Abstract
The field of bio- or medical ethics continues to show serious distress, appearances to the contrary notwithstanding. Not that such news will, I dare say, cause many tremors in the landscape of medicine or health care. What with the upheavals brought on by the open shift to commercializing health care—and the threats to the autonomy long enjoyed by many health professionals, physicians in particular, now experiencing the real anguish implicit to functioning as gatekeepers (Pellegrino ED, J Contemp Health Law Policy 2:23–45, 1986)—there has been quite enough to preoccupy physicians, researchers and others in health care’s increasingly embattled demesne.
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Notes
- 1.
It is not insignificant to note that from meager beginnings in the early 1960s in the United States, this ‘field’ quickly became an international phenomenon of the first order: often required in some form or other by hospitals, physician groups, even governmental agencies, world-wide. A stunning development in the essentially socially conservative field of education alone, this development is all the more remarkable for its general acceptance in public arenas everywhere (Pellegrino and McElhiney 1981).
- 2.
Although not cited by him, one hears faint echoes of Alasdair MacIntyre’s analysis of the moral confusion of our times. (MacIntyre, After Virtue, 1981).
- 3.
Of course, even Scofield would have to make a list of exceptions to this typical sort of claim: no children, no one believed to be mentally disabled, etc., would be admitted into this charmed circle, not even by the most devout egalitarian. And, this lands him in the same paradoxes already familiar to most of us: how ‘to draw the line’ demarcating inclusion and exclusion? Scofield neither raises nor hints at how to handle the problem he himself presents.
- 4.
I presume, too, that this view implies that Jonsen is opposed to Fletcher’s proposal.
- 5.
Especially acceptance in the world of clinical and academic medicine. I recall being stopped in the hall by the Dean of Medicine at Vanderbilt, not for a question for so he could observe, somewhat slyly, that ‘ethics is the first new program at Vanderbilt in more than 36 years!’ To his subsequent wink and smile I could only respond, ‘What? I’m a ‘program’ and not just a professor?’
- 6.
Despite his disclaimer of the term, quite clearly Jonsen does regard himself as a “consultant”.
- 7.
It should be noted that just this seems in some instances the pathos of the illness experience: wanting to know while precisely that is just what may not be knowable. People living through terminal illness often display just this profound enigma: why is that I must die? Why does cancer kill—not just kill, but kill me? Sick people do want to know, but it may not be at all clear just what it is that they want, and need, to know.
- 8.
This might possibly even qualify as one of those elusive phenomena, a ‘principle’.
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Zaner, R.M. (2015). Responsibility in Clinical Ethics Consultation. In: A Critical Examination of Ethics in Health Care and Biomedical Research. International Library of Ethics, Law, and the New Medicine, vol 60. Springer, Cham. https://doi.org/10.1007/978-3-319-18332-9_7
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