3.the Nature of Applied Ethics

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TOM L BEAUCHAMP BEAUCHAMP

Th t " l i d t h i" d it " t i l th i" it i h 1 97 97 0 h h i l h d th d i b t dd i l bl i it di f i l thi ( i l l d i l thi d b i t h i) P i t l th d bt i t h i th t ti fh d i l bjt i h i i f f t i ti acceptable risk in the workplace the th e legal enforcement of morality morali ty civil civil disobedi disobedi ence unjust wa r and the privacy of information information

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D i t th t ii f th t " l i d thi" i t i th t f t bjt tt tt b t d t i t ti F l li bt i t blih controversial controv ersial opinions enga ge in civil civil disobedience commit suicide suicide and choose one's religious viewpoint viewpoint are mat ters of perennial interest as are questions of of unj ust wars and the moral statu s of of animals Althou gh moral philosophers philosophers have long d i d th bl it i bl t h tht j h i l h t h h t th h i t f l h i l h h d l d thd f l id id thi M l h i l h h tditill f l t d t h i f th i h t h d d th it tht t t i th t lt A til i i i d f t hi hi t h t i l lit it i ll h hth d if h th i t b lid t t bli li ttl l bl d d t i t i l It is is not obvious t ha t applied ethics is is the offspri offspring ng of or even depende nt upo n general moral philosophy philosophy Its early succes successes ses in the 1 970 s owed more to a rgume nts directed directed at pressing and emerging mora l problems problems in society society tha n to tradit ional theor i f th i M idiidl i l h i l h i l dt h l i l t hi l it il th d th f i i l d i d ii ii b i i i d itifi h d d d th i Th idiidl f d l ff td b i th id it di i d i i d l li bt i il lit d i f f b dij t i d i t d t l b l Th i i d b iil i ht ' i ht i l i h t th t th i t l 1

TOM L BEAUCHAMP

t d th i h t f i d th t l l ill ft i l d d thil issues that stimulated the imagination of philosophers and nonphilosophers alike (A volume that nicely illustrates the state of one area of interdisciplinary ethical inquiry around 1970 is the massive compendium on research involving human bjt t it ld Experimentation with Human Beings [K t 1972]) I th l t 1960 d l 1970 h i l h i i l it t t ith l f th d i i l i h i t t d i l bl ldi th f th h l t h f i l b i i i d th il d b h i l i P h th t i f l t i l f l d i th d l t f hl l litt i l i d thi l d l h i l h M bl f applied ethics have since been framed in the vocabularies of these two disciplines This is not surprising since moral philosophy and law have common concerns over matte rs of basic social importance an d share various principles requirements and iti f id L i i t th bli' f t l t i lit i t l ii t il i dl i d ti df tilti i h t f ff C l i til h idd d t db i t i l tht i f l t i l i ll f l i d thi D i t h 1 97 0 d l 1 98 0 b f h i l h b t fhi their careers around interests in applied ethics an almost unprecedented develop ment in a profession generally skeptical that "applied ethics" was either a scholarly enterprise or had a future in the university The late 197 0s and early 198 0s saw th bliti f l b k d t d t h i l h i l t t t f bjt l i d thi Vitll b k bl i hd i l i d thi i t th l t 1970 h d b i d t i l l th th i t f l i i l h i l h i l t h i Thi i t t i h d idl i th l t 1970 d 1980

Problems of Definition M

h i l h h i d l i d thi th t t t t i l t ith l l l lt h i ith t h l f li til bl Th th t d l i t l tht b d t i th l bl H it i t d ll td tht t i h t f d t t til j d t i ibl b l ith t l t h i t l l i i l ( h "O ht t t t t l t th d f t h " "O ht t k i " "O ought not to inflict harm or risk of harm;" "One ought to treat people fairly and with equal respect;" and "One ought to respect the auto nomy of others") This s the socal led gap between theory and practice Theory and principles must it b l t d i b di f iht ti i i l dt i t i l i d th lik B t i i l hi h ( )? Thi ti hl h " l i d thi" i d i ff l t ti t d t d d d f A d i l it d b t f l tht l i d thi i b t d f d th li ti f l thil t h i t til l bl ( h l th d f i t i 2

