Academic journal article The Hastings Center Report

On the Other Hand

Academic journal article The Hastings Center Report

On the Other Hand

Article excerpt

By my lights, those who publicly take up ethical issues often seem to claim clarity and certainty where I am most struck by ambiguity and ambivalence. It's a feature both of much theoretical discussion and of much professional and political debate. I suspect this is partly a result of underlying theoretical suppositions (which seem shaky to me) about the nature of moral reasoning and the status of moral judgments. I suppose it is also an inevitable feature of any exchange of views that bears on policy or might be subject to legal scrutiny. A person who makes a bedside decision to withdraw care from a dying loved one cannot but feel some ambivalence about the decision, even if they are convinced it is the right or best decision, all things considered, but it is difficult to express this ambivalence without seeming to draw back from the decision.

Some of the contributions to this issue of the Report are especially noteworthy, however, for the pains they take to recognize complexity and ambiguity. In one of the essays, Joseph Fins explains the recent advances in the physiology of brain injury and recovery that have complicated the process of deciding whether a patient is in a vegetative state--one of the sources of ambiguity in these cases. Fins is critical of neurologists, who misdiagnose cases of MCS as vegetative states "at rates that would be intolerable in other clinical domains," but also of right-to-life advocates and journalists, who have sometimes deliberately ignored the distinctions between the multiple disorders of consciousness. (Fins believes that Terri Schiavo, who as of this writing has just entered the seventh day since her feeding tube was removed, is genuinely vegetative.)

The feature articles in this issue also take up complexity of various sorts, and in various ways. …

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