Towards Substantive Standardization: Ethical Rules as Ethical Presumptions

HEC Forum 28 (2):175-185 (2016)
Ben Chan
National Institutes of Health
This paper argues that substantive ethical rules serve a critical ethical function, even in those cases where we should deviate from those rules. Assuming that the rules are valid provides decision-makers with the context essential to reaching a well-justified decision. Recognizing this helps to reconcile two attractive but incompatible positions regarding the evaluation of healthcare ethics consultants. The first position is that ethical rules can validly be used to evaluate the quality of consultants’ advice, ensuring conformity to standards promoted by a significant portion of medical ethicists. The second position—the message of ethical particularism—is that we should not evaluate consultants according to strict rules, since good ethical advice may deviate from even the most carefully wrought moral rules. Steering a path between these extremes, I argue that we should evaluate the quality of consultations by examining whether consultants have communicated the relevant ethical rules to participants as ethical presumptions. In communicating presumptions, a consultant provides an indispensable ingredient to ethical decision-making, while leaving open the possibility that the ethical course of action involves violating the very ethical rules that one should presume.
Keywords Healthcare ethics  Practice standards  Presumptions  Consultation  Evaluation
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DOI 10.1007/s10730-015-9290-8
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References found in this work BETA

Principles of Biomedical Ethics.Tom L. Beauchamp - 1979 - Oxford University Press.
The Practice of Moral Judgment.Barbara Herman - 1985 - Journal of Philosophy 82 (8):414-436.
On Presumption.Edna Ullman-Margalit - 1983 - Journal of Philosophy 80 (3):143-163.

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