Bruce Jennings

The concept of consensus is often appealed to in discussions of biomedical ethics and applied ethics, and it plays an important role in many influential ethical theories. Consensus is an especially influential notion among theorists who reject ethical realism and who frame ethics as a practice of discourse rather than a body of objective knowledge. It is also a practically important notion when moral decision making is subject to bureaucratic organization and oversight, as is increasingly becoming the case in medicine. Two models of consensus are examined and criticized: pluralistic consensus and overlapping consensus. As an alternative to these models, the paper argues that consensus refers to the dialogic aspects of a broader normative conception of democratic moral agency. When the preconditions for that dialogic democratic practice are met, consensus has a justificatory role in ethics; when they are not, consensus, as distinct from mere agreement, does not emerge and can have no moral authority. Keywords: applied ethics, bioethics, consensus, contract theory, democracy, discourse ethics, liberalism CiteULike Connotea Del.icio.us What's this?

This paper advances a new paradigm in clinical ethics education that not only emphasizes development of individual cli but also focuses on the institutional context within which health care professionals work. This approach has been applied to the goal of improving the care provided to critically and terminally ill adults. The model has been adopted by about thirty hospitals and nursing homes; additional institutions will soon join the program, entitled Decisions Near the End of Life. Here, we describe the history and rationale for this approach, its goals, pedagogical assumptions, and design.

This paper argues that more attention should be paid to the civic functions of ethical discourse about the professions and to the moral virtues inherent in their practice and traditions. The ability of professional ethics to articulate civic ideals and virtues is discussed in relation to three issues. First, should professional ethics aim to enlighten ethical understanding or to motivate ethical conduct? Second, how should professional ethics define the professional's moral responsibilities in the face of ethical dilemmas — should the professional attempt to resolve the dilemma ethically or to change the social conditions that create the dilemma in the first place? The third issue discussed in the paper is whether professional ethics should be based on the model of regulation and rational self-interest or on the model of virtue and a fundamental personal commitment to the ideal of a certain form of life? In order for work in professional ethics to attain intellectual credibility among a non-philosophical audience, it must develop a coherent and convincing position on each of these issues.