THE NATURE OF APPLIED ETHICS

ffd b G t 1982 5 1 2 ) Thi d f i i t i i tht ill t recognize it as reflecting either the appropriate method or content of applied ethics A weaker and more defensible view is that "applied ethics" refers to any use of philosophical metho ds to treat moral problems practices and policies in the f i t h l t d th lik Thi b d k i t t t th l f l t h i i i l d d t i i t b l l i th l It b th t d t d i f th t ithi th f i f h i l h b t it ld b i d t id h i l h flti i i f i t di il i bi A d i f f t bi i f d i th id th t " l i d thi" i ith "professional ethics" Problems such as the allocation of scarce medical resources unjust wars abortion conflicts of interest in surroga te dec isio nmak ing hat e crimes pornog raphy war and terrorism whis tleb lowi ng the entr apme nt of public ffiil i t t i l jti h i l d th fidtilit f t i f t i t d b d f i l d t t ll t i i th d i f l i d thi Th t l ti b t th t f " l i d thi" l d t idti f b t h th t t d th thd f l i d thi

Problems of Moral Content Th

i f l t i l t f h d i th l i t t th it f t t i l i d thi i t l t t l t d i d i t l t l t Th t i fit f h i d f th l i f f i l thi b t th b lid t th h i t i t t i l d thi f ll t Th fit d f d thi d i d f f i l i t i t t i l ti t d d Th d it i tht t i tti f l i d t hi l d i jtifiti b external standa rds such as those of public opinion law the common morality religious ethics and philosophical ethics The third claims th at distinct forms of til thi internal t f i d ititti t h l d l i f l d b b d ( t l ) l t l f k Internalism

S

h i l h h i t i d th t tb li hd ti id th i f t i l thi I f l t i l i thi l i t t i Aldi M l t ' f "practice" to designate a cooperative arrangement in pursuit of goods that are intern al to a structur ed comm unal life He holds th at "goods intern al to a practi ce" such as those found in the professions are achievable only by engaging n the ti d f i t it t d d f ll S t d d i t l t th f i t h f d t i h t it t b d titi E h f i h hit d ifi h t tht ti td it i ii f i l t l t i t it i t (M lt 1984 17 175 187 1 9 02 0 3) H d B d d F k Mill ff f f i t l i t li th f d t i f d i l thi 3

TOM L BEAUCHAMP

Physicians by virtue of becoming socialized into the medical profession accept alle i t t f l l h i h dfi th t f dil ti Th l i ri t t l t f th l dti i b t h i i i t hi f i l l d i d i t th i t t h i i Th professional integrity of physicians is constituted by allegiance to this internal morality (Brody and Mill 1998 386) These writers and others like them main tain t ha t moral frameworks in the profes sions derive from rolespecific duties and professional virtues N bl d i t t h t f i l l i t l bliti didl H i t l lit t i l tb d t l h i h t ll t b l Tr d i t i d f i l t d d t f l d d f t t l f i l d i d ii b i j l i i i d th fild ft ilif l i t k th i d f i b l i id li lt d th ity th an they are entitled to claim Brody and Miller address this problem by distinguishing between the core moral norms appropriate to a profession and the dogmatic and unsystematic provisions f d i d f f i l thi A th it i t l lit d h l d l i th f f il h "Even the core f dil lit t b th ht fl l l t d d t t d t i t l d th t t i ill b id t b th h li i d it h i i t b l i f l d b itl l th i t t th h i t " ( B d d Mill 1998 3 9 3 4 3 97 h i ddd) T h h t thi i i ftl t i t l i It h tht i t l t d d may be shallow and expendable wherea s some external stan dards are deep and essential Even curr ent practice standar ds might be weak and insupportable We also know from recent history that a meaningful reconstruction of traditional pro f i l di t i t t i l liti t dt l t l h i likl t b l t th i t l t d d f f i l lit C i d thi h i t i l l I th l t 1960 th b k A Time to Speak: On il h l i t H b t Kl b Human Values and Social Research b lihd j t b f t i l f d f b fh bj t b il i t i t (Kl 1968) K l ' b k d th f t i d k ll l t i il i t i t t th f t t h t th hd i d f i i i in standards of research ethics Careful attent ion was subsequently paid to the moral judgments that psychologists should make in carrying out their research and to the man y defects of standa rds in the th en prevailing practices Problems were f d i ti h th i t l d t i f bjt th llt i f dt i i d i i d l l id ti fi bl f d th f fiil i ti t bti bjt It b l t h t th ili ti t d d d t t dd th ti Externalism

