Journal of Philosophy of Education, EarlyView.

This paper considers the role of ‘vices of culture’ in Immanuel Kant’s account of radical evil and education. I argue that Kant was keenly aware of a uniquely human tendency to allow a self-centered concern for status to misunderstand or co-opt the language of dignity and equal worth for its own purposes. This tendency lies at the root of the ‘vices of culture’ and ‘aggravated vices’ that Kant describes in the Religion and Doctrine of Virtue, respectively. When it comes to (...) moral education, then, it will be crucial that the developing agent have a clear understanding of the shared dignity of rational agents and the particular duties that are defined, in part, by their tendency to alter status among agents. I argue that the casuistical questions that Kant attaches to these discussions in the Doctrine of Virtue are an example of a pedagogical device that might help pupils to overcome this tendency so closely associated with radical evil. (shrink)

This paper considers the role of ‘vices of culture’ in Immanuel Kant’s account of radical evil and education. I argue that Kant was keenly aware of a uniquely human tendency to allow a self...

al-Qurṭubī (d. 671/1273) was a scholar of tafsīr, ḥadīth and fiqh. He experienced both Western and Eastern civilizations in the geography of Andalusia and Egypt, respectively. In his famous Tafsīr called al-Jâmi li-Aḥkâm al-Qur’ān, al-Qurṭubī comparatively explained and interpreted all legal verses. Also, in addition to exploring the spesific legal rulings denoted in the Qur’ān and the Sunnah, al-Qurṭubī has largely interpreted the legal norms regarding the issues of jurisprudence. By doing this, al-Qurṭubī contributed to the formation and development of (...) a civil codification activity under a kazuistic format. The casuistic structure of the legal exegesis of the Qur’ān is anlaysed in terms of the form and content in the sample of al-Jâmi. Therefore, neither the similarity or similarity of the schools of the legal exegesis of Qur’ān and of the legal schools nor the disciplines of positive law, but their kazuistic structures, which systems they built and which interpretation methods and techniques they operated on this basis, were evaluated in terms of their original structure. In this direction, the article emphasizes that the casuistic structure of the legal exegesis of Qur’ān is established on and by the Prophet’s sayings and practices. Although, it has been observed that it is a unique tradition, both as form and content, and that the interpretation means are identified with its own unique structure, it has been concluded that the casuistic method is not one of the fundamental elements of both this tradition and Islamic legal thought. This means that the casuistic method is always a tool that can be changed and transformed according to the conditions of time and space.Summary: As it is stated in al-Isrāʾ 17/106: “And (it is) a Qur’ān which we have separated (by intervals) that you might recite it to the people over a prolonged period. And we have sent it down progressive.”, the Qur’ān is revelaed in about twenty-three years by taking into consideration the sociocultural positions of its interlocutors. The Prophet Muḥammad explained the Qur’ān by the virtue of the ayah: “(We sent them) with clear proofs and written ordinances. And We revealed to you the message (i.e. that you may make clear to the people what was sent down to them and that they might give thought.” (an-Naḥl 16/44). Of course, there is no subject integrity in this Qurānic chronology-which also reflects life. As a matter of fact, the issues related to individual and society have been independently analyzed by a casuistic/case-based method and ruled in accordance with the intention of Allāh. It can be seen that the ayahs “They ask you about wine and gambling. Say, ‘In them is great sin and (yet, some) benefit for people. But their sin is greater than their benefit.’ And they ask you what they should spend. Say, ‘The excess (beyond needs).’ Thus Allāh makes clear to you the verses (of revelation) that you might give thought.” (al-Baqara 2/219) and other ayahs such as (al-Baqara 2/186; al-Nisāʾ 4/176; al-Anfāl 8/1) reflect the casuistic method in terms of form and content. This can also be exemplified by the Sunna. For example, when the question “Is it permissible to perform ablutions with sea water?” was posed to Messenger of Allāh. He said that “It’s water is clean and his dead (fish) are lawful “(Abū Dāwūd, “Ṭaḥāra”, 41). By this answer, the Prophet Muḥammad indeed ruled and established a general rule.It can be said that this early example table formed the basis of the legal exegesis of the Qur’ān in terms of origin, source and application, and that its shape and content are often immanent in the examples it contains. In this article, based on the prophetic period, the legal exegesis of the Qur’ān and casuistic structure has been studied with an analytical and critical approach. Again, because the casuistic method is one of the universal concepts of east-west science and cultural life, an interdisciplinary approach was exhibited in this study. The roots of the casuistic method date back to 5000 BC and the legal systems of the society and states of antiquity are examined from this method. This method is chosen and used in the legal exegesis of the Qur’ān. However, this study does not analyse the sameness or the similarity of the legal exegesis of the Qur’ān and the legal schools nor the positive law disciplines, but the casuistic structures used by these, the systems they have built on this basis and the interpretation methods and techniques they have been used and analyzed in terms of their originality.In effect, the article embodies the Qur’ānic exegesis called al-Jâmi li-Aḥkâm al-Qur’ān by al-Qurṭubī (d. 671/1273), a scholar of tafsīr, ḥadīth and fiqh. In addition to the works of the aḥkām al-Qur’āns, which deal with the interpretation of the ayahs related to the subjects of ʿibādāt, muʿāmalāt ve ʿuḳūbāt, many other works have been used in parallel with the development of the legal exegesis of the Qur’ān. al-Qurṭubī, who comparingly explained the legal verses in his tafsīr, investigated the aspects of the Qur’ān and Sunna that indicate the aḥkām, generally interpreted the existing legal norms within the framework of evidence and introduced his own opinions and etasblished his ijtihād. Thus, he benefited from the tafsīr accumulation and contributed to the formation and development of a civil legalization activity with casuistic format. As a matter of fact, the casuistic/case-based method has been used as a codification/tadwīn technique by Western and Eastern legal disciplines and systems. The casuistic method covers both concrete event and abstract ruling methods. In the casuistic method, which is fact-based event, the laws are organized according to all possible events that can be experienced. On the other hand, the abstract method, which is defined as the abstract ruling method, aims to organize the laws in a general and abstract framework. In the article, it is stated that the legal exegesis of the Qur’ān contains both concrete and abstract dimensions in its own way. It has been emphasized that the legal exegesis of the Qur’ān is based on divine revelation (waḥy) and that it is separated from human law as its origin and source, and that this feature is its most faithful characteristic. On this basis, the legal exegesis of the Qur’ān is a separate scholarly tradition and has its own definition, subject and purpose. Its original structure and function have been noted. As a matter of fact, the subject and purpose of the legal exegesis of the Qur’ān always require the tafsīr and taʾwīl of the legal verses having regard to the Qur’ān and Sunna. It is also necessary for the purpose of investigating the ways in which nuṣūṣ (an explicit statement upon which a ruling is based) can refer to the provisions and to resolve the issues related to individuals and society. As a matter of fact, the legal verses function as a guide for humanity until the day of judgment as the inspiration for religious-legal matters; they contain the content and provisions that offer happiness in the two worlds. (shrink)

