This article offers a general discussion of the concept of false hope. Its ultimate aim is to clarify the meaning and the relevance of that concept for medicine and medical research. In the first part, the concept of hope is discussed. I argue that hope is more than a combination of a desire and a belief about the probability that the desire will be fulfilled. Imagination and anticipation are as well components of hope. I also discuss if hope implies orientation (...) to action. In the second part, I examine the concept of false hope. I show that hope is false if it cannot be justified epistemically. There is, I argue, an intimate relation between false hope and ignorance. Hope is justified—“realistic”—when the hoping person knows and accepts experts’ judgement about the probability of hope fulfillment. I then argue that what matters for evaluating a person’s hope is not only whether it is realistic, but also whether it is reasonable in the light of the aim and goals that a person strives for in his life. Part three goes into the question of what is morally wrong about having or causing false hope. In the fourth part, the relevance is shown of the insights from the previous parts for the debate on false hope in medicine and clinical research. (shrink)

Empirische Ethik ist ein relativ neues Vorgehen in der Ethikforschung, das vor allem in der Medizinethik angewandt wird. Dieser Beitrag bespricht die kennzeichnenden Charakteristika der empirischen Ethik und unterscheidet zwischen generalistischer und kontextualistischer empirischer Ethik. Zuerst werden verschiedene Beispiele beider Arten von empirischer Ethik vorgestellt, danach werden für beide Ansätze mögliche Schwachpunkte diskutiert. Die Schlussfolgerung des Beitrages besteht darin, dass das Entstehen der empirischen Ethik eine positive Entwicklung ist. Empirische Ethik sollte jedoch als eine Ergänzung der traditionellen philosophischen Medizinethik betrachtet (...) werden, und nicht als die bessere Alternative. (shrink)

In this article I examine whether Moral Foundations Theory can fulfil the promises that Haidt claims for the theory: that it will help in developing new approaches to moral education and to the moral conflicts that divide our diverse society. I argue that, first, the model that Haidt suggests for understanding the plurality of moralities—a shared foundation underlying diverse moralities—does not help to overcome conflicts. A better understanding of the nature and background of moral conflicts can lead to a more (...) respectful attitude towards people with conflicting views, but need not contribute to ending conflicts. Second, I show that pervasive moral conflicts should be dealt with on the level of politics. They require a morality of compromising. Third, I examine why this approach does not seem to work in the USA. (shrink)

The double subjectivity of conscience and the need to test conscientious objections -/- Abstract In spite of the collapse of the traditional objective concept of conscience and the subsequent subjectivation of conscience, conscientious objections are still often considered as a valid ground for exemption from legal and professional obligations. Conscientious objections are seen as more serious than ordinary moral objections. It is not evident why this is so. I argue, with Niklas Luhmann, that the function of conscience is to protect (...) the moral core of a person’s identity. Overruling conscientious objections threatens this core. Claims of conscience are usually founded on the right of freedom of conscience. This right is not absolute. I discuss the view of Richard Arneson who rejects the right of freedom of conscience and defends the right against conscience. I agree with Arneson that, at the one hand, conscientious objectors may constitute a threat to the social and legal order when their objections are not recognised and, at the other hand, too easy giving in to conscientious objections may also threaten the viability of social and legal order. That is why it is needed to determine when conscientious objections cannot be taken at face value, but should be subjected to a series of tests. The aim of these tests is to contain the number of objectors. I discuss 6 criteria for determining whether conscientious objections ground an exemption to legal and professional obligations. At the end of the article I discuss the conscientious objections of medical doctors. (shrink)

Does ethics have adequate general theories? Our analysis shows that this question does not have a straightforward answer since the key terms are ambiguous. So we should not concentrate on the answer but on the question itself. “Ethics” stands for many things, but we let that pass. “Adequate” may refer to varied arrays of methodological principles which are seldom fully articulated in ethics. “General” is a notion with at least three meanings. Different kinds of generality may be at cross-purposes, so (...) we must not expect theories to be general in sundry senses. “Theory,” for that matter, is itself ambiguous. Some thinkers say that ethics cannot have theories, while others deny it. We doubt whether opposing parties are talking about the same things.No wonder, then, that controversies in ethics are long-lasting and unproductive. We hope that the methodology we have presented will alleviate some of them. The examples we chose show that this is feasible. Views such as Hare's and Jonsen and Toulmin's which are seemingly wide apart, show convergence if we put them in a methodological perspective.Our analysis also suggests that many alleged differences between science and ethics could fade away if methodology is brought to bear on them. Specifically, the idea that ethics compares poorly with science in view of limited generality, or poor means of justification, is unfounded. Those who defend this view over-rate the powers of science. (shrink)

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