Healthcare as a Relational Practice: A Hermeneutic-Pragmatic Perspective

Abstract

Bioethics is often presented as a pragmatic enterprise. A characteristic of bioethics named by virtually all authors writing about pragmatism and bioethics, including Schermer and Keulartz, is its practical orientation (Wolf, 1994; Fins et al., 1999; McGee, 1999; Moreno, 1999). One may however raise doubts about the pragmatic nature of bioethics. Bioethics has started as a critique of medical technology, emphasizing the need of setting limits to the application of technology in order to do justice to the patient’s perspective. In order to promote the patient’s perspective, bioethics has developed a specific concept of patient autonomy. The patient is seen as an individual who makes conscious decisions on the basis of given values, rather than as a part of a social network aimed at addressing practical problems. This view of decision-making in medical practice is not very pragmatic. A practical turn in ethics does not suffice to say that bioethics is pragmatic, nor does it by itself result in the development of ethical concepts that would do justice to the practical nature of moral life.