This paper addresses the question: Who or what can have a moral status in the sense that we have direct moral duties to them? It argues for a biocentric answer which ascribes inherent moral status value to all individual living organisms. This position must be defended against an anthropocentric position. The argument from marginal cases propounded by Tom Regan and Peter Singer for this purpose is criticised as defective, and a different argument is proposed. The biocentric position developed here is (...) related to that of Albert Schweitzer and Paul F. Taylor, but rejects their assumption of equal inherent value for all living organisms. It argues instead for equal moral status value for moral persons and agents, and gradual moral status value for nonpersons, depending on their degree of similarity with moral persons. Mary Ann Warren's recent book on Moral Status is also discussed. The argument is constructed as a casuistic argument, proceeding by analogical extension from persons to non-persons. The meta-ethical question of its pragmatic validity is discussed. (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)

What happens now is that we (by which I mean the West) eradicate state sponsored terrorism. And we can achieve that only by replacing all political systems that perpetrate or collaborate with terrorism, by systems that respect human rights both domestically and internationally.

Recent advances in genomic research have led to the development of new diagnostic tools, including tests which make it possible to predict the future occurrence of monogenetic diseases (e.g. Chorea Huntington) or to determine increased susceptibilities to the future development of more complex diseases (e.g. breast cancer). The use of such tests raises a number of ethical, legal and social issues which are usually discussed in terms of rights. However, in the context of predictive genetic tests a key question arises (...) which lies beyond the concept of rights, namely, What should we want to know about our future? In the following I shall discuss this question against the background of Kant’s Doctrine of Virtue. It will be demonstrated that the system of duties of virtue that Kant elaborates in the second part of his Metaphysics of Morals offers a theoretical framework for addressing the question of a proper scope of future knowledge as provided by genetic tests. This approach can serve as a source of moral guidance complementary to a justice perspective. It does, however, not rest on the – rather problematic – claim to be able to define what the “good life” is. (shrink)

