1. Moral Pluralism, Neutrality, and Secularism

Keyword(s):  
2014 ◽  
Vol 10 (2) ◽  
pp. 177-183 ◽  
Author(s):  
Lauris Christopher Kaldjian

The communication of moral reasoning in medicine can be understood as a means of showing respect for patients and colleagues through the giving of moral reasons for actions. This communication is especially important when disagreements arise. While moral reasoning should strive for impartiality, it also needs to acknowledge the individual moral beliefs and values that distinguish each person (moral particularity) and give rise to the challenge of contrasting moral frameworks (moral pluralism). Efforts to communicate moral reasoning should move beyond common approaches to principles-based reasoning in medical ethics by addressing the underlying beliefs and values that define our moral frameworks and guide our interpretations and applications of principles. Communicating about underlying beliefs and values requires a willingness to grapple with challenges of accessibility (the degree to which particular beliefs and values are intelligible between persons) and translatability (the degree to which particular beliefs and values can be transposed from one moral framework to another) as words and concepts are used to communicate beliefs and values. Moral dialogues between professionals and patients and among professionals themselves need to be handled carefully, and sometimes these dialogues invite reference to underlying beliefs and values. When professionals choose to articulate such beliefs and values, they can do so as an expression of respectful patient care and collaboration and as a means of promoting their own moral integrity by signalling the need for consistency between their own beliefs, words and actions.


1988 ◽  
Vol 13 (4) ◽  
pp. 305-321
Author(s):  
Norbert J. RIGALI

Author(s):  
Samuel Freeman

Rawls says that there are two sources for the primacy assigned to the basic structure: the profound effects of basic social institutions on persons and their future prospects, and the need to maintain background justice. This chapter discusses the main reasons behind Rawls’s position that the basic structure of society is the primary subject of justice, and that the political constitution, property, and the economic system are the first subject to which principles of justice apply. First, the primacy of the basic structure is necessary for the freedom, equality, and independence of moral persons. Second, the basic structure’s priority is a condition of economic reciprocity and the just distribution of income and wealth. Third, the primacy of the basic structure is required by moral pluralism and the plurality of values and reasonable conceptions of the good among free and equal persons.


Author(s):  
Michael Moehler

This book develops a novel multilevel social contract theory that, in contrast to existing theories in the liberal tradition, does not merely assume a restricted form of reasonable moral pluralism, but is tailored to the conditions of deeply morally pluralistic societies that may be populated by liberal moral agents, nonliberal moral agents, and, according to the traditional understanding of morality, nonmoral agents alike. To develop this theory, the book draws on the history of the social contract tradition, especially the work of Hobbes, Hume, Kant, Rawls, and Gauthier, as well as on the work of some of the critics of this tradition, such as Sen and Gaus. The two-level contractarian theory holds that morality in its best contractarian version for the conditions of deeply morally pluralistic societies entails Humean, Hobbesian, and Kantian moral features. The theory defines the minimal behavioral restrictions that are necessary to ensure, compared to violent conflict resolution, mutually beneficial peaceful long-term cooperation in deeply morally pluralistic societies. The theory minimizes the problem of compliance by maximally respecting the interests of all members of society. Despite its ideal nature, the theory is, in principle, applicable to the real world and, for the conditions described, most promising for securing mutually beneficial peaceful long-term cooperation in a world in which a fully just society, due to moral diversity, is unattainable. If Rawls’ intention was to carry the traditional social contract argument to a higher level of abstraction, then the two-level contractarian theory brings it back down to earth.


2021 ◽  
pp. 000183922110114
Author(s):  
Joelle Evans

Negotiations over professional boundaries are often contests about controlling technical expertise and authority. Less is known about the role of moral judgments in such contests because well-trained professionals often silence their moral commitments or engage moral debates outside the boundaries of their profession. Drawing on an ethnographic study of a science laboratory at the forefront of moral controversy, this article shows how professionals manage moral challenges by reconfiguring their conventional domain of expert authority to include moral as well as technical expertise. Scientists drew on their plural moral views to develop, apply, and mobilize abstract knowledge about morals as resources to claim authority in debates over the moral definition of their work. Collective learning and collaboration ensured the cohesion of the professional community throughout the process of developing authority despite continued moral pluralism. By unpacking one mechanism for the pursuit of moral authority, the study elaborates our understanding of the moral foundations of professionalism and of the emergence of morally complex work activities.


2010 ◽  
Vol 27 (2) ◽  
pp. 317-340 ◽  
Author(s):  
H. Tristram Engelhardt

AbstractOnce God is no longer recognized as the ground and the enforcer of morality, the character and force of morality undergoes a significant change, a point made by G.E.M. Anscombe in her observation that without God the significance of morality is changed, as the word criminal would be changed if there were no criminal law and criminal courts. There is no longer in principle a God's-eye perspective from which one can envisage setting moral pluralism aside. In addition, it becomes impossible to show that morality should always trump concerns of prudence, concerns for one's own non-moral interests and the interests of those to whom one is close. Immanuel Kant's attempt to maintain the unity of morality and the force of moral obligation by invoking the idea of God and the postulates of pure practical reason (i.e., God and immortality) are explored and assessed. Hegel's reconstruction of the status of moral obligation is also examined, given his attempt to eschew Kant's thing-in-itself, as well as Kant's at least possible transcendent God. Severed from any metaphysical anchor, morality gains a contingent content from socio-historical context and its enforcement from the state. Hegel's disengagement from a transcendent God marks a watershed in the place of God in philosophical reflections regarding the status of moral obligations on the European continent. Anscombe is vindicated. Absent the presence of God, there is an important change in the force of moral obligation.