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tht ti l t t th f i t l lit P bl i ii law religious insti tutions and philosophical ethics hav e all served (whether justifi ably or not) as sources of external morality One influential answer in philosophy to the question of which external source is t i t i t h t t h i l th id t h it b i f lid thi A l i f d i th k fB d G t dD Cl Th i t i th t t k dj d t i l i d thi th t b " i l i f d t h i l t h " Th l f t h i th i t id " f k h i h ll f t h d i t i ti " d t i " i d i t tht tititil ll l " Th b l i t h t t h i th will alert at tentive persons to issues of applied ethics identify t he morally relevant features of circumstances determine the difference betw een morally acceptable and unacceptab le solutions to problems and show which conditions are necessary and f f i t t j t i f th ilti f l l (Cl d G t 1 99 0 2 3 1 2 f G t t l 1 99 7 3 6 15 19 ) G t d Cl d t h l d t h t th i l li it t l t d d f f i l thi O l t h i th d ll th t h i f tl l f l d di b l f d di P t f th t h i ll assume a similar partisa n stance Independent of this confusion over whet her one particula r theory is morally authoritati ve it is often unc lear whe ther a nd if so how a philosophical theory is to be used to criticize internal standards or address a diff ilt l bl If ld b fidt tht t h i l th li d h b t b i ld k t t i l til d li ti b i l ki th i t h t th ifi H t t h h th d l it tht th f t hi d i ti i l ik l t Bt h ithi d itht h i l h th t h i tht i f t t d th th i t t f th il lit f h i h th i E if idiidl i i d th t til theory is correct (authoritative) he or she needs to deal responsibly with the fact that other morally serious and informed individuals reject this conviction Skepticism about the practical relevance of theory is not surprising in light of the f t th t h i l h h tditill tid t li d jt if lit t lif l t t i h lj d t d t d d t b i i i l f l t t ti t h i t l til l bl d l i t d f f i l thi G l t h i ill i t d ll itd f til kb th dd h i l h i l bl t ht i t h l d i d f ti Althh b t l ity philosophical theories are primarily attempts to underst and or unify morality not attempts to specify its practical commitments Mixed interncdism and externalism

A thid t f h t th t t f li d thi i bth i t l i d t l i It t t ith th i ti t i l t d i difft i di lt f th f i d th t t d i t i t t i b d b

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TOM L BEAUCHAMP

fid t l b th i b h i ( i t l l it ) b t l b th moral standa rds of the broader culture or communit y (an external morality) The authority to practice is itself granted by society on the condition that its professions and institutions will in a responsible manner be educated in and adhere to the high l t d d td b tht it If f i d ititti td t f thi ti t h t th ili l l f th l it ill b h d i ti Th il t d d di t th t ti ill f it t it I t l liti i t h f i ill dil b th i i i f i t d d t th t l liti A theory of this description ha s been advanced by H Tristram Engelhardt He holds that profound disagreement exists about the nature and requirements of professional practice across larger communities such as Orthodox Judaism Roma n C t h li i Hidi d l h i There is no way to discover either a canonical contentfull secular morality or the t ll ttfll lt i t t h th t b d b th lit f h d l ii t ht bid lf i d M l t d t see the world in the same way Moral strangers [cannot] resolve contentfull moral t i b d t i l t M l fid th th h d di idl h d h h i i (Elhdt d Wild 1994 136 l 13547) A d i t E l h d t tt fl l lit di ff t iti Th t l k f Ot hd Jdi f l d t i ht i t bl tbl l f tht ti f th J i h ti hih t it dititi F thi ti l t d d f h t i blit d permissible for professionals in medicine politics law and business derive from t he more general moral commitments of a larger community beyond the narrower community of professionals Th d lthi t k i thi t i k t i l th b t t i f d t i f l l id thi d lki h f d t i th f d t i f t f l i d thi th th h i t i l t i iti N i t l lit it t i th t l lit f til lt ( E l h d t d Wild 1994 1 3 7 8 E l h d t 1 9 9 6 1 0 5 2 4 ) Thi t h i i h t it th l ti bt t l d i t l liti b t it h k B h i i d i i t it i t overlook basic similarities; th at is to neglect the core of nea r identical mor al goals interests and commitments th at exist amo ng we lltr ai ne d professionals from differ t l t l b k d F l h i i ll th ld h l d t h i fhli lliti h bi li tt i i d i f t di ti t t i d th lik Th i h d l i i t (h iitd) d h d f f i l ti th iti P d i l l thi th "th iti f Th th ii 6