This paper examines the methodological problem of casuistry by reference to Immanuel Kant's position on it. He addressed “Casuistical Questions” in his last work on ethics, Metaphysik der Sitten, in order to defend his position against attacks from scholars defending an Aristotelian eudemonistic viewpoint. It is argued that Kantian casuistry has much in common with the Aristotelian idea of emphasizing the moral objectives and sensibility of an agent in concrete circumstances. Nevertheless, Kant did not entirely adopt the case-oriented ethical (...) perspective because he saw the moral duty as the „wide“ one. Moral duties are wide in the sense that they demand continuous self-examination: asking whether there might be a better way to limit one's maxim by another. According to Kant, although casuistry as a case study could give moral law or duties more practicability through the training of moral judgment, the moral agent cannot use with individual cases in order to modify or devise new moral rules or duties. (shrink)

The question I investigate concerns the ethics of clinical ethics consultation. To begin, I reconstruct and critically assess a widespread understanding of clinical medical ethics, one most prominently advanced by Mark Siegler. That examination reveals an overtly political strategy designed to reinforce physician authority. Next, John La Puma's work is discussed. Arguably the most prominent of Siegler's students, and certainly the most prolific, La Puma appears attentive to the problems in Siegler's view regarding clinical judgment. I conclude, however, that La (...) Puma assumes a relatively flexible system of formal rules and more extensive informal codes which define the concepts and procedures of medical consultation and which he simply transcribes for ethics consultation. ;Albert Jonsen and Stephen Toulmin have apparently endorsed this medicalized strategy. They contend that the view of ethics advocated by these physicians represents a "new" casuistry consistent if not identical to their own theory. I show that the casuist method of clinical ethical decision making simply appropriates features of the diagnostic apparatus embedded in the political economy of the enterprise of medicine and makes the role of ethicist parasitic on that of the physician as expert. Their casuistry, I argue, merely serves as a means to reinforce the standardized apparatus of professional authority exercised in medical procedures and concepts. ;Finally, I sketch an alternative way to think about how experience with other persons informs ethical decision making. On the basis of an extensive and nuanced account of an ethics consultation, I argue that to consult as a clinical philosopher in any situation is, necessarily, to be focused on that individual situation for its own sake. Clinical philosophy, as a result, must be done by attending strictly to what appears as it appears: the issues, concerns, and questions expressed, in their own terms, by those individuals whose situation it is. (shrink)

Questions of medical ethics are often treated as especially difficult casuistical problems or as difficult cases illustrative of paradoxes or advantages in global moral theories. I argue here, in opposition to such approaches, for the inseparability of questions of social history and social theory from any normative assessment of medical practices. The focus of the discussion is the question of the legitimacy of the social authority exercised by physicians, and the insufficiency of traditional defences of such authority in (...) liberal societies (voluntarist, informed consent approaches), as well as traditional attacks on such strategies (ideology critique). Seeing such authority as institution bound and role based, it is argued, can help reframe, more broadly and more adequately, what is an “ethical problem” in medical practice and why. (shrink)

ABSTRACTIn The Netherlands, the public funding of a number of health care services is controversial. What can we learn from this about the moral concerns that underlie these judgements? And, if there is anything to learn, can we use this improved understanding to scrutinise the adequacy of particular decisions concerning the public funding of health care services? In the present paper, I will analyse three cases: corrective surgey, In Vitro Fertilisation and liver transplantation. I will summarise the arguments that have (...) been used to support or to challenge the public funding of these services. I will then assess the merits of Daniels’fair equality of opportunity account of justice in health care. Can this account improve our understanding of the moral concerns underlying our judgements about the public funding of these services? Can it serve to scrutinise the adequacy of particular decisions that are made concerning the public funding of health care services? My answer to both questions will be a qualified yes. Daniels’account can provide guidance, but not because we can deductively infer from it what is right and what is wrong. Instead, I will argue for a more casuistic use of the concept of fair equality of opportunity. (shrink)

ABSTRACT In The Netherlands, the public funding of a number of health care services is controversial. What can we learn from this about the moral concerns that underlie these judgements? And, if there is anything to learn, can we use this improved understanding to scrutinise the adequacy of particular decisions concerning the public funding of health care services? In the present paper, I will analyse three cases: corrective surgey, In Vitro Fertilisation and liver transplantation. I will summarise the arguments that (...) have been used to support or to challenge the public funding of these services. I will then assess the merits of Daniels’fair equality of opportunity account of justice in health care. Can this account improve our understanding of the moral concerns underlying our judgements about the public funding of these services? Can it serve to scrutinise the adequacy of particular decisions that are made concerning the public funding of health care services? My answer to both questions will be a qualified yes. Daniels’account can provide guidance, but not because we can deductively infer from it what is right and what is wrong. Instead, I will argue for a more casuistic use of the concept of fair equality of opportunity. (shrink)

