Abstract

Moral decisions concerning what ought to be done always assume metaphysical presuppositions concerning the way the world is. In the field of biomedical ethics, some of the metaphysical presuppositions underlying many current discussions of issues of life and death seem particularly implausible. These include our assumption of the reality of social atomism and our beliefs relating to the possibility of autonomy. Given the implausibility of these two assumptions, many discussions have focused our attention on the wrong issues by reducing questions of alternative social practices to questions of individual preferences. Far from facilitating intelligent solutions to our problems, this merely clouds the issues involved.