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ff i d hih bl tbl d li bl t di th l f th professions and professional ethics However in communities of almost any size there exists a pluralism of viewpoint These communities are not lacking in sub groups with different moral points of view and hopes to revise prevailing conditions ti d d C h i i t f b i t i d t i i d t i liti th lti f ii l i h t d t h lik k f f l id i t th iti ith t dt l iti At h k i t h t thi i d i t l i t t l i t t f f ti l ld l t l th t i it j d t Th lidit f l dj d t d d i thi t thi d t b nity; no trans cende nt principle war ran ts cros scu ltu ral appraisal It follows th at there are no universal hu ma n rights that protect individuals Hum an rights are by definition valid claims that are justified by reference to morally relevant features of h bi tb f t l t d d It i l d i f f l t t h i thi th ll td bli li i t b f h i d i lli ti i t It i t h thi th tf i t lii i i t ititti b t it i b i l i t t li tif d iti i bli li k it t ft h ith th d ld d bl t apply ethics to our deepest social problems

Problems of Method and Justification S l dl f th d ti lld th d dl f tifti h b d i d i l i d thi Th f th t i f l t i l dl t t d i thi ti Th fit dl h jtifiti d thd f t d ti t h t h i l d t h i l th Th d approaches justification and method from a bottomup perspective that emphasizes moral tradition experience and particular circumstance s The third refuses to assign priority to either a topdown or a bottomup strategy Top-down models

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TOM L BEAUCHAMP

t d i t i l ti i t i t t i l l d j d t Whil h i th moral life conforms roughly to this conception of moral priority mu ch does not There are several problems with this mor alp rior ity thesis First moral judgme nts in hard cases almost always require that we make the norms themselves more ifi ( th ti "P bl fS i f t i " b l ) bf bi til i t d i l i i l I th f i fi di ki til j d t ft t tk i t t f t l blif b t th ld l t l tti j d t f likl t d i d t t h l fill t d i iht t l i i l d t h i Th i l l i i t i th S d th f t f itti also be such t ha t no genera l norm (principle or rule) clearly applies and th e differ ent moral norms that can be brought to bear on a set of facts may yield inconclu sive results For example destroying a no nv ia bl e hu ma n embryo or fetus does not l l ilt l i t killi d d th l tht h iht t t t bdil i t i t d t l l l t thi l i E if h f t t i h t th h i ff t d th h i f l tht d l t ill t j d t t ht i i t i b l ith th ' hi ff t d l Slti th i h t t ff t d b i i th right set of rules to bear on these facts are not reducible either to a deductive form of judgment or to the resources of a general ethical theory The to pdo wn model also creates a potentially infinite regress of ustification a di d d f fil jtifiti b h l l f l t i t i hi h l l t j t i f it If t d d jt if id til b h t d jtifid i t it ld th ti f thi h t h t th jt if id i i l j d t I th ld h d l thi bl b ti tht i lfjtifi t h t it i i t i l t t hl d b t f tht thi t t d t h t th j t i f ll th i i l d l i t d d th t t thil theory is well equipped to meet Bottom-up models

S it i l i d thi t thi ttti l h til d i i d th th l i i l d t h i Th bli t ht l i d jtifiti d bt t t t d Th it t f iti il t d ti i i h t d i l d ti l i th t t i i t f hi h common ly make moral decisions They also depict an evolving structure of moral beliefs based on exemplary lives and narra tives experience wit h har d cases and analogy from prior practice Btt dl ttill i l d ldi ti t t h d l i C i t h b th t idl d i d i l i d thi bt i f f ti t i l i d th thd l lif P t f th h l i i l d i t i i th d fk l d t i T h t i th i f t i d iht f i i l d i f i l t l i til i t (J dT l i 1988) F l h i i 8


