Reading the Medical Ethics
Literature: A Discourse on Method
Daniel P. Sulmasy
What constitutes a good paper or book in medical ethics? This important question cannot be decided merely by whether or not one agrees with the conclusion of a paper or a book! As the previous chapters should make clear, there are many fine works in medical ethics, written by talented authors employing a wide variety of methods. The best of these works genuinely expand knowledge, expose hidden assumptions, challenge prevailing convictions, make rigorous arguments, enrich understanding, or illuminate contentious issues in fresh ways. However, frankly speaking, the medical ethics literature is also filled with chaff—often sincere chaff, but chaff nonetheless. The aim of this chapter is to provide an overview on how to read the medical ethics literature critically, separating the golden grains of wheat from the inconsequential chaff.
The many methods of medical ethics make this a very challenging task. Many readers of the literature of medical ethics do not have a background in particular research disciplines. Clinicians, for example, are often keenly interested in medical ethics, yet their training rarely equips them to read studies about ethics sensibly and critically. Many scholars in the field of medical ethics read research studies conducted by scholars in other disciplines, often examining the same questions they themselves are examining. However, they may be unfamiliar with the methods and disciplinary assumptions of these, and unsure how to apply this work to their own inquiry. The editors of medical journals are often scientists for whom any paper that does not present empirical data in numerical form is considered “opinion.” They might have little experiential basis for distinguishing an editorial from a philosophical essay or a qualitative empirical study, let alone judging whether these are good or bad pieces of scholarship. In such cases, editors generally rely upon the judgments of peer reviewers. However, without sufficient background, they might even have difficulty determining who should play the role of “peer.” Finally, many persons who are neither clinicians nor scholars are interested in the writings of medical ethicists. Since the issues of medical ethics affect the lives of almost everyone, all readers of the medical ethics literature have an interest in distinguishing sound bites from sound scholarship.
This chapter provides suggestions about aspects of medical ethics research that readers might want to look for in assessing the quality of scholarship in the field. If there is to be