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- David J. Casarett (1999). Moral Perception and the Pursuit of Medical Philosophy. Theoretical Medicine and Bioethics 20 (2).This paper begins by examining the claim that the practice of medicine is essentially a moral endeavor. According to this view, all clinical practice has moral content, and each clinical situation has a moral dimension. I suggest that in order to recognize this moral dimension, clinicians must engage in an interpretive process, and that they must be able to interpret clinical data in ethical terms. However, clinicians often lack the ‘moral perception’ required to appreciate this moral dimension. I will argue that physicians lack moral perception when the clinical data they are given do not offer sufficient opportunity for interpretation. This paper draws on the work of Merleau-Ponty to suggest that this loss of interpretation is, paradoxically, the result of the way that patients experience illness. This thesis may be productive, first, because it suggests opportunities to explore the process of moral perception. This thesis also suggests ways for ethicists and educators to enhance clinicians' perception of the ethical dimensions of clinical practice. Finally, the concept of moral perception, when grounded in the patient's experience of illness, creates a fruitful area of inquiry that warrants inclusion in what may someday be the philosophy of medicine's canon.
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One of the primary motivations behind moral anti-realism is a deep-rooted scepticism about moral knowledge. Moral realists attempt counter this worry by sketching a plausible moral epistemology. One of the most radical proposals in the recent literature is that we know moral facts by perception – we can literally see that an action is wrong, etc. A serious objection to moral perception is the causal objection. It is widely conceded that perception requires a causal connection between the perceived and the perceiver. But, the objection continues, we are not in appropriate causal contact with moral properties. Therefore, we cannot perceive moral properties. This papers demonstrates that the causal objection is unsound whether moral properties turn out to be secondary, natural properties; non-secondary, natural properties; or non-natural properties. 1.
: Fins, Bacchetta, and Miller's clinical pragmatism has several appealing features: an emphasis on dialogue, a commitment to consensus, a focus on particular individuals rather than persons in general, and a strong interest in the process as well as the product of moral decision making. Nevertheless, for all its protests to the contrary, clinical pragmatism has a tendency to privilege medical facts over nonmedical values, to conflate appropriate medical decisions with right moral decisions, and to conceive problems at the bedside in terms of "getting" patients and families to "go along" with the treatment plans of clinicians. In sum, there is within clinical pragmatism the potential for physicians to take back some of the power they ceded to patients during the height of the patients' rights and autonomy movement. Provided that clinicians guard against the temptation to use clinical pragmatism manipulatively, however, the method promises, more than most other methods of moral problem solving, to help increasingly diverse individuals make good moral decisions about patients' care under conditions of enormous uncertainty.
On the face of it, some of our knowledge is of moral facts (for example, that this promise should not be broken in these circumstances), and some of it is of non-moral facts (for example, that the kettle has just boiled). But, some argue, there is reason to believe that we do not, after all, know any moral facts. For example, according to J. L. Mackie, if we had moral knowledge (‘‘if we were aware of [objective values]’’), ‘‘it would have to be by some special faculty of moral perception or intuition, utterly different from our ordinary ways of knowing everything else’’(1977,p.38).But wehavenosuchspecialfaculty.So,wehavenomoralknowledge. Following Mackie, let us distinguish two questions: Q1: Assuming that we have moral knowledge, how do we have it? Q2: Do we in fact have any moral knowledge? In response to the first question, I argue that if we have moral knowledge, we have some of it in the same way we have knowledge of our immediate environment: by perception. Many people think that this answer leads to moral skepticism, because they think that we obviously cannot have moral knowledge by perception. But I will argue that this is incorrect. The plan for the paper is as follows. In Sections 2–4, I work up to my answer to Q1 by considering rivals. In Section 5, I explain what marks my answer to Q1 as a distinctive view, and defend it. In Section 6, I briefly discuss how this answer to Q1 affects what we say in response to Q2.