This article examines the emergence of casuistical case analysis as a methodological alternative to more theory-driven approaches in bioethics research and education. Focusing on The Abuse of Casuistry by A. Jonsen and S. Toulmin, the article articulates the most characteristic features of this modernday casuistry (e.g., the priority allotted to case interpretation and analogical reasoning over abstract theory, the resemblance of casuistry to common law traditions, the ‘open texture’ of its principles, etc.) and discusses some problems with casuistry as an (...) ‘anti-theoretical’ method. It is argued that casuistry so defined is ‘theory modest’ rather than ‘theory free’ and that ethical theory can still play a significant role in casuistical analysis; that casuistical analyses will encounter conflicting ‘deep’ interpretations of our social practices and institutions, and are therefore unlikely sources of increased social consensus on controversial bioethical questions; that its conventionalism raises questions about casuistry's ability to criticize norms embedded in the societal consensus; and that casuistry's emphasis upon analogical reasoning may tend to reinforce the individualistic nature of much bioethical writing. It is concluded that, notwithstanding these problems, casuistry represents a promising alternative to the regnant model of ‘applied ethics’ (i.e., to the ritualistic invocation of the so-called ‘principles of bioethics’). The pedagogical implications of casuistry are addressed throughout the paper and include the following recommendations: (1) use real cases, (2) make them long, richly detailed and comprehensive, (3) present complex sequences of cases, (4) stress the problem of ‘moral diagnosis’, and (5) be ever mindful of the limits of casuistical analysis. Keywords: casuistry, interpretation, methodology, pedagogy CiteULike Connotea Del.icio.us What's this? (shrink)

This chapter presents a new version of the theory of deliberative democracy, focusing on its specificity as a future genre, and based on arguments used to defend plausibility. Moral philosophy of ethical theories is applied in this context as a form of casuistics, involving probabilities, and not limited to case studies within the framework of applied ethics. The chapter then considers relationships between the sciences, scientific practices and ethics; the interweaving of facts and values; the quarrels that exist between coexisting (...) disciplines; the competing approaches of epistemic pluralism, in both inter‐ and intra‐disciplinary forms; and argumentative coexistence in interdisciplinary contexts. It outlines the possible solution pathways, notably that of dialogical co‐argumentation. The chapter explores the question of pluralism of ethical theories with a focus on relevant elements that may modify an evaluation. In France, the precautionary principle has been enshrined in the Constitution since 2005, within the framework of the Environment Charter. (shrink)

The article is dedicated to the application questions of a case study method known as casuistry. In its long tradition, it focuses on an influential variant of the early modern period and reconstructs its functionality. In the course of reading recent receptions, it is noted that some studies speak of a “casuistic revival” in moral case deliberation in health care. As a result of this revival, casuistry has been modified in such a way that it guides case discussions (...) in practice with the help of a tripartite methodology. However, as it turns out, casuistry, a case comparison method of ethical judgement based on reasoning logic, is less suitable for moral case deliberations in direct patient care. This stems from the fact that casuistry is a detailed procedure of ethical learning beneficial to institutionalized ethics committees or similar forms of ethics consultation in health care. (shrink)

In the previous article the hermeneutical approach to ethics was outlined. In my presentation, I would like to illustrate further the methodological consequences of this approach by using two points in contemporary applied ethics. The question is: to what extent is the hermeneutical approach casuistically applicable. We start with the presupposition that the hermeneutical approach does not offer answers to the question of current applied ethics — namely, to the question of what is or is not acceptable in a particular (...) problem situation — but rather, intends to clarify our moral, i.e. normative, response to problem situations. It tries to offer a precise articulation of the normative components of a successful moral decision, without presuming its detailed result. Hermeneutical ethics harks back to conceptual possibilities from the philosophical tradition to clarify the fundamental problem posed by current moral casuistry, and this for two reasons. The first is the idea that these traditional concepts are still at work in our experience and speech, such that, in taking up the tradition, the structure of our present experience is highlighted. The second is the idea that our present experience has moved away from this tradition on certain important points, such that a confrontation with these other possibilities can reveal the recent and relative character of what seems self-evident. To start with, I would like to examine the recent discussions in the media on postmenopausal pregnancy, in particular the argument that a pregnancy resulting from a medical treatment of these ‘older mothers’ is unnatural. Appealing to nature has come into discredit in ethics and in public discussions. Yet, I will defend the position that the notion of naturalness is still part of our moral experience. In other words, when we abandon any appeal to the moral significance of our biological nature, we are no longer able to express essential aspects of our moral experience. This, however, does not deny that the moral meaning of nature needs to be rethought and more accurately articulated; the appeal to nature is not obvious. At the end of my presentation, I will show that an appeal to nature also has a role to play in the recent discussions on cloning human embryos. (shrink)

