Over the course of its first seven editions, Principles of Biomedical Ethics has proved to be, globally, the most widely used, authored work in biomedical ethics. It is unique in being a book in bioethics used in numerous disciplines for purposes of instruction in bioethics. Its framework of moral principles is authoritative for many professional associations and biomedical institutions-for instruction in both clinical ethics and research ethics. It has been widely used in several disciplines for purposes of teaching in the (...) classroom, during conferences, etc. (shrink)

: Many bioethicists assume that morality is in a state of wide reflective equilibrium. According to this model of moral deliberation, public policymaking can build upon a core common morality that is pretheoretical and provides a basis for practical reasoning. Proponents of the common morality approach to moral deliberation make three assumptions that deserve to be viewed with skepticism. First, they commonly assume that there is a universal, transhistorical common morality that can serve as a normative baseline for judging various (...) actions and practices. Second, advocates of the common morality approach assume that the common morality is in a state of relatively stable, ordered, wide reflective equilibrium. Third, casuists, principlists, and other proponents of common morality approaches assume that the common morality can serve as a basis for the specification of particular policies and practical recommendations. These three claims fail to recognize the plural moral traditions that are found in multicultural, multiethnic, multifaith societies such as the United States and Canada. A more realistic recognition of multiple moral traditions in pluralist societies would be considerably more skeptical about the contributions that common morality approaches in bioethics can make to resolving contentious moral issues. (shrink)

: Fins, Bacchetta, and Miller's clinical pragmatism has several appealing features: an emphasis on dialogue, a commitment to consensus, a focus on particular individuals rather than persons in general, and a strong interest in the process as well as the product of moral decision making. Nevertheless, for all its protests to the contrary, clinical pragmatism has a tendency to privilege medical facts over nonmedical values, to conflate appropriate medical decisions with right moral decisions, and to conceive problems at the bedside (...) in terms of "getting" patients and families to "go along" with the treatment plans of clinicians. In sum, there is within clinical pragmatism the potential for physicians to take back some of the power they ceded to patients during the height of the patients' rights and autonomy movement. Provided that clinicians guard against the temptation to use clinical pragmatism manipulatively, however, the method promises, more than most other methods of moral problem solving, to help increasingly diverse individuals make good moral decisions about patients' care under conditions of enormous uncertainty. (shrink)

Some defenders of the view that there is a common morality have conceived such morality as being universal, in the sense of extending across all cultures and times. Those who deny the existence of such a common morality often argue that the universality claim is implausible. Defense of common morality must take account of the distinction between descriptive and normative claims that there is a common morality. This essay considers these claims separately and identifies the nature of the arguments for (...) each claim. It argues that the claim that there is a universal common morality in the descriptive sense has not been successfully defended to date. It maintains that the claim that there is a common morality in the normative sense need not be understood as universalist. This paper advocates the concept of group specific common morality, including country-specific versions. It suggests that both the descriptive and the normative claims that there are country-specific common moralities are plausible, and that a country-specific normative common morality could provide the basis for a country's bioethics. (shrink)

I could not write the essay I hoped to write. I hoped to write about cultural pluralism and moral epistemology by assuming that the first is the case and exploring what implications this may have for the second. But I soon realized that I do not know what cultural pluralism is. I do not mean that I have just belatedly discovered that the phrase “cultural pluralism” is used in different ways on different occasions. I mean that I realized that I (...) myself did not know in what sense the phrase may be used which makes it relevant to the inquiry suggested by the general topic of this volume. So the following reflections are based on one assumption: The fact of multiculturalism cannot have much bearing on moral epistemology unless it bears on moral truths. (shrink)

The notion of common morality plays a prominent role in some of the most influential theories of biomedical ethics. Here, I focus on Beauchamp and Childress’s models in the fourth and fifth edition of Principles of Biomedical Ethics as well as on a revision that Beauchamp proposed in a recent article. Although there are significant differences in these works that require separate analysis, all include a role for common morality as starting point and normative framework for theory construction in combination (...) with a coherence theory of moral justification. I defend to some extent the existence and empirical significance of common morality, as delineated by Beauchamp and Childress in different versions, but criticize its normative role. It is neither convincing as a moral foundation nor well compatible with a standard coherentist justification. I suggest that the authors should give up the foundational account for a more modest account of common morality as resource of well-established moral insights and experiences, which have proved generally valid but neither sufficient nor infallible. Beauchamp’s latest proposal appears as a step in this direction; indeed, it may be the beginning of the end of his common-morality theory. (shrink)

[This book] develops an account of rationality and justice that is tradition specific.-http://undpress.nd.edu.

In "Democracy and Tradition," Jeffrey Stout contends that American constitutional democracy constitutes a well-functioning moral and political tradition that is not hostile to religion, although it does not depend on any specifically religious claims. I argue that Stout's contention is supported by a consideration of the great common law subject of contracts, as taught to first-year law students across the United States. First, I demonstrate how contract law can fruitfully be understood as a Maclntyrean tradition. Second, I illustrate the moral (...) richness of this tradition, and the mutually interpreting nature of rules and facts, by close attention to one particularly colorful case, Syester v. Banta. I conclude by suggesting that both religious and secular ethicists might find common law cases in general and contract law cases in particular to be a source of moral reflection that is substantively rich without being religiously divisive. (shrink)

Bernard Gert argues that legitimate moral disagreement calls for tolerance and moral humility; when there is more than one morally acceptable course of action, then intolerance and what Gert calls “moral arrogance” would be objectionable. This article identifies some possible difficulties in distinguishing moral arrogance from moral reform and then examines Gert's treatment of abortion as a contemporary example of moral disagreement that he characterizes as irresolvable.

