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Published online by Cambridge University Press: 29 July 2009
Virtue ethics attempts to identify certain commonly agreed-upon dispositions to act in certain ways, dispositions that would be accepted as ‘good’ by those affected, and to locate the goodness or badness of an act internal to the agent. Basically, virtue ethics is said to date back to Aristotle, but as Alisdair MacIntyre has pointed out, the whole idea of ‘virtue ethics’ would have been unintelligible in Greek philosophy for “a virtue (arete) was an excellence and ethics concerned excellence of character; all ethics was virtue ethics.” Virtue ethics as a method to approach problems in medical ethics is said by some to lend itself to working through cases at the bedside or, at least, is better than the conventional method of handling ethical problems. In this paper I want to explore some of the shortcomings of this approach, examine other traditional approaches, indicate some of their limitations, and suggest a different conceptualization of the approach.
1. Among the more recent defenders of this approach to ethics the work of Pellegrino and Thomasma deserves particular attention.
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24. 1 do not wish to make a wrong accusation. Kant seemed very much aware of the importance of forming character: after all character is essential if one is to be obedient to rules. But while forming character was important it was secondary to the rationally formulated rules that govern, or ought to govern, our lives. There is a paradox: undoubtedly a morally more correct world would result from having our inclinations shaped so as to accord with our duties. But the more we act from (mere) inclinations, it seems, the less do we become praiseworthy for our actions. Some may argue then that in the first place praise worthiness, white it may diminish when we act in accordance with our inclinations, increases as we seek to shape our inclinations so as to form habits and create virtues.
25. Throughout John Dewey's work he is at pains to show that the strict division we make between things like means and ends or theory and praxis is a largely artificial one. To Dewey virtues are formed in community, must eventuate in action and are ultimately deemed ‘good’ or ‘bad’ according to the ends they serve. Proper ends are those that allow us to effectively deal with problems at hand and allow us to learn from praxis. They are good insofar as they promote the development of all, not merely some, within a community. Ultimately such learning, growth, and vigorous communal interaction are only possible when the democratic ideal is conserved and when political democracy is underwritten by mutual respect, as well as by economic and educational democracy. For an analysis of a Deweyan method of decision-making applied to the healthcare context see Loewy, Springer R. Integrity and Personhood: Looking at Patients from a Bio-Psycho-Social Perspective. Thesis submitted for PhD, Loyola University of Chicago, 1996.Google Scholar
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