Skip to main content
Log in

Theoretical and practical problems with wide reflective equilibrium in bioethics

  • Published:
Theoretical Medicine and Bioethics Aims and scope Submit manuscript

Abstract

Various theories have been put forward in an attempt to explain what makes moral judgments justifiable. One of the main theories currently advocated in bioethics is a form of coherentism known as wide reflective equilibrium. In this paper, I argue that wide reflective equilibrium is not a satisfactory approach for justifying moral beliefs and propositions. A long-standing theoretical problem for reflective equilibrium has not been adequately resolved, and, as a result, the main arguments for wide reflective equilibrium are unsuccessful. Moreover, practical problems that arise in using the method of wide reflective equilibrium undermine the idea that it is a viable approach for justifying moral judgments about cases and policies. Given that wide reflective equilibrium is the most prominent version of coherentism, these considerations call into question the coherentist approach to justification in bioethics.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Similar content being viewed by others

Notes

  1. It would be true in one sense, although somewhat facile, to claim that the right to refuse treatment, based on the principle of autonomy, provides a justification for writing a DNR order for R.S. A theory of moral justification would seek to answer the question of why it is morally justifiable to follow the principle of autonomy. And for any other moral precept, such a theory would seek to explain why it is (or is not) morally justifiable to act in accordance with that precept.

  2. “Having a reason” and “there being a reason” are distinct concepts. There could be a good reason, call it R, for Jones to believe a particular moral proposition P. However, if Jones is not aware of R, then it cannot be said that R is a reason Jones has for believing P.

  3. I acknowledge that this formulation of the distinction assumes that moral judgments are expressed as propositions, which implies that they are capable of being true or false. Some might object to this, claiming that moral statements do not have truth values. In reply, I would point out that, as a matter of practice, we generally treat moral statements as if they are true or false. Moreover, the endeavor to justify moral statements seems to presuppose that they have truth values. For these reasons, and in the absence of compelling reasons to abandon our usual practice, I shall assume that it makes sense to speak of moral propositions.

  4. For example, Kant's arguments for the categorical imperative and Mill's arguments for the principle of utility are concerned with propositional justification. Similarly, propositional justification is the concern of more recent writers such as Alan Donagan [9], Alan Gewirth [13], and Bernard Gert [12], among others.

  5. Later Rawls acknowledges a pluralism of reasonable but conflicting religious, philosophical, and moral doctrines, and that this pluralism prevents a consensus on any one WRE. For example, in "The Independence of Moral Theory," he states:

    The independence of moral theory from epistemology arises from the fact that the procedure of reflective equilibrium does not assume that there is one correct moral conception. It is, if you wish, a kind of psychology and does not presuppose the existence of objective moral truths. Even should everyone attain wide reflective equilibrium, many contrary moral conceptions may still be held [22, pp. 289–290].

  6. For a statement of these principles, see Rawls [20, p. 266].

  7. As he puts it, “The account I have sketched defines a wide equilibrium for a given individual at a given time” [6, p. 39, emphasis added]; see also [6, p. 27], where Daniels states that a considered moral judgment is a person's moral opinion. Similarly, he states that "A wide reflective equilibrium is a coherent ordered triple of sets of beliefs held by a particular person…" [p. 48, emphasis added]; see also [6, p. 82].

  8. See also Daniel Little [17, p. 379].

  9. For an account of this feature of justification in science, see e.g., Carl Hempel [15, pp. 38–40].

  10. A somewhat different reply to Daniels’s argument is found in Haslett [14, pp. 307–308]; see also Little [17, p. 382].

  11. Daniels makes this point [6, pp. 4–5]; see also Haslett [14, pp. 308–309]; Little [17, pp. 378–379, 384].

  12. A similar argument is given by Little [17, p. 381]; see also St. John [25, p. 209].

  13. See also Daniels [6, p. 6].

  14. Note that I am not assuming that cases are to be resolved by applying theories to them. Rather, I am suggesting that if a theory is an acceptable method for justifying moral beliefs about cases, then one should be able to apply it in this manner.

  15. In Political Liberalism, Rawls states that the justification of basing public policy on a particular theory would require an “overlapping consensus” and would happen when “all the reasonable members of political society carry out a justification of the shared political conception by embedding it in their several reasonable comprehensive views” [23, p. 387; see also pp. 58–66, 385–395]. In other words, the theory in question would have to be part of each reasonable comprehensive doctrine. If I interpret him correctly, this means that, although not everyone reaches the same WRE, the theory in question would be part of the WRE of each citizen who has a reasonable comprehensive doctrine. But if, as I argue, practical problems prevent individuals from using the method of WRE, then they also prevent the identification of an overlapping consensus.

  16. For example, Arras suggests this approach [1, pp. 18–19]. Also, Daniels acknowledges the possibility of allowing as CMJ only those that are a matter of consensus [6, p. 40].

  17. In suggesting that there are prima facie rules that are basic to morality, I am not appealing to intuitionism; one can give a justification of basic moral precepts along the lines I have described previously [26, pp. 9–10]; see also the discussion in the concluding section of this paper.

  18. To clarify, I make a distinction between general normative theories, such as utilitarianism and Kantianism; and theories about the structure of justification, such as coherentism and foundationalism, which are properly regarded as epistemological theories. General normative theories can be used to systematize moral rules and principles; I am suggesting that one might try to use them in this way to reach a reflective equilibrium within a coherentist theory such as WRE. Moreover, the criticism over bridging the gap has been directed toward general normative theories, not epistemological theories.

