Academic journal article The Hastings Center Report

From the Ethicist's Point of View: The Literary Nature of Ethical Inquiry

Academic journal article The Hastings Center Report

From the Ethicist's Point of View: The Literary Nature of Ethical Inquiry

Article excerpt

Contra those bioethicists who think that their cases are based on "real" events and thus not motivated by any particular ethical theory, Chambers explores how case narratives are constructed and thus the extent to which they are driven by particular theories.

Why do those of us who write about bioethics often feel it is necessary to reassure our readers that the cases which are presented are "real" or "actual" Tom Beauchamp and Laurence McCullough, in the preface to Medical Ethics The Moral Responsibilities of Physicians, state that each of the cases they discuss "is based on actual events."[1] In Cases in Bioethics, Carol Levine and Robert Veatch note in their introduction that all the cases presented "are based on real events."[2] And in the acknowledgments to Mortal Choices, Ruth Macklin mentions that "all material is taken from actual cases."[3] These declarations of authenticity, I suspect, merely reflect a general distrust in the bioethics discipline of the "hypothetical" or "fictional" case. If there is any strongly held article of faith within the discipline, it is that bioethicists deal with the Aristotelian messy "real world" and that academic philosophers spend their time in a Platonic domain of unclouded abstraction. Bioethicists confront actual cases; academic philosophers contemplate imagined ones.

This distinction has been explicitly considered and justified by scholars who analyze how cases should be used in the bioethics discipline. Dena Davis, for instance, acknowledges that fiction can provide a useful source for studying ethical problems, but she maintains that the "daily bread of bioethics" is the "real" case.[4] Furthermore she insists that these real cases keep the bioethicist honest, for "by describing real experiences ethicists can make points and draw conclusions while inviting their readers to make their own independent judgments" (p. 13). Similarly John Arras, in his discussion of the pedagogical value of casuistry, counsels against using fabricated cases

because hypothetical cases, so beloved of academic philosophers, tend to be theory-driven; that is, they are usually designed to advance some explicitly theoretical point. Real cases, on the other hand, are more likely to display the sort of moral complexity and untidiness that demand the (non-deductive) weighing and balancing of competing moral considerations and the casuistical virtues of discernment and practical judgment (phronesis)."[5]

William Donnelly also cautions against using the hypothetical case, for, "Such histories are usually constructed to illustrate the application of theory to concrete situations. The plot and characters are begotten of theory, not life, and exist to demonstrate and confirm theory."[6] For these ethicists, hypothetical cases are biased, theory driven, and constructed, and real cases are by implication impartial, theory-free, and guileless. The danger of "made up" cases, they suggest, resides in the teller's intentions to illustrate a prior theory; real cases because of their origin in actual events can question rather than support a philosopher's moral analysis. Real cases from this perspective are something akin "to what Charles Taylor calls "brute data,"[7] that is, they are objective and empirical.

Yet for the ethicist to present the data received from real life situations, he or she must present those events in a narrative; a story must be constructed. Every telling of a story--real or imagined--encompasses a series of choices about what will be revealed, what will be privileged, and what will be concealed; there are no artless narrations. All stories are shaped by a particular teller for a particular purpose, for all narratives are infected by their situatedness. Consequently the ethics case, even though it may be based on a real life event, is mediated and thereby interpreted through narrative discourse. In presenting a case, situations must be plotted, people characterized, a narrative persona assumed, and a point of view adopted. …

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