What is the status of empirical contributions to bioethics, especially to clinical bioethics? Where is the empirical approach discussed in bioethics related to the ongoing debate about principlism versus casuistry? Can we consider an integrative model of research in medical ethics and which empirical methodology could then be valuable, the quantitative or the qualitative? These issues will be addressed in the first, theoretical part of the paper. The concept of the “embedded researcher” presented in this article was stimulated by the (...) two questions, (1) how can we safeguard that our research will yield valid and meaningful results to practice? and (2), how can we convince clinical colleagues that medical ethics offers relevant contributions to the analysis and solution of problems? One tentative answer has been our effort to elaborate a coherent methodological research approach in the field of end-of-life issues integrating qualitative and quantitative as well as casuistic methodologies. This development is characterized in the second part describing the ECOPE Study (short title)“Ethical Conditions Of Passive Euthanasia.” The achievements and limitations of the suggested approach of the “embedded researcher” are discussed referring to 3 examples of our joint studies about ethical issues concerning(1) critical decision-making in neonatology(2) limitation of treatment in intensive care(3) problems with doctor-patient conversation at the end of life in oncologyConclusions from our studies are put to discussion in the final part of the paper about how to further develop research in the field of end-of-life care and, maybe,clinical bioethics as a whole. (shrink)

: This essay examines the increasing commodification of the body with respect to tissues, gametes, and embryos. Such commodification contributes to a diminishing sense of human personhood on an individual level, even as it erodes commitments to human flourishing at the societal level. After the case for social harm resulting from the increasing commodification of the body is made, the question becomes whether that harm is best remedied by following any of three approaches by which government traditionally seeks to promote (...) the flourishing of its citizens. The author concludes that it is not, and that what is needed is a pragmatic and somewhat casuistic approach to the regulation of contested commodities--that which legal scholar Margaret Jane Radin calls "incomplete commodification.". (shrink)

Considers the ways in which alternative moral positions—consequentialism, natural law theory (adjusted to incorporate recognition of non-human animals' moral standing), and Stephen Clark's version of Aristotelian virtue ethics—respond to the question whether a boycott of the meat industry is morally obligatory. Investigates the likely responses of the various positions to a range of casuistic concerns.

This paper investigates the actual use of truth as a criterion in the setting up of and choice between descriptive characterisations. The consideration for truth is often weighed against other considerations. This weighing character is illuminated through examples from everyday life, politics, law, and science. In everyday life the weighing character shows itself inter alia through the categories of ‘white lies’ and ‘great questions’, and in politics, inter alia through the categories of ‘personal character’ versus ‘the party’. In law (...) there are numerous examples of norms that increase the probability of untrue characterisations being taken as a basis for the application of the law. This paper focuses on the categories of ‘exclusion of evidence’, ‘burden of proof’, and ‘adjusting of facts as a means to concretely reasonable and just results’. The paper concludes by showing that burden of proof considerations are also found in an area in which many people assume that the truth criterion is paramount, namely science. The method is thus casuistic. However, the aim is a certain representativity in relation to the problem aspects. (shrink)

Il s'agit de déterminer le statut des normes chez les nouveaux casuistes . On indique d'abord quelles sont les circonstances de cette nouvelle casuistique ; on suggère ensuite qu'elle exporte dans le domaine de l'éthique certaines thèses de T. Kuhn, comme le « modèle déductiviste », qu'elle prétend détrôner, s'alimentait au schéma Hempel-Oppenheim de l'explication scientifique. On suggère enfin que les nouveaux casuistes procèdent, de façon plus ou moins radicale, à une naturalisation des normes.It is intented to investigate about the (...) status of norms in the thought of the new casuists . First, the circumstances of the new casuistry are set out; then it is suggested that the new casuists have integrated in their argument concepts from T. Kuhn, just as the “deductivist model” they so sharply criticize integrates concepts from C.G. Hempel and P. Oppenheim. With regard to the initial question, it is shown that the new casuists uphold a kind of norms-naturalizing constructivism. (shrink)

