Intuition and the junctures of judgment in decision procedures for clinical ethics

Theoretical Medicine and Bioethics 28 (1):1-30 (2007)
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Abstract

Moral decision procedures such as principlism or casuistry require intuition at certain junctures, as when a principle seems indeterminate, or principles conflict, or we wonder which paradigm case is most relevantly similar to the instant case. However, intuitions are widely thought to lack epistemic justification, and many ethicists urge that such decision procedures dispense with intuition in favor of forms of reasoning that provide discursive justification. I argue that discursive justification does not eliminate or minimize the need for intuition, or constrain our intuitions. However, this is not a problem, for intuitions can be justified in easy or obvious cases, and decision procedures should be understood as heuristic devices for reaching judgments about harder cases that approximate the justified intuitions we would have about cases under ideal conditions, where hard cases become easy. Similarly, the forms of reasoning which provide discursive justification help decision procedures perform this heuristic function not by avoiding intuition, but by making such heuristics more accurate. Nonetheless, it is possible to demand too much justification; many clinical ethicists lack the time and philosophical training to reach the more elaborate levels of discursive justification. We should keep moral decision procedures simple and user-friendly so that they will provide what justification can be achieved under clinical conditions, rather than trying to maximize our epistemic justification out of an overstated concern about intuition.

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John Davis
Gordon-Conwell Theological Seminary

Citations of this work

Ethics consultation and autonomy.Jukka Varelius - 2008 - Science and Engineering Ethics 14 (1):65-76.
The role of regret in informed consent.Miles Little - 2008 - Journal of Bioethical Inquiry 6 (1):49-59.
Is there a real nexus between ethics and aesthetics?John Miles Little - 2010 - Journal of Bioethical Inquiry 7 (1):91-102.

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References found in this work

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Clinical ethics: a practical approach to ethical decisions in clinical medicine.Albert R. Jonsen, Mark Siegler & William J. Winslade - 2015 - New York: McGraw-Hill Education. Edited by Mark Siegler & William J. Winslade.
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The Right and the Good. Some Problems in Ethics.W. D. Ross - 1930 - Oxford: Clarendon Press. Edited by Philip Stratton-Lake.
Utilitarianism.John Stuart Mill - 1863 - Cleveland: Cambridge University Press. Edited by Geraint Williams.

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