dd ith di i l i f i t h l i f tit t f i missible killing But progressively after dealing with ma ny agonizing cases they and society came to frame many of these acts as forms of permissible allowing to die or even as morally required acts of acknowledging refusals of tre atmen t All practical l l b t killi d lt ti di i d f d ti th b th i i l l it i l t l ti f i dl i A it' l i fid thi tt h h bddd l tdi ti d t f d tht it d f t i i h t d j d t A l t th thit ti i l i ti id t b t th h t f thi thd h th d i i f jit fj d b thitti i case the judgmen ts in their decision are positioned to become a uthorita tive for o ther courts hear ing cases with similar facts Defenders of bo tt om up reasoning see moral authority as analogous: social ethics develops from a social consensus formed d hi h th b t d d t itht l f th ltd l id A hit f iil d iil d t t it b i i l f d t i it l l i d k l d liti ( l i i l ) i it li t di ti f thil flti Case analysis which is central to casuistry has long been used in law schools and business schools Train ing in the case meth od is widely believed to sharp en skills of legal and business reasoni ng as well as mora l reasoning One can te ar a t d th t t btt f t t i iil itti I th t h t d l tti t h d t d t lik h l i b t ih t d b t t i Th bjti i t d l it t bl d t fd l lti tht k i th t t k i h t d ti i d th k i tht thi i th th b i f f d t i l l Th th d i l h t b d t d t f l i ble facts and judge the weight of evidence enabling the transfer of th at weight to new cases This task is accomplished by generalizing and mast erin g the principles tha t control the transfer usually principles at work in the reasoning of judges Use of the th d i b i h l i f idl f d t i tht t th t d t i th d i i k i l ft i it il i i i t th f t f l itti H th f th thd i t t itti lt i th t h f t ii d jdi tht iht t dt fd f ki it d i i i h i t A ith t d t h i i bl li i it f d f d f btt up theories First defenders sometimes write as if paradigm cases or particular circumstances speak for themselves or inform moral judgment by their facts alone Clearly they do not To move constructively from case to case or to atte nd to th e l t f t f til itti i d l f l l t t th itti Th l i t t f th itti bt th f i t t i d liki i tt i All l i l i i ti t i d i t tht bjt t i ik lik th i l t t Th ti di f th i t l i k i t b h i d b l i t lf B tt t 9

TOM L BEAUCHAMP

t h f t i i l l i til l l ents in the case or set of facts at hand "Paradigm cases" and "morally relevant features of circumstances" seem to com bine facts th at can be generalized to othe r situations (for example "The employee bl th hitl th l " ) d ttld l (f l " K l d b l l h iht t di l th di f th l " ) Th ttld l ltill ditit f th f t f t il Th l th t l l ti th l th t th t t f l i i l l Btt t l t bl h th it fliti l gies judgme nts and case interpreta tions Defenders stress tha t cases and partic ular circumstances point beyond themselves and evolve into generalizations but they also may evolve in the wrong way if they were improperly grounded from the t t B tt t h l t h d l i l t t b i d d l t f l t f l t f t f Th bl l d t ti b t th j t i f i t f th t H d jtifti ? I it l b il ti d l ? Miht t difft l i d l t ti "iht" ? With out some stable framework of norms the re seems to be a lack of control over judgment and no way to prevent prejudiced or poorly formulated social conven tions This criticism is a varia nt of the muchd iscu ssed problem that bo tt om up t l k i t i l dit f l t l blid h l d l ii Idtifti f th ll l t f t f d d th h k j d t b t d th idiidl ld t f t il it d i i bi jdiil f l th t i h k d b tb l t fi t i l i i l dh i ht Th h t f th bl b t h t th t t thd itht t t tht i t l ft h h t tht d i l th f d t l i t f comparison and analogy in moral thinking but th at lacks initial moral premises It is certain that we reason morall y by analogy almost daily and we are often confi dent in our conclusions However such analogies also often fail and analogies t li ft t h t i t Thi t h d th l ith t h bl tht tt h ti t i t ii ti ll h if f th f t i t t t th t i th d i t i l d d fl t t t Coherentism

"The to p" (principles theories) and "the bottom" (cases partic ular udgments) are bot h now widely regarded as insufficient resources for applied ethics Neither gen l i i l til i t h ffiit t t l i ith t h dd l i bi li t P i i l d t b d if f d l i d i l l i t i f l i i l I t d f t d btt dl t i f th dl i l f d t "fl ti ilibi" d " h t h "