The aim of the paper is to examine the possible relationships between the different dimensions of aesthetics on the one hand, and medical practice and medical ethics on the other hand. Firstly, I consider whether the aesthetic perception of the human body is relevant for medical practice. Secondly, a possible analogy between the artistic process and medical action is examined. The third section concerns the comparison between medical ethical judgements and aesthetic judgement of taste. It is concluded that the mutual relevance between the aesthetic sphere, moral judgement and medical practice can be understood only if we recognize these spheres as distinct.
I argue that emotional sensitivity (or insensitivity) has a marked negative influence on ethical perception. Diminished capacities of ethical perception, in turn, mitigate what we are morally responsible for while lack of such capacities may altogether eradicate responsibility. Impairment in ethical perception affects responsibility by affecting either recognition of or reactivity to moral reasons. It follows that emotional insensitivity (together with its attendant impairment in ethical perception) bears saliently on moral responsibility. Since one distinguishing mark of the psychopath is emotional insensitivity, emotional insensitivity and the resulting impairment in moral perception either excuses the psychopath from moral culpability or moderates the degree to which he is culpable.
This paper presents a theory of how perception provides a basis for moral knowledge. To do this, the paper sketches a theory of perception, explores the sense in which moral perception may deserve that name, and explains how certain moral properties may be perceptible. It does not presuppose a causal account of moral properties. If, however, they are not causal, how can we perceive, say, injustice? Can it be observable even if injustice is not a causal property? The paper answers these and other questions by developing an account of how moral properties, even if not causal, can figure in perception in a way that grounds moral knowledge.
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This paper explores the relevance of the debate about ethical expertise for the practice of clinical ethics. We present definitions, explain three theories of ethical expertise, and identify arguments that have been brought up to either support the concept of ethical expertise or call it into question. Finally, we discuss four theses: the debate is relevant for the practice of clinical ethics in that it (1) improves and specifies clinical ethicists' perception of their expertise; (2) contributes to improving the perception of moral competence of non-ethicists; (3) gives insight into complementary styles of argumentation of ethicists and non-ethicists; and (4) contributes to the awareness of the problem of profession-building of (clinical) ethicists.
: "Clinical pragmatism" is an important new method of moral problem solving in clinical practice. This method draws on the pragmatic philosophy of John Dewey and recommends an experimental approach to solving moral problems in clinical practice. Although the method may shed some light on how clinicians and their patients ought to interact when moral problems are at hand, it nonetheless is deficient in a number of respects. Clinical pragmatism fails to explain adequately how moral problems can be solved experimentally, it underestimates the relevance and importance of judgment in clinical ethics, and it presents a questionable account of the role that moral principles should play in moral problem solving.
Abstract: In this paper, I defend the view that we can have perceptual moral knowledge. First, I motivate the moral perception view by drawing on some examples involving perceptual knowledge of complex non-moral properties. I argue that we have little reason to think that perception of moral properties couldn't operate in much the same way that our perception of these complex non-moral properties operates. I then defend the moral perception view from two challenging objections that have yet to be adequately addressed. The first objection is that the moral perception view has implausible commitments concerning the morally blind, people who would claim not to perceive wrongness. The second objection is that the moral perception view is not really compatible with a wide range of the main candidate moral theories. I argue that the moral empiricist has plausible responses to both of these objections. I then address three residual concerns that my defense raises.
One popular reason for rejecting moral realism is the lack of a plausible epistemology that explains how we come to know moral facts. Recently, a number of philosophers have insisted that it is possible to have moral knowledge in a very straightforward way—by perception. However, there is a significant objection to the possibility of moral perception: it does not seem that we could have a perceptual experience that represents a moral property, but a necessary condition for coming to know that X is F by perception is the ability to have a perceptual experience that represents something as being F . Call this the ‘Representation Objection’ to moral perception. In this paper I argue that the Representation Objection to moral perception fails. Thus I offer a limited defense of moral perception.
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