: "Clinical pragmatism" is an important new method of moral problem solving in clinical practice. This method draws on the pragmatic philosophy of John Dewey and recommends an experimental approach to solving moral problems in clinical practice. Although the method may shed some light on how clinicians and their patients ought to interact when moral problems are at hand, it nonetheless is deficient in a number of respects. Clinical pragmatism fails to explain adequately how moral problems can be solved experimentally, (...) it underestimates the relevance and importance of judgment in clinical ethics, and it presents a questionable account of the role that moral principles should play in moral problem solving. (shrink)

In his article 'Specifying, balancing and interpreting bioethical principles' (Richardson, 2000), Henry Richardson claims that the two dominant theories in bioethics - principlism, put forward by Beauchamp and Childress in Principles of Bioethics , and common morality, put forward by Gert, Culver and Clouser in Bioethics: A Return to Fundamentals - are deficient because they employ balancing rather than specification to resolve disputes between principles or rules. We show that, contrary to Richardson's claim, the major problem with principlism, either the (...) original version, or the specified principlism of Richardson, is that it conceives of morality as being composed of free-standing principles, rather than as common morality conceives it, as being a complete public system, composed of rules, ideals, morally relevant features, and a procedure for determining when a rule can be justifiably violated. (shrink)

Book reviewed in this article: Principles of Biomedical Ethics. By Tom L. Beauchamp and James F. Childress.

: The fifth edition of Beauchamp and Childress's Principles of Biomedical Ethics is distinguished by its emphatic embrace of common morality as the ultimate source of moral norms. This essay critically evaluates the fifth edition's discussion of common morality and, to a lesser extent, its treatment of coherence (both the model of ethical justification and the associated concept). It is argued that the book is overly accommodating of existing moral beliefs. The paper concludes with three suggestions for improving this leading (...) text. (shrink)

: Phenomena of moral conflict and disagreement have led writers in ethics to two antithetical conclusions: Either valid moral distinctions hold universally or they hold relative to a particular and contingent moral framework, and so cannot be applied with universal validly. Responding to three articles in this issue of the Journal that criticize his previously published views on the common morality, the author maintains that one can consistently deny universality to some justified moral norms and claim universality for others. Universality (...) is located in the common morality and nonuniversality in other parts of the moral life, called "particular moralities." The existence of universal moral standards is defended in terms of: (1) a theory of the objectives of morality, (2) an account of the norms that achieve those objectives, and (3) an account of normative justification (both pragmatic and coherentist). (shrink)

This paper represents the first installment of alarger project devoted to the relevance of pragmatism forbioethics. One self-consciously pragmatist move would be toreturn to the classical pragmatist canon of Peirce, James andDewey in search of substantive doctrines or methodologicalapproaches that might be applied to current bioethicalcontroversies. Another pragmatist (or neopragmatist) move wouldbe to subject the regnant principlist paradigm to Richard Rorty'ssubversive assaults on foundationalism in epistemology andethics. A third pragmatist method, dubbed ``freestandingpragmatism'' by its proponents, embraces a ``pragmatist'' approachto practical (...) reasoning without discernable moorings either to theclassical canon or to Rorty's neopragmatism. This thirdpragmatist approach to method in practical ethics is the subjectof this article. I begin with an examination of freestandingpragmatism in the theory of judicial decision making. I arguethat this version of legal pragmatism – so described on account ofits commitments to contextualism, instrumentalism, eclecticism,and freedom from grand theory – bears a striking resemblance tomuch self-described pragmatist work in bioethics today. Ifurther argue that if this is what we mean by ``pragmatism,'' thenin a certain sense ``we are all pragmatists now.''. (shrink)

This book offers the fullest and most sophisticated account of Gert's influential moral theory, a model first articulated in the classic work The Moral Rules: A New Rational Foundation for Morality, published in 1970. In this final revision, Gert makes clear that the moral rules are only one part of an informal system that does not provide unique answers to every moral question but does always provide a range of morally acceptable options. A new chapter on reasons includes an account (...) of what makes one reason better than another and a second new chapter is devoted to the question of justifying violations of the rules. Moral impartiality, the moral ideals, and virtue and vice, are all treated in greater detail. Throughout, Gert attempts to answer all of the challenges that his work has provoked. (shrink)

Moral problems do not always come in the form of great social controversies. More often, the moral decisions we make are made quietly, constantly, and within the context of everyday activities and quotidian dilemmas. Indeed, these smaller decisions are based on a moral foundation that few of us ever stop to think about but which guides our every action. Here distinguished philosopher Bernard Gert presents a clear and concise introduction to what he calls "common morality" -- the moral system that (...) most thoughtful people implicitly use when making everyday, common sense moral decisions and judgments. Common Morality is useful in that -- while not resolving every disagreement on controversial issues -- it is able to distinguish between acceptable and unacceptable answers to moral problems. In the first part of the book Gert lays out the fundamental features of common morality: moral rules, moral ideals, and a two-step procedure for determining when a violation of a moral rule is justified. Written in a non-technical style, the ten general moral rules include rules on which everyone can agree, such as "do not kill," "do not deceive," and "keep your promises." The moral ideals include similarly uncontroversial precepts such as "Relieve pain" and "Aid the needy." In the second part of the book Gert examines the underlying concepts that justify common morality, such as the notions of rationality and impartiality. The distillation of over 40 years of scholarship, this book is the most accessible version of Gert's influential theory of morality as well as an eye-opening look at the moral foundations of our everyday actions. Throughout the discussion is clear enough for a reader with little or no philosophy background. (shrink)