10


Jh R l ' l b t d t f "flti ilibi" h b th t influential model of this sort In developing and maint ain ing a system of ethics he argues it is appropriate to start with th e broadest possible set of considered mo ral judgments about a subject and to erect a provisional set of principles th at reflects th Rfl ti ilibi i i t i t i i thi ( d th t t i ) flti tti f l i i l t h t i l t l t d th l t l b li f t k th h t ibl " C i d d j d t " i t h i l t f i t j d t i hih l blif d iti t likl t b td itht ditti bi E l j d t b t th f il d i i i t i li gious intoleran ce terro rism tor tur e and political conflicts of interest These con sidered judg ments occur at all levels of generality "from those about p articular situations and institutions through broad standards and first principles to formal d b t t diti l t i " E th i d d j d t tht t " i i l l fid it " R l " l i bl t i i " Th l f fl ti i li bi i t th d djt i d d j d t i d t d th h t ith th i f t l l i t t W t t ith d d t of moral lightness and wrongness and then constru ct a more general and more specific account th at is consistent with these paradigm judgments rendering the m as coherent as possible We then test the result ant act ion guid es to see if they yield i h t lt If d j t th id i th d th W ltl tbl ilibi th i d djti b td t t i l l ( R l 19 71 20ff 4 6 5 0 5 7 9 8 0 [1999 d 17ff 4 0 5 5 0 8 9 ] 1996 8 381 384 399) T tk l i th thi f t l t t i i i t ht t t t d t h ft lii (1) d i t i b t b td b f f i l (i d t i i th b f i i l t f th d ) d (2) distribute organs by time on the waiting list (in order to give every candidate an equal opportunity) As they stand these two distributive principles are not coheren t because using either will unde rcut or even eliminate the other We can reta in bot h (1) d (2) i th f fi ditibti bt t d ill h t i t d liit bth i i l t t h ith t fh t if i t t d bl th i t t i t th i t t Th liit d t ill i t h t b d h t i th t h i i l d l h di d i i i t i i t th l d l d th l f bilit t i j t h f th l l t i f i dil d We have no reason in applied ethics to anticipate that the process of achieving moral coherence will either come to an end or be perfected A mora l framework adequate for applied ethics is more a process than a finished product; and moral bl h d l i th t itbl t f t d d it ib ti h l d b i d d j t i d f t i l d j t t b flti i l ib i W h l d i l i d t hi tht f di h f i h d f l itti t h t h ll t lf k ( R l 1971 1 9 5 2 0 1 [1999 d 1 71 6] )

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One problem with this general model is that a bare coherence of norms never provides a sufficient basis for justification because the body of substantive udgments and principles that cohere could themselves be morally unsatisfactory This points to the great importance but also the great difficulty of starting with considered judgments that are themselves morally justified These considered judgments presumably will have a history rich in moral experience that undergirds our confidence that they are credible and trustworthy; but how is one to justify such a claim in the case of any proposed set of considered judgments? After all the persons codes institutions or cultures from which the premises descend may not themselves be highly reliable For example the Hippocratic tradition the starting-point in medical ethics for centuries has turned out to be a limited and generally unreliable basis for medical ethics In addition vagueness surrounds the precise nature and scope of the method of appeals to coherence A philosopher seeking coherence might be pursuing one or more of several different interests: evaluating public policy constructing a moral philosophy improving his or her personal set of moral beliefs and so on The focus might be on judgments on policies on cases or on finding moral truth It is also not clear how we should and should not achieve coherence or how to be sure that we have done so In light of the differences in the models explored in this section and the diverse literature in applied philosophy it is questionable whether applied ethics has a distinct method or type of justification Applied philosophers appear to do what philosophers have always done: they analyze concepts examine the hidden presuppositions of moral opinions and theories offer criticism and constructive accounts of the moral phenomena in question and criticize strategies that are used to justify beliefs policies and actions They seek a reasoned defense of a moral viewpoint and they use considered judgments and moral frameworks to distinguish justified moral claims from unjustified ones They try to stimulate the moral imagination promote analytical skills and weed out prejudice undue emotion false authority and the like From this perspective differences between traditional ethical theory and applied ethics can be easily exaggerated In philosophy journals that publish both applied and theoretical work no sharp line of demarcation is apparent between the concepts and norms of ethical theory and applied ethics There is not even a discernible continuum from theoretical to applied The applied-theoretical distinction therefore needs to be used with caution (Beauchamp 1984: 514-31; Gert 1984: 532-48)

