Intuition and the junctures of judgment in decision procedures for clinical ethics

Abstract
Moral decision procedures such as principlism or casuistry require intuition at certain junctures, as when a principle seems indeterminate, or principles conflict, or we wonder which paradigm case is most relevantly similar to the instant case. However, intuitions are widely thought to lack epistemic justification, and many ethicists urge that such decision procedures dispense with intuition in favor of forms of reasoning that provide discursive justification. I argue that discursive justification does not eliminate or minimize the need for intuition, or constrain our intuitions. However, this is not a problem, for intuitions can be justified in easy or obvious cases, and decision procedures should be understood as heuristic devices for reaching judgments about harder cases that approximate the justified intuitions we would have about cases under ideal conditions, where hard cases become easy. Similarly, the forms of reasoning which provide discursive justification help decision procedures perform this heuristic function not by avoiding intuition, but by making such heuristics more accurate. Nonetheless, it is possible to demand too much justification; many clinical ethicists lack the time and philosophical training to reach the more elaborate levels of discursive justification. We should keep moral decision procedures simple and user-friendly so that they will provide what justification can be achieved under clinical conditions, rather than trying to maximize our epistemic justification out of an overstated concern about intuition.
Keywords casuistry  decision procedure  discursive justification  heuristic  intuition  judgment  moral epistemology  moral theory  principles  principlism
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Citations of this work BETA
Jukka Varelius (2008). Ethics Consultation and Autonomy. Science and Engineering Ethics 14 (1):65-76.
Miles Little (2009). The Role of Regret in Informed Consent. Journal of Bioethical Inquiry 6 (1):49-59.
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