Finally, another question: In using the model of biomedical ethics for moral education, do we sacrifice too much? After all, the value of thinking with cases in biomedical ethics is still unproven. Does thinking with cases leave us with unmanageable and ultimately unintelligible moral judgments? Are we trapped in particularity, like the professor in Gulliver's voyage to Balnibarbi?
. . . since words are only names for things, it would be more convenient for all men to carry about them such things as were necessary to express the particular business they are to discourse on . . . many of the most learned and wise adhere to the new scheme of expressing themselves by things; which hath only this inconvenience attending it; that if a man's business be very great, and of various kinds, he must be obliged in proportion to carry a greater bundle of things upon his back, unless he can afford one or two strong servants to attend him.5
Skepticism -- an array of questions -- is, for the moment, the final word. In the effort to make moral sense, it is perhaps more salutary than certainty. Hence, thinking with cases suggests its lesson, an offering of humility that is the lasting benefit of doubt. So we are left with the skeptic's question: Is what we learn in the clinical situation transferable, and if so, ought it to be transferred? The answer awaits the effort.