The historical emphasis of medical ethics, based on substantive frameworks and principles derived from them, is no longer seen as sufficiently sensitive to the moral pluralism characteristic of our current era. We argue that moral decision-making in clinical situations is more properly derived from a process of dialogic consensus. This process entails an inclusive, noncoercive, and self-reflective dialogue within the community affected. In order to justify this approach, we make two claims—the first epistemic, and the second normative. The epistemic claim (...) follows from Habermas’ “ways” of knowing. We argue that the dialogue emanating from this episteme focuses on the relevant facts about the patient, as well as on the values attached to these facts, thus allowing facts and their meanings to serve as the basis for reflective action appropriate to the circumstances. The normative claim follows from Habermas’ discourse theory of morality and communicative action. It determines that clinical decision-making should be approached from the perspective of the actual reality of people in their situation of illness, set in their socio-cultural background, and hence be grounded in the second-person perspective. Relocating ethical decision-making from a monological space into one characterized by dialogue is especially appropriate to the clinical encounter. (shrink)

Amongst traditionally-available frameworks within which end-of-life decisions in Intensive Care Units are situated, we favour Ordinary versus Extra-ordinary care distinctions as the most helpful. Predicated on this framework, we revisit the concepts of personhood and autonomy. We argue that a full account of personhood locates its foundation in relationships with others, rather than merely in “rationality”. A full account of autonomy also recognises relationships with others, as well as the actual reality of the patient’s situation-in-the-world. The fact that, when critically (...) ill, the patient may no longer be able to take an active role in decision-making does not bring about the end of their personhood, or of their autonomy. Because the patient’s autonomy is intimately linked to their relationships with others, once critical illness supervenes, respect for their autonomy devolves to those others with whom the patient is in relationship. In practical application, this means that there must be a dialogue, as the end-of-life of the critically-ill patient in ICU comes into view. Such dialogue should be grounded on this understanding in order to conform best to moral philosophical principles. Ideally the dialogue will involve all those with whom the patient is in relationship and, practical difficulties within an ICU notwithstanding, will aim to be inclusive, non-coercive and reflective as it seeks to maximise the good of the patient in their unique context. (shrink)

Prompted by recent comments on the moral authority of dialogic consensus, we argue that consensus, specifically dialogic consensus, possesses a unique form of moral authority. Given our multicultural era and its plurality of values, we contend that traditional ethical frameworks or principles derived from them cannot be viewed substantively. Both philosophers and clinicians prioritize the need for a decision to be morally justifiable, and also for the decision to be action-guiding. We argue that, especially against the background of our pluralistic (...) society, it is only via unforced dialogue and properly founded argumentation, aiming for consensus, that we can ascribe rightness or wrongness in a normative fashion to dilemmatic situations. We argue that both the process of dialogue, properly constituted, and the consensual outcome itself have moral authority vested within them. Finally, we argue that the consensual decision made is able to withstand moral scrutiny and is action-guiding, without claiming absolute moral authority in other contexts. (shrink)

This article seeks to revisit the distinction between the words ethics and morals. First, we understand the word ethics to be focused on the way we seek to live our own life, and hence to connote a relativistic and essentially subjective perspective, whereas we understand the word morals to be focused on the way we should live our lives together, especially through sensitivity to viewpoints other than our own. Second, we perceive a usefulness in such a differentiation when the ethical (...) values of those in a dilemmatic situation are conflicted in order to prioritize moral decision making in contemporary society. We argue that in our current era, characterized by a multiplicity of faiths and by pronounced value pluralism, a philosophical basis for moral decision making needs to be clearly attuned with intersubjectivity and interconnectivity among people. It should be able to determine principles of conduct toward others, no matter how one’s own ethical values, conceptions of the good, or life choices might differ from those of others. To do this, we relocate ethical decision making away from an essentially monological reflection on our own values and purposes into a social space wherein we have an inclusive, noncoercive, and reflective dialogue. (shrink)

The article will focus on the implicit values dimension that is evident in research findings concerning quality teaching. Furthermore, it sets out to demonstrate that maximizing the effects of quality teaching requires explicit attention to this values dimension and that this can be achieved through a well-crafted values education program. Evidence for this latter claim will come from international studies as well as from the Australian Government's Values Education Program and, especially from the Values Education Good Practice Schools Project Stage (...) 1 Report (DEST, 2006). (shrink)

In this paper we suggest an alternative approach to ethics in social work: virtue ethics. We argue that Habermas's theory of communicative action and discourse ethics needs to be supplemented with virtue ethics to provide an account useful to social work. In these times, sensitivity to others is needed for social work to succeed as a profession interested in combating the complacency, self-interest and lack of compassion evident in cutbacks to social welfare programmes and the resultant concerns with outcomes and (...) efficiencies that have all but obliterated care and compassion. We see in Habermas a furthering of Aristotelian and Thomist philosophy, most importantly with respect to his focus on emancipatory knowing?the critically reflective knower who knows self as the person doing the knowing. Habermas's distinction between values (objective), ethics (social) and morals (subjective) makes the province of emancipatory knowing (his epistemological theory) consistent with his moral theory?morality is personal. (shrink)

The ‘Other’ can be near to us, or far from us. We are in-relation with both. Given that, we explore whether, from a moral philosophical perspective, the ‘near-other’ is in tension with the ‘far-other’. We argue that we find our relationship with the near-other through a transcendent metaphysical empathy derived from the noumenon, which is manifest in the phenomenon as compassion and justice. We then argue that perceived differences in the phenomenon mean that we do not reliably transfer this empathy (...) for the near-other, to the far-other. Further, empathic and constructive dialogue is made more difficult because of our proclivity to actively engage in ‘othering’ those not-like-us. Properly, moral decision-making is positioned in a space cognizant of the other. Near-otherness makes consensus in the decision-making process easier, while far-otherness makes consensus more difficult. In our post-modern, multicultural and multifaith era, we need to be alert to the other’s perspective, to find a way to have a meaningful dialogue and thus achieve consensus in our moral decision-making. (shrink)

This article explores the integrity of the discourse in the Anglican eucharistic tradition by considering the philosophical assumptions that underlie eucharistic theology. It argues that where the conversation of the Anglican eucharistic tradition is open and unfinished then the integrity of the discourse is facilitated as opposed to the conversations of party positions and particular interests which suggest exclusive versions of truth. The conversation or dialogue of Anglican eucharistic theology is seen to be enhanced through the consideration of the philosophical (...) assumptions of realism and nominalism to both the moderate and immoderate degrees that underpin eucharistic theology as a state of affairs. The insights of contemporary philosophers are used as a way of conceptualising the discourse of the Anglican eucharistic tradition and a model of Anglican eucharistic theology is suggested as a means of facilitating the integrity of the discourse through the recognition of multiformity in the tradition and by distancing the discourse from the hermeneutic idealism of particular interest. (shrink)

The article will focus on the implicit values dimension that is evident in research findings concerning quality teaching. Furthermore, it sets out to demonstrate that maximizing the effects of quality teaching requires explicit attention to this values dimension and that this can be achieved through a well‐crafted values education program. Evidence for this latter claim will come from international studies as well as from the Australian Government's Values Education Program and, especially from the Values Education Good Practice Schools Project Stage (...) 1 Report (DEST, 2006). (shrink)