To resort to hypoxic air machines—would that be to cheat? This clearly depends on whether such machines are prohibited or not. So the important question is this: Should sport authorities prohibit them or not?One way of approaching this question may be to argue casuistically. Erythropoietin is prohibited. Blood doping is prohibited. Training at high altitude is allowed. Does the hypoxic air machine bear more resemblance to training at high altitude than to the use of EPO? If that is the case (...) it should not be prohibited. If, on the other hand, it bears more resemblance to the use of EPO, then it should be prohibited.However, to argue casuistically is not entirely satisfactory. Even if, through such reasoning, we reach an answer, we do not obtain a principled explanation of the answer. We may get a hint at what to do , but not at why we should do so.1 So the question need to be posed at a more principled level: If rules against doping in sport are to be …. (shrink)

In this essay, I will try to answer two related questions. Adopting Nietzsche’s principle of the “enhancement of life” as a kind of basic value, would truth and truth-telling have high, medial, or no significance at all? In what sense does Nietzsche think that “the falsehood of a judgment is […] not necessarily an objection to it”?1 In order to give a satisfactory answer to these two questions, I will first illustrate how, from his essay entitled “On Truth (...) and Lies in an Non Moral Sense” to the collection of aphorisms entitled Beyond Good and Evil, Nietzsche develops his analysis and critique of the conventional philosophical theory of truth into a full-fledged theory of multiperspectivism. Having reconstructed Nietzsche’s inquiry of the conventional concept of truth and his theory of perspectivism, I will be able to give a casuistic answer to the two abovementioned questions. (shrink)

...how do we train residents to employ ethical reasoning? This is a good question, not only for the problem of strikes, but also for all medical training. The best method is inductive, since that most closely parallels the clinical reasoning processes that define the reality of medical practice. The strengths of inductive reasoning are that it most closely matches the realities of practice, it arises from the particular circumstances of the case, and it leads to a casuistic conclusion that (...) applies more directly than abstract reasoning models to the problem at hand. The weaknesses, though, require that inductive models include a check and balance. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Bioethics ConsultationPat Milmoe McCarrick (bio)(John La Puma, M.D., from the Department of Medicine at Lutheran General Hospital in Chicago, contacted the National Reference Center for Bioethics Literature and suggested bioethics consultation as a topic for the Scope Note Series. He provided an extensive list of citations about ethics consultations collected by him and by David Schiedermayer, M.D., for their new book Ethics Consultation: A Practical Guide.)In Ethics Consultation in (...) Health Care, editors John Fletcher, Norman Quist, and Albert R. Jonsen (I, 1989) define ethics consultation as "the provision of specialized help in identifying, analyzing, and resolving ethical problems that arise in clinical care. In medical ethics the area of consultation has grown rapidly since 1978 when Edmund D. Pellegrino (II, 1978) noted, "we cannot separate technical-moral decisions from the philosophic principles we use to justify them. Medicine and ethics must be engaged with each other at every level."In 1980 Albert Jonsen raised the question of whether an ethicist could be a consultant and said that the ethicist as consultant is a casuist, one whose moral reasoning is based on a system of reasoning that is applied to particular cases. He describes historical casuistry in Western culture, comparing it to modern moral philosophy, and suggests that a "new casuistry seems timely" for ethics consultation (II, Jonsen 1980). By 1984 ethicist Ruth Purtilo recorded her thoughts following an ethics consultation. She raised questions about the ethicist's place on a hospital staff and how to make that role appropriate and beneficial to all concerned, saying that "the ethicist retreats after the consultation; under no circumstances would the outcome of an ethics consultation be that the ethicist became the primary care giver or assumed ongoing responsibility for the clinical management of a case" (II, Purtilo 1984). Nevertheless, in 1992 two physician-ethicists who had been called as ethics consultants for a patient who had requested that he be removed from his ventilator reported that they became the persons who turned off the ventilator and administered the drugs that eased his dying (II, Edwards and Tolle 1992).In recognition of the growing number of persons identifying themselves as [End Page 433] consultants, the Society for Bioethics Consultation was founded in October 1985 as a professional society of persons engaged in bioethics consultation. It encourages and supports consultation, assists in establishing clinical education programs, and raises funds for consultation education. Although the Society has no permanent office, the president (currently, George Kanoti in the Cleveland Clinic Foundation's Bioethics Department) conducts its work and plans an annual meeting.The Joint Commission on the Accreditation of Healthcare Organizations (JCAHO) established new criteria concerning ethics in its 1992 Manual (III, JCAHO 1992) and in a special issue of QRB devoted to ethics consultation (I, Defining Quality 1992). These publications undoubtedly have contributed to the increased use of experts in medical ethics. The Manual notes that all organizations seeking accreditation should have some sort of "mechanism for the consideration of ethical issues arising in the care of patients and to provide education to care givers and patients on ethical issues in health care." A health care institution's eligibility for JCAHO accreditation, which is required for federal reimbursement, requires adherence to this specification (III, JCAHO 1992).The new International Directory of Bioethics Organizations provides an index of 129 different groups that indicated to the authors that they offer bioethics consultations. Of these, 83 are in the United States and 46 are in other countries. The ethics consultants included in the directory encompass a broad group of professionals who will assist patients, families, and primary care medical staff in finding solutions to ethical dilemmas resulting from use of new technologies or new treatments in health care. Consultants often come from the health fields: physicians, nurses, and other health personnel, but other professionals are also active as ethics consultants. Lawyers, pastoral counselors, philosophers, and social workers also offer bioethics consultation services (III, Nolen and Coutts 1993).Drs. Siegler, Pellegrino, and Singer wrote in 1990 that "Physician-ethicists and professional ethicists will continue to work side by side in the future. One is not likely to replace the other, nor is this desirable, because... (shrink)

