes much to the social philosophy of Josiah Royce, MacKaye's former teacher at Harvard. While the Appalachian Trail never delivered on MacKaye's goals of progressive reform and failed to unite the regional planning and conservation communities of the time, his vision remains highly relevant to our present-day deliberations about the relationship between wild nature and society at the dawn of the 21st century. (shrink)

Benton MacKaye's name is rarely evoked in the fields of environmental history and philosophy. The author of the Appalachian Trail in the early 1920s and a co-founder of the Wilderness Society with Aldo Leopold and Bob Marshall in the 1930s, MacKaye's unique contribution to American environmental thought is seldom recognized. This neglect is particularly egregious in the current debate over the intellectual foundations of the American wilderness idea, a discussion to which I believe MacKaye has much to contribute. Specifically, I (...) believe that his pragmatic vision for wilderness conservation, a project supported through an appeal to the values of a reconstructed "indigenous" communal environment, owes much to the social philosophy of Josiah Royce, MacKaye's former teacher at Harvard. While the Appalachian Trail never delivered on MacKaye's goals of progressive reform and failed to unite the regional planning and conservation communities of the time, his vision remains highly relevant to our present-day deliberations about the relationship between wild nature and society at the dawn of the 21st century. (shrink)

Summary 1. Ecologists and conservation biologists consider many issues when designing a field study, such as the expected value of the data, the interests of the study species, the welfare of individual organisms and the cost of the project. These different issues or values often conflict; however, neither animal ethics nor environmental ethics provides practical guidance on how to assess trade-offs between them. -/- 2. We developed a decision framework for considering trade-offs between values in ecological research, drawing on the (...) field of ecological ethics. We used a case study of the population genetics of three frog species, in which a researcher must choose between four methods of sampling DNA from the study animals. We measured species welfare as the reduction in population growth rate following sampling, and assessed individual welfare using two different definitions: (i) the level of suffering experienced by an animal, and (ii) the level of suffering combined with loss of future life. -/- 3. Tipping the tails of tadpoles ranked as the best sampling method for species welfare, while collecting whole tadpoles and buccal swabbing of adult frogs ranked best for the first and second definitions of individual welfare, respectively. Toe clipping of adult frogs ranked as the worst sampling method for species welfare and the first definition of individual welfare, and equal worst for the second definition of individual welfare. -/- 4. When considering species and individual welfare simultaneously, toe clipping was clearly inferior to the other sampling methods, but no single sampling method was clearly superior to the other three. Buccal swabbing, collecting tadpoles and tail tipping were all preferred options, depending on the definition of individual welfare and the level of precision with which we assessed species welfare. -/- 5.Synthesis and applications. The decision framework we present can be used by ecologists to assess ethical and other trade-offs when planning field studies. A formal decision analysis makes transparent how a researcher might negotiate competing ethical, financial and practical objectives. Defining the components of the decision in this way can help avoid errors associated with human judgement and linguistic uncertainty. (shrink)

This important book brings together leading environmental thinkers to debate a central conflict within environmental philosophy: Should we appreciate nature ...

Several recent writers have argued that the rejection of hypothetical constructs is one of the defining features of radical behaviorism. The present discussion argues that this claim is ill-founded and based on an erroneous distinction regarding different kinds of theoretical constructs. All constructs, including those commonly employed by behavior analysts, are argued to be inherently hypothetical, because they provide a causal basis for extending empirical findings to new sets of variables. Moreover, the constructs employed by radical behaviorists are not qualitatively (...) different from those often employed by cognitivists . The result is that much of the basis for recent criticisms of cognitive psychology by behaviorists disappears. To the extent that differences do remain it is not in the qualitative nature of the two enterprises, but instead in attitudes about parsimony in the relation between data and theory. (shrink)

The concept of person is integral to bioethical discourse because persons are the proper subject of the moral domain. Nevertheless, the concept of person has played no role in the prevailing formulation of human death because of a purported lack of consensus concerning the essential attributes of a person. Beginning with John Locke's fundamental proposition that person is a ‘forensic term’, I argue that in Western society we do have a consensus on at least one necessary condition for personhood, and (...) that is the capacity for conscious experience. When we consider the whole brain formulation of death, and the most prominent defense of it by the President's Commission for the Study of Ethical Problems in Medicine and Biomedical and Behavioral Research, we can readily identify the flaws that grow out of the failure to define human death as the permanent loss of the capacity for conscious experience. Most fundamental among these flaws is a definition of human death that reduces persons to the capacity of the brain to regulate purely physiological functioning. Such a formulation would, in theory, apply to any member of the animal kingdom. I suggest that an appropriate concept of death should capture what it is about a particular living being that is so essential to it that the permanent loss of that thing constitutes death. What is essential to being a human being is living the life of a person, which derives from the capacity for conscious experience. (shrink)