Problems of Specification It is now generally agreed in literature on the problems addressed in the previous two sections that specific policy guidelines and truly practical udgments cannot be squeezed from abstract principles and general ethical theories alone Additional content must be introduced from some quarter General theories and principles f used at all must be made specific for contexts; otherwise moral guidelines will be empty and ineffectual The implementation of these general norms must take account of feasibility efficiency cultural pluralism political procedures uncertainty 12


b t rik li b difftd ti l dil d th lik I short theories and principles must be specified for a context Specification should not be understood as a process of producing general norms; it assumes they are already available It is the process of making these n orm s t t h t th ifl l id d t Sifiti i d i th i d t i t f th l t i th i d ti idi it hil t ii th l i t t i th i i l Filli t th i t t f th it h h i h t t i lihd b i th f th t l b lii h t th l Th i d H Rihd t it b " l l i t where whe n why how by wh at means to whom or by who m the action is to be done or avoided" (Richardson 200 0: 289 ; see also Richardson 1990 : 2 7 9 3 1 0 ) For example wit hou t further specification the principle "respect the auto nomy of t t " i t t h d l litd bl f ht t k f i l ii l d ii d h i l i h bjt A d fi iti f " t f t " ( " l l i t t t i thi libt riht") iht lif ' i bt ld t th l d it if S i f t i i d i f f t ki d f lli t th analysis of mea ning It adds con tent For example one possible specification of "respect the autonomy of competent persons" is "respect the autonomy of compe tent persons after they become incompetent by following their advance directives" Wh i th f thi til ifti b t l t d if fil ti i l i d diti ld if f t h f ll " R t th t f t t (ft th b i t t ) b f l l i th i d diti if d l if th d i t i l d tii t th i t t h d " A th bl th f ifi ti ill ti Tht i l d ifd l id li d lii ill b fth ifd t h d l l i t Thi i specification is one way to practice applied ethics and it may be the best way In progressive specification there must remain a tran spar ent connection to he initial norm that gives moral authority to the string of norms that develop over ti Th i l th ibilit f th ifiti bi bl d it i ibl t h t d i f f t ti ill ff d i f f t ifti Th ti ifti ll b ttti d jtifibl Of t ll ifti jtifibl Th t f f i l iti (i thi d l ii d j d t ) h ft b t d i th h b b i d d l f t t i P f i l thrit i thi way protect shoddy moral reflection In the process of specification overconfidence in one's specifications is a mora l vice th at ca n have profound consequences Moral disagreement in the cour se of formulating specifications is inevitable n t t I i b l t i d i l t i l ti i ft i it l l ti t b ffd bt l t t i i fi ti d t b tt f t th th i th t t i hih flti ff l t t i lti t til bl Thi b t i tk t th bjt fh h l d i itti i hih l l i t d d d i i dk l d b l fid t h l i d i t 13

TOM L BEAUCHAMP

Problems of Conflict and Disagreement Moral disagreements emerge in the moral life from several different sources These include disagreements over which specification is appropriate factual disagreements (for example about the level of suffering that an action will cause) conceptual disagreements scope disagreements about who should be protected by a moral norm (for example whether fetuses or animals are protected) disagreements resulting from a genuine moral dilemma disagreements about which norms are relevant in the circumstances and disagreements about the weight of the relevant norms in the circumstances It should not be presumed in a context of disagreement that at least one party is morally biased mistaken or otherwise deficient Conscientious and reasonable moral agents who work with due diligence at specification and reasoning about moral problems sometimes understandably disagree The parties may disagree about whether religious values have any place in political affairs whether any form of affirmative action is viable whether physician-assisted suicide is ever acceptable and dozens of other issues in applied ethics When evidence is incomplete or different sets of evidence are available to different parties one party may be justified in reaching a conclusion that another party s justified in rejecting We cannot hold persons to a higher standard than to make judgments conscientiously and coherently in light of the relevant basic and specified norms together with the available evidence Of course tolerance for some norms rightly has its limits The method of specification offered in the previous section needs enrichment by an account of moral justification that will help distinguish justified and unjustified specifications The models of method and ustification discussed in earlier sections may be our best resources in this endeavor but if so these resources stand in need of further development to be of real practical assistance in applied ethics

