Elsevier

Social Science & Medicine

Volume 39, Issue 9, November 1994, Pages 1155-1164
Social Science & Medicine

The forms and limits of medical ethics

https://doi.org/10.1016/0277-9536(94)90348-4Get rights and content

Abstract

As medical ethics has evolved over the past several decades, it has come to be regarded as a domain of applied ethics, that is, the application of a rationally based, philosophical theory to moral problems in health care. But an array of difficulties arise in the attempt to apply general moral theories or norms to concrete problems, difficulties that expose the incompleteness and indeterminacy of philosophical moral theory. The doubtful ability of applied ethics to be practically helpful has led to the development of two main competitors. One is the attempt to reprise and rehabilitate the tradition of moral casuistry, which focuses on the analysis of specific cases rather than on the defense and application of theories and norms. The second is the search for moral insight and guidance in narratives or stories. These alternatives suffer from some of the same difficulties that plague applied ethics, however. Another trend in medical ethics rejects the theoretical preoccupation of applied ethics in favour of contextualism—an insistence on situating moral problems in institutional and organizational structures and in social and cultural backgrounds. Social science investigations of medical ethics pay attention to the former, while feminist critiques of medical ethics are concerned with exposing and eradicating cultural biases against women. Contemporary work in medical ethics is diverse, but these manifold approaches hold out the promise of improving our understanding of morality as a truly practical enterprise.

References (50)

  • B. Hoffmaster

    Can ethnography save the life of medical ethics?

    Soc. Sci. Med.

    (1992)
  • P. Ramsey

    The Patient as Person

    (1970)
  • A.R. Jonsen

    American moralism and the origin of bioethics in the United States

    J. Med. Phil.

    (1991)
  • E.D. Pellegrino

    The metamorphosis of medical ethics

    JAMA

    (1993)
  • B. Brody

    Life and Death Decision Making

  • I. Kant

    Fundamental Principles of the Metaphysic of Morals

  • J.S. Mill
  • J. Rawls

    A Theory of Justice

  • R.M. Veatch

    A Theory of Medical Ethics

    (1981)
  • H.T. Engelhardt

    The Foundations of Bioethics

    (1986)
  • National Commission for the Protection of Human Subjects of Biomedical and Behavioral Research

    The Belmont Report: Ethical Principles and Guidelines for the Protection of Human Subjects of Research

    (1979)
  • T.L. Beauchamp et al.

    Principles of Biomedical Ethics

    (1989)
  • A. Donagan

    The Theory of Morality

    (1977)
  • Committee on Bioethics

    Infants with anencephaly as organ sources: ethical considerations

    Pediatrics

    (1992)
  • B. Jennings et al.

    Ethical challenges of chronic illness

    Hastings Center Report

    (1988)
  • B. Collopy et al.

    New directions in nursing home ethics

    Hastings Center Report

    (1991)
  • C.W. Lidz et al.

    The Erosion of Autonomy in Long-Term Care

    (1992)
  • G.J. Agich

    Autonomy and Long-Term Care

    (1993)
  • The GUSTO Investigators

    An international randomized trial comparing four thrombolytic strategies for acute myocardial infarction

    New Engl. J. Med.

    (1993)
  • V. Fuster

    Coronary thrombolysis—a perspective for the practicing physician

    New Engl. J. Med.

    (1993)
  • B. Gert

    Morality

    (1988)
  • N. Daniels

    Just Health Care

    (1985)
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