Kevin Wildes

Secular bioethics has been involved in the resolution of moral controversies both in the clinic and in the discussion of public policy and there are three models used to justify moral judgments in bioethics. The first is the foundational model which seeks to build a theoretical account of the moral life. The foundational project must confront two difficulties. First, it must come to terms with the dilemma that there is no universal account of the nature of moral reason. Second, each foundational account requires some ranking of moral values if it is to make content-full judgments. Absent a universal moral narrative there is no canonical ranking of values. ;Two attempts to circumvent these foundational dilemmas have been prominent in bioethics. The first is the middle level principle approach. This model appeals to a set of principles to justify moral judgments. The model assumes that these principles are shared and that they can resolve moral dilemmas without requiring the resolution of the foundational questions. The model faces three difficulties. First there is no conclusive argument as to why this list of principles should be canonical. Second, it is not clear how the principles are related to one another. Third, the principles, without foundations, are ambiguous in their meaning. ;Another attempt to avoid foundational dilemmas is the hope of Jonsen and Toulmin to revive some model of casuistry. Jonsen and Toulmin select the model of Roman Catholic casuistry in the High Middle Ages. Yet they fail to take full account of the moral values and moral authority which governed this practice of casuistry. ;Both casuistry and principlism argue that we can reach agreement on moral controversies without appeal to foundations. In carefully examining what is agreed to one comes to see that the assertion of agreement is a sham. It becomes clear that secular discourse in bioethics must rely on a procedural morality which is empty of content. Content-full moral judgments can only be understood and accepted within particular moral communities

When many people think of bioethics, they think of gripping issues in clinical medicine such as end-of-life decision-making, controversies in biomedical research such as that over work with stem cells, or issues in allocating scarce health-care resources such as organs or money. The term “bioethics” may evoke images of moral controversies being discussed on news programs and talk shows. But this “controversy of the day” focus often treats ethical issues in medicine superficially, for it addresses them as if they could be examined and discussed in isolation from the context in which they are situated. Such a focus on the latest controversies fails to take into account that medicine is a social institution and that the controversies in bioethics often reflect deeper social and moral issues that transcend the boundaries of medicine and ethics. If one moves beyond the issue-of-the-day approach to bioethics, one can see that the field must address these deeper issues.

In the postscript to Wittgenstein and the Mystical, Sontag notes that while most philosophers attend to Wittgenstein's technical work in logic and the philosophy of language, there is little attention given to his "life situation." Yet, Sontag argues throughout this fine book, understanding many of Wittgenstein's philosophical insights depends on understanding how the wider concerns of his life influenced and related to his philosophical concerns. While Wittgenstein was concerned with the clarity of philosophical language, he recognized that beyond the confines of such language was what Sontag calls "the mystical" and much of what makes human life meaningful. Put another way, Wittgenstein's logical and linguistic concerns were but a part of his larger concerns about human life and the logical and linguistic interests are better understood when seen as part of this wider context.

Several recent attempts to develop models of moral reasoning have attempted to use some form of casuistry as a way to resolve the moral controversies of clinical ethics. One of the best known models of casuistry is that of Jonsen and Toulmin who attempt to transpose a particular model of casuistry, that of Roman Catholic confessional practice, to contemporary moral disputes. This attempt is flawed in that it fails to understand both the history of the model it seeks to transpose and the morally pluralistic context of secular, postmodern society. The practice of casuistry which Jonsen and Toulmin wish to revive is a practice set in the context of a community with a shared set of moral values and structures of moral authority. Without a set of common moral values and rankings, and a moral authority to interpret cases the casuistry of the postmodern age will be pluralistic; that is, there will be many casuistries not just one. Keywords: casuistry, common morality, kinetics, moral authority, moral pluralism, morphology, paradigm cases, taxonomy CiteULike Connotea Del.icio.us What's this?

Non-ecumenical Christian bioethics will seem a strange category for many. The category relies on the recognition that bioethics mediates morality and ethics in healthcare. As such bioethics will have particular content. It is the content of a moral vision that both divides and unites. The enterprise of non-ecumenical Christian bioethics explores how Christians are both divided and united on the issues of bioethics. Non-ecumenical Christian bioethics is opposed to a facile ecumenism that reduces the content of Christian morality to the lowest common denominator

James Tallmon has argued that my criticisms of Jonsen and Toulmin are ill founded. Tallmon argues that Jonsen and Toulmin argue for a method of rhetorical reasoning and not for a particular content. He argues that if one distinguishes the content and method of casuistry the Jonsen-Toulmin model can work. But Tallmon, like Jonsen and Toulmin, cannot escape the need for casuistry to have a content. Tallmon's response evidences that need since he assumes that there is a ‘Medical Community’ which has a moral vision. Keywords: casuistry, content, Jonsen, method, rhetoric, Tallmon, Toulmin CiteULike Connotea Del.icio.us What's this?

In the last 25 years, Roman Catholic moral theology has debated issues ranging from the sources of moral theology to the role of ecclesiastical authority in moral theology. In 1993, Pope John Paul II issued his encyclical letter Veritatis Splendor, which addresses issues in fundamental moral theology. The encyclical must be understood against the background of ongoing debates since Pope Paul VI's 1968 encyclical on birth control (Humanae Vitae). It is not clear what the impact of Veritatis Splendor will be. However, it seems safe to say that it will be deployed in debates about issues such as birth control, artificial reproduction, sterilization, and abortion.

The advent of moral pluralism in the post-modern age leads to a set of issues about how pluralistic societies can function. The questions of biomedical ethics frequently highlight the larger issues of moral pluralism and social cooperation. Reflection on these issues has focused on the decision making roles of the health care professionals, the patient, and the patient's family. One species of actor that has been neglected has been those institutions which are part of the public, secular realm and which have a particular moral heritage. Keywords: approval, compromise, condemnation, integrity, toleration CiteULike Connotea Del.icio.us What's this?

Practices such as physician assisted suicide, even if legal, engender a range of moral conflicts to which many are oblivious. A recent proposal for physician assisted suicide provides an example by calling upon physicians opposed to suicide to refer patients to other, more sympathetic, physicians. However, the proposal does not address the moral concerns of those physicians for whom such referral would be morally objectionable. Keywords: collaboration, euthanasia, intrinsic evil, material cooperation, projects, referral, toleration CiteULike Connotea Del.icio.us What's this?

Bioethics evolved from traditional physician ethics and theological ethics. It has become important in contemporary discussions of Medicine and ethics. But in contemporary secular societies the foundations of bioethics are minimal in their content and often rely on procedural ethics. The bioethics of particular communities, particularly religious communities, are richer than the procedural ethics of a secular society. Religious bioethics, situated within religious communities, are richer in content in general and in the lived reality.

When many people think of bioethics, they think of gripping issues in clinical medicine such as end-of-life decision-making, controversies in biomedical research such as that over work with stem cells, or issues in allocating scarce health-care resources such as organs or money. The term “bioethics” may evoke images of moral controversies being discussed on news programs and talk shows. But this “controversy of the day” focus often treats ethical issues in medicine superficially, for it addresses them as if they could be examined and discussed in isolation from the context in which they are situated. Such a focus on the latest controversies fails to take into account that medicine is a social institution and that the controversies in bioethics often reflect deeper social and moral issues that transcend the boundaries of medicine and ethics. If one moves beyond the issue-of-the-day approach to bioethics, one can see that the field must address these deeper issues