  19. Haslett makes this point [14, pp. 309–310].

  20. I have in mind what I have called group-specific common morality, which leaves open the possibility of specifying the group in question [26]. Various types and degrees of specificity are possible, ranging from the most general—all cultures and countries across time—to narrower groups, including a particular country during a particular period and subgroups within a country, such as particular cultural or religious groups. I suggest that the concept of country-specific common morality is especially useful for bioethics.

  21. This is an adaptation of Ebertz's distinction between classical and modest ethical foundationalism [10, pp. 200–201].

  22. Specifying a principle involves qualifying it, making it more specific in regard to a type of circumstance in which it is applied; see Richardson [24].

  23. For example, Beauchamp and Childress propose a structure of moral justification that includes an independently justified set of basic precepts of common morality, joined with reflective equilibrium [3, pp. 381–396].

References

  1. Arras, John D. 2009. The hedgehog and the Borg: Common morality in bioethics. Theoretical Medicine and Bioethics 30: 11–30.

    Article  Google Scholar 

  2. Beauchamp, Tom L. 2003. A defense of the common morality. Kennedy Institute of Ethics Journal 13 (3): 259–274.

    Article  Google Scholar 

  3. Beauchamp, Tom L., and James F. Childress. 2009. Principles of biomedical ethics. 6th ed. New York: Oxford University Press.

    Google Scholar 

  4. Brand-Ballard, Jeffrey. 2003. Consistency, common morality, and reflective equilibrium. Kennedy Institute of Ethics Journal 13: 232–258.

    Article  Google Scholar 

  5. Brandt, Richard B. 1979. A theory of the good and the right. Amherst, NY: Prometheus Books.

    Google Scholar 

  6. Daniels, Norman. 1996. Justice and justification: Reflective equilibrium in theory and practice. Cambridge: Cambridge University Press.

    Book  Google Scholar 

  7. DeGrazia, David. 1992. Moving forward in bioethical theory: Theories, cases, and specified principlism. Journal of Medicine and Philosophy 17: 511–539.

    Google Scholar 

  8. DeGrazia, David. 1996. Taking animals seriously: Mental life and moral status. Cambridge: Cambridge University Press.

    Google Scholar 

  9. Donagan, Alan. 1977. The theory of morality. Chicago: University of Chicago Press.

    Google Scholar 

  10. Ebertz, Roger P. 1993. Is reflective equilibrium a coherentist model? Canadian Journal of Philosophy 23 (2): 193–214.

    Google Scholar 

  11. Feldman, Richard. 2004. The justification of introspective beliefs. In Evidentialism: Essays in epistemology, ed. Earl Conee and Richard Feldman, 199–218. Oxford: Oxford University Press.

    Google Scholar 

  12. Gert, Bernard. 2005. Morality: Its nature and justification. Rev. ed. New York: Oxford University Press.

    Google Scholar 

  13. Gewirth, Alan. 1978. Reason and morality. Chicago: University of Chicago Press.

    Google Scholar 

  14. Haslett, D.W. 1987. What is wrong with reflective equilibrium? Philosophical Quarterly 37: 305–311.

    Article  Google Scholar 

  15. Hempel, Carl. 1966. Philosophy of natural science. Englewood Cliffs, NJ: Prentice-Hall.

    Google Scholar 

  16. Kushner, Thomasine, Raymond A. Belliotti, and Donald Buckner. 1991. Toward a methodology for moral decision making in medicine. Theoretical Medicine 12: 281–293.

    Article  Google Scholar 

  17. Little, Daniel. 1984. Reflective equilibrium and justification. Southern Journal of Philosophy 22: 373–387.

    Article  Google Scholar 

  18. Momeyer, Richard W. 2002. What conception of moral truth works in bioethics? Journal of Medicine and Philosophy 27: 403–416.

    Article  Google Scholar 

  19. Rawls, John. 1971. A theory of justice. Cambridge, MA: Harvard University Press.

    Google Scholar 

  20. Rawls, John. 1999. A theory of justice. Rev. ed. Cambridge, MA: Harvard University Press.

    Google Scholar 

  21. Rawls, John. 1999. Outline of a decision procedure for ethics. In Collected papers, ed. Samuel Freeman, 1–19. Cambridge, MA: Harvard University Press.

    Google Scholar 

  22. Rawls, John. 1999. The independence of moral theory. In Collected papers, ed. Samuel Freeman, 286–302. Cambridge, MA: Harvard University Press.

    Google Scholar 

  23. Rawls, John. 2005. Political liberalism. Exp. ed. New York: Columbia University Press.

    Google Scholar 

  24. Richardson, Henry S. 2000. Specifying norms as a way to resolve concrete ethical problems. Philosophy & Public Affairs 19: 279–310.

    Google Scholar 

  25. St. John, Jeremy. 2007. Problems with theory, problems with practice: Wide reflective equilibrium and bioethics. South African Journal of Philosophy 26: 204–215.

    Google Scholar 

  26. Strong, Carson. 2008. Justifying group-specific common morality. Theoretical Medicine and Bioethics 29: 1–15.

    Article  Google Scholar 

  27. Timmons, Mark. 1987. Foundationalism and the structure of ethical justification. Ethics 97: 595–609.

    Article  Google Scholar 

  28. Willems, Dick L. 2001. Balancing rationalities: Gatekeeping in health care. Journal of Medical Ethics 27: 25–29.

    Article  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Carson Strong.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Strong, C. Theoretical and practical problems with wide reflective equilibrium in bioethics. Theor Med Bioeth 31, 123–140 (2010). https://doi.org/10.1007/s11017-010-9140-2

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s11017-010-9140-2

Keywords

Navigation