Når man går i gang med et forskningsprojekt, vil der typisk være nogle forskningsetiske problemstillinger, man skal forholde sig til. Det kan fx være, at man skal have indhentet informeret samtykkeerklæringer fra de deltagere, der skal være med, eller man skal have indhentet forskningsetiske tilladelser og godkendelser fra uafhængige instanser. Det er altså overvejelser, som typisk dukker op ved begyndelsen af et forskningsprojekt. Der kan efterfølgende være en risiko for, at man forsømmer refleksioner over emergerende etiske problemstillinger, og at forskningsetik (...) således reduceres til, at man som forsker har underskrevet og overholdt nogle prædefinerede retningslinjer for god forskningspraksis. Sådanne retningslinjer er naturligvis særdeles vigtige. Men det er pointen i denne artikel, at de ikke kan stå alene. Forskningsetiske dilemmaer er et epistemologisk vilkår gennem hele forskningsprocessen, og de må således overvejes og genovervejes, forhandles og genforhandles gennem hele forskningsprocessen. Den form for forskningsetik, der følger bestemte på forhånd fastlagte retningslinjer, som typisk er formuleret i standardiserede, kontekstuafhængige principper for god etisk adfærd, benævnes i artiklen procedural forskningsetik, mens en forskningsetik, der foretager en konkret og kontekstafhængig vurdering af de specifikke etiske problemstillinger og dilemmaer, som de viser sig i praksis gennem hele forskningsprocessen, benævnes kasuistisk forskningsetik. Distinktionen mellem disse to typer forskningsetik er udtryk for en teoretisk konstruktion, og de skal ikke betragtes som modsatrettede alternativer, men derimod som supplerende sider ved god forskningsetisk praksis. I artiklen diskuteres forholdet mellem dem for ad den vej at fremhæve enhver forskers pågående og kontinuerlige ansvar gennem hele forskningsprocessen. Nøgleord: forskningsetik, procedural, kasuistisk, Leibniz English summary: Dic cur hic – a casuistic research ethic When embarking on a research project, researchers must customarily confront some ethical issues. To begin with, they may need informed consent from the participants, or research ethics permission and approval from an independent Research Ethics Committee. However, there is more involved than these legal requirements alone, for just complying with some pre-defined guidelines for good research practice is by no means enough. In fact, a number of ethical issues demanding thorough reflection may emerge during the research project. Far from being neglected, such questions deserve careful attention. Research ethical dilemmas are an epistemological condition throughout the whole research process, and must therefore be constantly considered and reviewed, negotiated and renegotiated. This article purports to categorize the ethical issues likely to arise during the course of an investigation into two main types, namely procedural and casuistic. The kind of research ethics following certain pre-established guidelines, which are typically expressed in standardized, context-independent principles of good ethical behavior, will be labeled as procedural research ethics, while the type of research ethics ensuing from the analysis and contextual assessment of the specific dilemmas arising in practice in the particular situation studied, will be named casuistic research ethics. A distinction between these two types of research ethics reflects a theoretical construct. Both types should not be regarded as opposing alternatives, but as complementary aspects of good ethical research practices. This article discusses the relationship between the two types in order to highlight the researcher’s ongoing and continuous responsibility throughout the research process. (shrink)

