The attempt to critique the profession of clinical ethics consultation by establishing the impossibility of ethics expertise has been a red herring. Decisions made in clinical ethics cases are almost never based purely on moral judgments. Instead, they are all-things-considered judgments that involve determining how to balance other values as well. A standard of justified decision-making in this context would enable us to identify experts who could achieve these standards more often than others, and thus provide a basis for expertise (...) in clinical ethics consultation. This expertise relies in part on what Richard Zaner calls the “expert knowledge of ethical phenomena”. (shrink)

Abram Brummett and Christopher Ostertag offer critiques of my argument that clinical ethics consultants have expertise but are not “ethics experts”. My argument begins within our less-than-ideal world and asks what a justification of a clinical ethics consultation recommendation might look like under those conditions. It is a challenge to what could be called an “inflationary” position on ethics expertise that requires agreement on or rational proof of metaethical facts about the values at stake in clinical ethics consultation. Brummett and (...) Ostertag critique three distinct steps in the argument. Two of those I have a brief answer for, and an assessment of the third demonstrates that Brummett and Ostertag do not consider the premise upon which I based my account. Instead, they assert a counter-premise without argument, which at best results in a stalemate between our two accounts. However, the reasons supporting my premise still seem to me to be stronger, so I am in the end unconvinced by their critiques. (shrink)

The legitimacy of clinical ethics consultation is often implied to rest on the legitimacy of moral expertise. In turn, moral expertise seems subject to many serious critiques, the success of which implies that clinical ethics consultation is illegitimate. I explore a number of these critiques, and forward “ethics expertise,” as distinct from “moral expertise,” as a way of avoiding these critiques. I argue that “ethics expertise” succeeds in avoiding most of the critiques, captures what clinical ethics consultants might justifiably do, (...) and expresses a subject matter which can be taught and assessed. (shrink)

A major obstacle to broad support of clinical ethics consultation is suspicion regarding the nature of the moral expertise it claims to offer. The suspicion seems to be confirmed when the field fails to make its moral expertise explicit. In this vacuum, critics suggest the following:Clinical ethics consultation's legitimacy depends on its ability to offer an expertise in moral matters.Expertise in moral matters is knowledge of a singular moral truth which applies to everyone.The claim that a clinical ethics consultant can (...) offer knowledge of a singular moral truth in virtue of her professional training is absurd, false, or gravely immoral.Therefore,The field is illegitimate. (shrink)

Philosophers have harbored doubts about the possibility of moral expertise since Plato. I argue that irrespective of whether moral experts exist, identifying who those experts are is insurmountable because of the credentials problem: Moral experts have no need to seek out others’ moral expertise, but moral non-experts lack sufficient knowledge to determine whether the advice provided by a putative moral expert in response to complex moral situations is correct and hence whether an individual is a bone fide expert. Traditional accounts (...) of moral expertise require that moral experts give reliably correct moral advice supported by adequate justification, an account which, I argue, is too lean in allowing for the possibility of a moral expert who is motivationally indifferent to her own moral judgments and advice. Yet even if the proposition that a moral expert is an individual who provides reliably correct moral advice supported by adequate justification and is necessarily motivated by that advice exhausts the necessary and sufficient conditions for moral expertise, this proposition cannot function as an applicable criterion for non-experts to use in appraising would-be experts’ claims to expertise. The credentials problem thus remains unanswered. (shrink)

The philosophical method is critical to ethics consulting. To be truly effective, ethicists need grounding in ethics theory, abstract reasoning and conceptual analysis. A Practical Guide to Clinical Ethics Consulting allows ethicists to understand problems from practitioners' points-of-view, and allows for a genuine appreciation of the working life of practitioners.