Abstract

In ethics generally and bioethics in particular, criticisms have been made of a model of applied ethics that emphasizes theory, foundationalist principles, and deduction. This model has been criticized as making inflated claims, and producing inequitable decisions or failing to provide guidance in actual cases. Casuistical approaches have been at the forefront of this criticism, stressing the importance of details of cases, flexibility in the application of rules, and pluralism, as well as arguing for a crucial role for case judgments in ethical reasoning. ;Chapters 1 and 2 clarify various casuistical claims regarding the significance of cases and case judgments. Many of these claims are or clearly should be accepted by virtually any approach to ethics, and to applied ethics in particular. Here the differences between "casuists" and "theorists" are those of emphasis and degree. Other, more controversial claims require evaluation in the context of developed casuistical approaches. ;Chapters 3 and 4 examine in depth two casuistical approaches: the pluralistic casuistry of Baruch A. Brody, characterized by cognitive intuitions and conflicting appeals; and the casuistry of Albert R. Jonsen and Stephen Toulmin, which more eclectically looks to practices and traditions as well as particular insights. The approaches are constructed, and strengths and weaknesses are noted. Both articulate attractive and persuasive casuistical claims concerning case deliberation and the importance of cases in ethical thought. Nonetheless, limitations in both approaches indicate the need for a greater role for general norms and theoretical argumentation. ;Chapters 5 and 6 draw on interpretations of reflective equilibrium in developing a holistic model of ethical reasoning, in which there need be no absolute order of priority among particular ethical judgments and more general norms. The model best incorporates and accounts for the strongest elements of casuistical and theoretical approaches, while correcting for the weaknesses of each. The holistic model offers resources to guide deliberation in the context of particular cases, and makes room for intuitive judgments that build on but go beyond the application of general norms. Combining criteria of input and coherence, it allows the testing, reshaping, and vindication of particular beliefs, and of the system of ethical beliefs as a whole