Author(s):  
Yongsong GUO

LANGUAGE NOTE | Document text in Chinese; abstract also in English.對於沒有臨床救治希望的病人,要不要繼續治療?誰有最終的決定權?這既是臨床醫療問題,又是一個涉及社會倫理法規的問題。對於這樣的病人,不放棄治療可能意味著要消耗更多的醫療資源但又無法挽救病人,但是如果放棄治療,可能會遇到更多的來自社會傳統的、倫理法規的問題。筆者認為,在社會多元化發展的今天,面對臨床無效治療,應在尊重病人或病人家屬有最終決定權的前提下,以一定道德、法規為依據,按照一定的醫療程式和法律手續進行處理,可能是更為符合人道和社會公眾利益的理性選擇。There has not been a clear medical definition of futility. The concept of futile treatment involves not only medical, but also social, ethical, and legal components. This paper argues that in today's pluralistic moral circumstances, the patient and/or the family should have the final right to decision regarding futile treatment.Some are opposed to renouncing futile treatment, whatever futility is defined. For them, first, abandoning treatment is in conflict with the physician's basic duty of offering treatment. Second, giving up treatment also gives up the chance of making medical progress by attempting to treat the patient. Third, the patient would thereby lose the opportunity of prolonging the life. And finally, it would change the good image of the physician (as taking care of the patient). On the other hand, those who support renouncing futile treatment offer different reasons. First, giving up futile treatment will turn out to be respecting the value of the patient's life. Second, It would help people recognize the natural limit of contemporary medical development. Third, it would facilitate a reasonable pattern of distributing scarce medical resources. And finally, it could reduce the suffering of the patient. As a result, we face a social situation of moral pluralism: people disagree with each other regarding renouncing futile treatment.A difficult practical issue is who has the right to decide renouncing futile treatment. This paper argues that, giving individuals hold conflicting views of life, valoue and morality, the patient should have the final decision power regarding his/her own treatment. If the patient is incompetent, then the family should have the deciding right. In this respect we should overcome the longstanding medical paternalism. In addition, society should establish a prcocedure to regulate and facilitate the decision-mading of renouncing futile treatment.DOWNLOAD HISTORY | This article has been downloaded 16 times in Digital Commons before migrating into this platform.


Author(s):  
Aviad E. Raz ◽  
Tamar Nov-Klaiman ◽  
Yael Hashiloni-Dolev ◽  
Hannes Foth ◽  
Christina Schües ◽  
...  

Abstract Definition The routinization of prenatal diagnosis is the source of bioethical and policy debates regarding choice, autonomy, access, and protection. To understand these debates in the context of cultural diversity and moral pluralism, we compare Israel and Germany, focusing on two recent repro-genetic “hot spots” of such policy-making at the beginning of life: pre-implantation genetic diagnosis (PGD) and non-invasive prenatal genetic testing (NIPT), two cutting-edge repro-genetic technologies that are regulated and viewed very differently in Germany and Israel, reflecting different medicolegal policies as well as public and bioethical considerations. Arguments First, we compare policy-making in the context of PGD for HLA (human leukocyte antigen) typing, used to create sibling donors, approved in Israel under specific conditions while prohibited in Germany. Second, we compare policy-making in the context of NIPT, which came under fire in Germany, while in Israel there has been little public debate about it. Conclusion Both countries justify their contrasting policies as reflecting a concern for the well-being and care of the embryo/child, thus highlighting different concepts of embryo/child protection, (relational) autonomy, family relations, and the impact of religion and history on the promotion/protection of life. We use the juxtaposition of PGD and NIPT to highlight some inconsistencies in policies concerning the protection of extra- and intra-corporeal embryos. We conclude by drawing on the comparison to show how national variations exist alongside co-evolution.


1984 ◽  
Vol 6 (1) ◽  
Author(s):  
David Miller

AbstractMaclntyre presents an account of the virtues first in terms of practices and then in terms of the narrative unity of a person’s life. He fails, however, to observe an important distinction between self-contained and purposive practices; if the virtues are to be understood by reference to practices, they must be of the latter kind. By the same token, a defence of the virtues must refer to the social purposes which practices serve rather than to the goods internal to practices. An appeal to the idea of narrative unity does not save the position in the absence of any concrete specification of the good life for man. Maclntyre’s attempt to reconstitute the virtues falls foul of the moral pluralism that he has earlier diagnosed so acutely.


2009 ◽  
pp. 31-60
Author(s):  
Giovanni De Grandis

- The paper analyses Thucydides's views on history, ethics and politics trying to highlight how they affect each other. Thucydides has a tragic conception of history, according to which, notwithstanding the presence of some constants, human vicissitudes are open to unpredictability and chance. This view is closely related to Thucydides moral outlook, which is interpreted as a version of moral pluralism that recognises two mutually incompatible families of values: those related with greatness and success, and those stemming from compassion and pity. Coming to politics, it is argued that Thucydides's most valuable contribution lies in his penetrating analysis of the dynamics of power and in particular in his understanding of the fundamental importance of the dialectic between stabilizing and chaotic factors. Political thought should take account of those factors and that means that historical and empirical considerations should enter political theory no later than moral ideals and normative standards.


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