Abstract:The specialty of psychiatry has a long-standing, virtually monolithic view that a desire to die, even a desire for a hastened death among the terminally ill, is a manifestation of mental illness. Recently, psychiatry has made significant inroads into hospice and palliative care, and in doing so brings with it the conviction that dying patients who seek to end their suffering by asserting control over the time and manner of their inevitable death should be provided with psychotherapeutic measures rather than (...) having their expressed wishes respected as though their desire for an earlier death were the rational choice of someone with decisional capacity. This article reviews and critiques this approach from the perspective of recent clinical data indicating that patients who secure and utilize a lethal prescription are generally exercising an autonomous choice unencumbered by clinical depression or other forms of incapacitating mental illness. (shrink)

Abstract:Recently the scope of protections afforded those healthcare professionals and institutions that refuse to provide certain interventions on the grounds of conscience have expanded, in some instances insulating providers (institutional and individual) from any liability or sanction for harms that patients experience as a result. With the exponential increase in the penetration of Catholic-affiliated healthcare across the country, physicians and nurses who are not practicing Catholics are nevertheless required to execute documents pledging to conform their patient care to the Ethical (...) and Religious Directives for Health Care Services as a condition of employment or medical staff privileges. In some instances, doing so may result in patient morbidity or mortality or violate professional standards for respecting advance directives or surrogate decisionmaking. This article challenges the ethical propriety of such institutional mandates and argues that legal protections for conscientious refusal must provide redress for patients who are harmed by care that falls below the prevailing clinical standards. (shrink)

Prognostication, the process offormulating and communicating a prognosis, isno longer considered by most physicians to bean essential task in caring for patients withserious illness. Because of this fact, it isnot surprising to find that when physiciansattempt to engage in prognostication, they doit poorly. What may be surprising to thoseoutside the medical community is the extent towhich professional norms have developed whichactively discourage physicians from engaging inprognostication. This article explores thecauses of this state of affairs and thejustifications offered for it. The (...) conclusionis reached that physicians have a professionalresponsibility to competently engage inprognostication based upon the doctrine ofinformed consent, and that a failure or refusalto do so has not only potential legalramifications, but serious negativeimplications for many of the core issues inbioethics, such as the use of advancedirectives, palliative medicine, and medicalfutility. (shrink)

In a recent special supplement to the Hastings Center Report entitled “Improving End-of-Life Care—Why Has It Been So Difficult?” Robert Burt wrote the following in an essay ominously entitled “The End of Autonomy”: No one should be socially authorized to engage in conduct that directly, purposefully, and unambiguously inflicts death, whether on another person or on oneself. Decisions that indirectly lead to death should be acted upon only after a consensus is reached among many people. No single individual should be (...) socially authorized to exercise exclusive control over decisions that might lead to death, whether that individual is the dying person, the attending physician, or a family member acting as health care proxy. (shrink)

Until quite recently bioethicists have had little of depth and probity to say about the duty of healthcare professionals in general and physicians in particular to relieve pain and suffering associated with disease and/or its treatment.

In the mid to late 1980s a debate arose over the moral and legal authority of advance medical directives. At the center of this debate were two point-counterpoint law journal articles by Rebecca Dresser and Nancy Rhoden. What appeared to have the makings of an ongoing critical dialogue ended with the untimely death of Nancy Rhoden. Rebecca Dresser, however, has continued her challenge of advance directives in numerous publications, most recently in a critique of Ronald Dworkin's Life's Dominion. Like Rhoden, (...) Dworkin has been a staunch advocate of advance directives as an exercise of what has come to be referred to as prospective or precedent autonomy. In this paper I will consider a number of the issues that Dresser has repeatedly raised about the infirmities of advance directives, and suggest that it is from an understanding of and appreciation for the narrative dimension of the life of a person that advanced directives draw one of their most powerful justifications. (shrink)

The American Journal of Bioethics, Volume 11, Issue 6, Page 52-53, June 2011.

Abstract:Recent contributions to the medical literature have raised yet again the issue of whether the term “terminal” is an intelligible one and whether there is a consensus view of its meaning that is sufficient to justify or even require its use in discussing end-of-life care and treatment options with patients. Following a review of the history and development of informed consent, persistent problems with the communication of prognosis and the breaking of bad news are analyzed. The author argues that candid (...) but compassionate communication between physicians and patients about prognosis is essential to informed decisions about both disease-directed (curative) and palliative therapies. (shrink)

(2013). Distinguishing Difficult Patients From Difficult Maladies. The American Journal of Bioethics: Vol. 13, No. 4, pp. 24-26. doi: 10.1080/15265161.2013.767957.