The nature of ethical expertise

Hasting Center Report

Volumn 28, Issue 6, 1998, Pages 11-19

  Yoder, Scot D ^a  

^a NONE

Author keywords

[No Author keywords available]

Indexed keywords

ANALYTICAL APPROACH; BIOETHICS AND PROFESSIONAL ETHICS; CLINICAL COMPETENCE; CONFLICT; ETHICIST; ETHICS; GROUP PROCESS; HUMAN; KNOWLEDGE; MEDICAL ETHICS; MEDICAL PROFESSION; MORALITY; REVIEW; ROLE PLAYING; STANDARD; WORK;

ANALYTICAL APPROACH; BIOETHICS AND PROFESSIONAL ETHICS;

CLINICAL COMPETENCE; DISSENT AND DISPUTES; ETHICISTS; ETHICS CONSULTATION; ETHICS, CLINICAL; ETHICS, MEDICAL; GROUP PROCESSES; HUMANS; JOB DESCRIPTION; KNOWLEDGE; MORALS; ROLE; SPECIALISM;

EID: 0032197562     PISSN: 00930334     EISSN: None     Source Type: Journal    
DOI: 10.2307/3528262     Document Type: Article

References (54)

1. Magali Sarfatti Larson, The Rise of Professionalism: A Sociological Analysis (Berkeley: University of California Press, 1977), p. x.
2. For a recent discussion of the nature of the professions and their role in American society see also William M. Sullivan, Work and Integrity: The Crisis and Promise of Professionalism in America (New York: Harper Collins, 1995).
3. See Ruth Shalit, "When We Were Philosopher Kings," The New Republic, 28 April 1997, for a more popularized critique of professional ethics consultation.
4. Cheryl N. Noble, "Ethics and Experts," Hastings Center Report 12, no. 3 (1982): 7-9.
5. Also in that issue, commentaries by Peter Singer, "How Do We Decide?" pp. 9-11;
6. Daniel Wilder, "Ethicists, Critics, and Expertise," pp. 12-13;
7. Tom L. Beauchamp, "What Philosophers Can Offer," pp. 13-14;
8. Jerry Avorn, "A Physician's Perspective," pp. 11-12.
9. Wilder, "Ethicists, Critics," p. 4.
10. Giles R. Scofield, "Ethics Consultation: The Least Dangerous Profession?" Cambridge Quarterly of Healthcare Ethics 2, no. 4 (1993): 417-26.
11. Also in that issue: John C. Fletcher, "Commentary: Constructiveness Where It Counts," pp. 426-34;
12. Albert R. Jonsen, "Commentary: Scofield as Socrates," pp. 434-38;
13. Donnie J. Self, "Commentary: Is Ethics Consultation Dangerous?" pp. 442-45;
14. Christian Lilje, "Commentary: Ethics Consultation: A Dangerous, Antidemocratic Charlatanry?" pp. 438-42;
15. Judith Wilson Ross, "Commentary: Why Clinical Ethics Consultants Might Not Want to Be Educators," pp. 445-48.
16. See also Giles R. Scofield, "Ethics Consultation: The Most Dangerous Profession: A Reply to Critics," Cambridge Quarterly of Healthcare Ethics 4, no. 2 (1995): 225-28.
17. Fletcher, "Commentary," p. 426.
18. While Shalit makes this sort of argument, it is Scofield who has articulated the concern most vehemently. See Scofield, "Ethics Consultation," p. 422.
19. Several authors have warned about the potential intentional or unintentional abuses that might result. See Noble, "Ethics and Experts," pp. 8-9;
20. Wilder, "Ethicists, Critics," p. 12;
21. Scofield, "Ethics Consultation," p. 421;
22. Shalit, "When We Were Philosopher Kings," p. 27.
23. Scofield, "Ethics Consultation," p. 417.
24. Shalit, "When We Were Philosopher Kings," p. 24.
25. Scofield, "Ethics Consultation," p. 420.
26. Fletcher, "Commentary," p. 430.
27. Jonsen, "Commentary," p. 436.
28. Lilje, "Commentary," p. 441.
29. Jan Crosthwaite, "Moral Expertise: A Problem in the Professional Ethics of Professional Ethicists," Bioethics 9, no. 5 (1995): 361-79.
30. Bruce D. Weinstein, "What Is an Expert?" Theoretical Medicine 14 (1993): 57-73;
31. "The Possibility of Ethical Expertise," Theoretical Medicine 15 (1994): 61-75 .
32. Weinstein, "The Possibility of Ethical Expertise," p. 67. Weinstein provides an analysis of moral justification in which the moral judgments are justified by moral rules that are in turn justified by principles, themselves justified by moral theories. In other words, although he acknowledges that there may be other forms of justification, he invokes a form of principlism.
33. Weinstein, "The Possibility of Ethical Expertise," p. 69.
34. Shalit, "When We Were Philosopher Kings," p. 25.
35. Ellen Fox and Carol Stocking, "Ethics Consultants' Recommendations for Life-Prolonging Treatment of Patients in a Persistent Vegetative State," JAMA 270 (1993): 2578-82, at 2581.
36. Aristotle, Nicomachean Ethics, tr. Martin Oswald (Englewood Cliffs, N.J.: Prentice Hall, 1962), p. 5.
37. Scofield, "Ethics Consultation," p. 422.
38. See Journal of Clinical Ethics 7, no. 2 (1996). A collection of articles, entitled "Evaluation of Case Consultation in Clinical Ethics," provides such a discussion.
39. Among others, see Weinstein, "The Possibility of Ethical Expertise";
40. Crosthwaite, "Moral Expertise";
41. Jonathan D. Moreno, "Call Me Doctor? Confessions of a Hospital Philosopher," Journal of Medical Humanities 12, no. 4 (1991): 183-96;
42. Terrance Ackerman, "The Role of an Ethicist in Health Care," in Health Care Ethics: A Guide for Decision Makers, ed. Gary R. Anderson and Valerie A. Glesnes-Anderson (Rockville, Md.: Aspen Publishers, 1987), pp. 308-20.
43. Dan W. Brock, "Truth or Consequences: The Role of Philosophers in Policy-Making," Ethics 97, no. 4 (1987): 786-91, at 787.
44. Ackerman, "Role of an Ethicist," p. 313. Emphasis in the original.
45. John C. Fletcher and Mark Siegler, "What Are the Goals of Ethics Consultation? A Consensus Statement," Journal of Clinical Ethics 7, no. 2 (1996): 122-26, at 125. This document was developed at a Conference of Evaluation of Ethics Case Consultation in Clinical Ethics held in Chicago, September 1995.
46. Ackerman, "Role of an Ethicist," pp. 316-18. Other authors have offered similar lists.
47. Fletcher, "Commentary," p. 430.
48. See also SHHV-SBC Task Force on Standards for Bioethics Consultation, "Draft Discussion of the SHHV-SBC Task Force on Standards for Bioethics Consultation," distributed to members of the Society for Health and Human Values and the Society for Bioethics Consultation in October 1997. This document included very similar items.
49. Moreno, "Call Me Doctor?" pp. 194-95.
50. Noble makes a similar point when she argues that moral theories which abstract from particular cases allow us to neglect "historical, social, scientific, literary, or psychological" considerations.
51. Scofield, "Ethics Consultation," p. 419.
52. Weinstein, "What Is an Expert?" p. 59.
53. This helpful observation is from Dr. Howard Brody.
54. For a discussion of the advantages and disadvantages of specialized knowledge, the connection between specialization and positivism, and the need for more integrative knowledge in the professions see Sullivan, Work and Integrity, pp. 159-90.