Lester Hunt reviews Tara Smith's Viable Values: A Study of the Root and Reward of Morality. He finds it an excellent contribution to the ongoing discussion of Objectivist ethics. Especially noteworthy, he says, are Smith's treatment of the concept of intrinsic value, her use of the concept of flourishing, and her treatment of the relations between the interests of different people. Though the book provides no sustained discussion of casuistical applications, epistemological assumptions, or potentially interesting side-issues, it raises many provocative (...) questions that will fuel further debate. (shrink)

LESTER HUNT reviews Tara Smith's Viable Values: A Study of the Root and Reward of Morality. He finds it an excellent contribution to the ongoing discussion of Objectivist ethics. Especially noteworthy, he says, are Smith's treatment of the concept of intrinsic value, her use of the concept of flourishing, and her treatment of the relations between the interests of different people. Though the book provides no sustained discussion of casuistical applications, epistemological assumptions, or potentially interesting side-issues, it raises many provocative (...) questions that will fuel further debate. (shrink)

This essay concerns itself with the methodology of practical ethics. There are a variety of methods employed in ethics. Although none have been firmly established as dominant, it is generally agreed that casuistry, or the case-based method, is one important strategy commonly used for resolving ethical issues. Casuists compare the case under consideration to a relevantly similar precedent case in which judgements have already been made, and they use these earlier judgements to determine the proper resolution of the present case. (...) In this article, I try to provide a better understanding of the nature of contemporary casuistry. To accomplish this, I explain the basic features of casuistic reasoning. The second section focuses on the logic of casuistry. By assessing casuistic reasoning from the logical viewpoint, casuistry can be reconstructed as a logically correct method of reasoning. The third section looks at casuistry from the epistemic point of view and investigates the justificatory force of casuistic reasoning. Finally, in the fourth section, I show the usefulness of formal casuistry. (shrink)

This paper assesses the epistemic challenges of giving nutrition advice to elite athletes in light of recent philosophical discussion concerning evidence-based practice. Our trust in experts largely depends on the assumption that their advice is based on reliable evidence. In many fields, the evaluation of the reliability of evidence is made on the basis of standards that originate from evidence-based medicine. I show that at the Olympic or professional level, implementing nutritional plans in real-world competitions requires contextualization of knowledge in (...) a way that contravenes the tenets of evidence-based thinking. Nutrition experts need to be able to combine and apply evidence from multiple sources, including the previous successes and failures of particular athletes. I argue that in this sense, the practice of elite sport nutrition embodies casuistic reasoning. (shrink)

This paper examines medical writing in Karl Philipp Moritz’ Journal of Empirical Psychology by looking at the alterations Moritz made to his sources. It shows how he rearranged the data in order to introduce a new type of text into psychology: the case or case study. He did so by altering the main parts of a report that had been published a few years earlier. In rewriting the report, Moritz introduced not only a new type of text but also a (...) style of reasoning; i.e. the casuistic form of thinking that became more widely acknowledged only later in the course of experiential psychology. The paper thus links writing techniques in psychology to the rise of a type of text and a new style of reasoning. (shrink)

When a company raises its share price by sacking workers or polluting the environment, it is avoiding paying real costs. Accountancy, which quantifies certain rights, needs to combine with applied ethics to create a "computational casuistics" or "moral accountancy", which quantifies the rights and obligations of individuals and companies. Such quantification has proved successful already in environmental accounting, in health care allocation and in evaluating compensation payments. It is argued that many rights are measurable with sufficient accuracy to make them (...) credible and legally actionable. (shrink)

In the absence of a well articulated conceptual framework for nursing ethics, this article argues for a theory of applied ethics - casuistics - used within a clinical reasoning model, to analyse the complicated issues presented in three cases involving adolescents receiving treatment for abuse through a rural alternative learning centre. The clinical nurse specialist, as an independent practitioner within the community, is presented with many ethical challenges arising from cultural diversity. The inherent independent nature of such practice environments combined (...) with the pluralism which exists in today's multicultural society demands that professional nurses working in these circumstances develop and utilize an ethical framework for the analysis of patient care in situations that involve moral conflict. (shrink)