Conclusion A robust confidence in and enthusiasm for the promise and harvest of applied ethics is far from universal Many are unconvinced that traditional philosophical ethics or contemporary ethical theory can play any significant role in case analysis or in policy or professional contexts There is for reasons discussed throughout this chapter skepticism that philosophical theories even have practical implications (or applications) However these suspicions may rest on misconceptions of the nature of applied ethics No morally serious individual doubts the importance of the issues treated in applied ethics and virtually everyone familiar with work in the field can cite some examples of outstanding applied work The better view is that adequate conceptions of the method and moral content of applied ethics remain a project n the making

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References Beauchamp T L (1984) On eliminating the distinction between applied ethics and ethical theory The Monist, 67: 514-31 Brody H and Miller F G (1998) The internal morality of medicine: explication and application to managed care Journal of Medicine and Philosophy, 23: 384-410 Clouser K D and Gert B (1990) A critique of principlism The Journal of Medicine and Philosophy, 15: 219-36 Engelhardt H T (1996) The Foundations of Bioethics, 2nd edn New York: Oxford University Press and Wildes K (1994) The four principles of health care ethics and post-modernity In R Gillon (ed) Principles of Health Care Ethics, pp 135—47 London: John Wiley Gert B (1982) Licensing professions Business and Professional Ethics Journal, 1: 51-60 (1984) Moral theory and applied ethics The Monist, 67: 532^48 Culver C M and Clouser K D (1997) Bioethics: A Return to Fundamentals. New York: Oxford University Press Jonsen A and Toulmin S (1988) The Abuse of Casuistry: A History of Moral Reasoning. Berkeley CA: University of California Press Katz J with Capron A and Glass E S (1972) Experimentation with Human Beings. New York: Russell Sage Foundation Kelman H (1968) A Time to Speak: On Human Values and Social Research. San Francisco: Jossey-Bass Maclntyre A (1984) After Virtue, 2nd edn Notre Dame IN: University of Notre Dame Press Rawls J (1971) A Theory of Justice. Cambridge MA: Belknap Press of Harvard University Press (rev edn 1999) (1996) Political Liberalism. New York: Columbia University Press Richardson H S (1990) Specifying norms as a way to resolve concrete ethical problems Philosophy and Public Affairs, 19: 279-310 (2000) Specifying balancing and interpreting bioethical principles Journal of Medicine and Philosophy, 25: 285-307

Further reading Advisory Committee on Human Radiation Experiments (1996) Final Report. New York: Oxford University Press Altaian A (1983) Pragmatism and applied ethics American Philosophical Quarterly, 20: 227-35 Beauchamp T L and Childress J F (2001) Principles of Biomedical Ethics, 5th edn New York: Oxford University Press Brock D W (1987) Truth or consequences: the role of philosophers in policy-making Ethics, 97: 786-91 Daniels N (1996) Wide reflective equilibrium in practice In L W Sumner and J Boyle (eds) Philosophical Perspectives on Bioethics, pp 96 -1 14 Toronto: University of Toronto Press DeGrazia D (1992) Moving forward in bioethical theory: theories cases and specified principlism Journal of Medicine and Philosophy, 17: 511-39

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Dworkin R (1993) Life's Dominion: An Argument about Abortion Euthanasia and Individual Fd Feinberg J (1984-7) Th Ml 4 vols New York: Oxford UniverLiit f th C i i l L sity Press Freeman E and Werh ane P (eds) (1997) Dictionary of Business Ethics Cambridge MA: Mthil hy 20: 222-34 Macln tyre A (19 84) Does applied ethics rest on a mistake? The Monist 67: 498- 513 Alid Ethi i Tbld Wld Dordrecht: Kluwer Rachels J (1990) Created from Animals: The Moral Implications of Darwinism New York: Oxford University Press Mtt f Lif d Dth N I t d t E i Ml Philh 3rd edn New York: McGraw-Hill Reich W (ed) (1995) Encyclopedia ofBioethics 2nd edn New York: Macmillan

Alid Ethi A C i t Ethi (1993) P t i l Ethis 2nd edn New York: Cambridge University Press Sugarman J and Sulmasy D P (eds) (2001) Methods in Medical Ethics Washington DC: Sunstein C ( 1993) On analogical reasoning H d Winkler E R and Coombs J R (eds) (1993) Alid well

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106: 741 -91 L Riw Cambridge MA: BlackEthi A Rdr

3.the Nature of Applied Ethics

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