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What’re your Qualifications?

8 Feb, 11 | by Iain Brassington

“I’ve never read a more outrageous job advert,” says a colleague’s Facebook update, in reference to this from Georgetown University.

Georgetown University is seeking outstanding candidates for the position of Director of the Center for Clinical Bioethics at Georgetown University Medical Center (CCB).  The CCB Director will report directly to the Medical Center’s chief executive officer, the Executive Vice-President for Health Sciences and Executive Dean of the Georgetown University School of Medicine.  The Director will ideally possess an MD or equivalent medical training with additional graduate training in theology and/or philosophy.  The Director must have an international reputation for scholarly and professional achievements, along with a strong commitment to the advancement of the humane, theological, philosophical and ethical dimensions of medicine.  The Director should command the respect of peers from a variety of religious and non-religious backgrounds, demonstrate dedication to interdisciplinary, inter-religious and cross-cultural dialogue, possess a deep knowledge of the Roman Catholic tradition of medical ethics and  a commitment to the Ethical and Religious Directives for Catholic Health Care Services, and be a strong advocate of and spokesperson for the Catholic/Jesuit tradition in healthcare.

I’m not sure it’s as outrageous as all that, and the ad does go on to say that

Georgetown University is an equal opportunity, affirmative action employer, and does not discriminate on the basis of race, sex, sexual orientation, age, religion, national origin, marital status, veteran status or disability.

The not discriminating according to religion bit is a bit curious, admittedly – I mean, I’ll accept that a Hindu could carry out a role that involves advocacy “for the Catholic/Jesuit tradition in healthcare”*; but a Catholic is likely to have an advantage on this front.  (And what is it with veterans?  I know that Americans take the military Very Seriously Indeed; but, really – it’s just a job, albeit a job with abnormally high levels of shouting.)

But there is a couple of further questions that the ad raises, albeit short of causing outrage.

For one thing, it’s not clear exactly why being a medic first and an ethicist second is the ideal ordering of things.  I know that there’re plenty of medics who turn out to be very good ethicists, but their being good ethicists doesn’t depend – as far as I can tell – on their having been a medic.**  I’ve mentioned before that there is a problem with defining what a bioethicist should be.  But I think that a background in philosophy is, and ought to be, a big component of being an ethicist.  Naturally, a bioethicist ought to be at least capable of understanding roughly what the science can do – but what makes an ethicist an ethicist is an ability to reason about practical matters; there’s no more need to be able to participate in those practices and have a detailed understanding of them than there is for a music critic to have mastered every instrument in the orchestra (or any of them) or even to be able to read music.  And yet the ad doesn’t specify that the successful applicant will be a philosopher at all; ideally, the successful candidate will have some postgrad philosophy experience – but that seems to be an aspiration rather than a stipulation.

What puzzles me further, though, is the sense of priority.  The people who drafted the ad clearly thought that being a medic was the most important area of experience – OK, I’ll let them have that for the moment – and then moved to theology, and only after that does philosophy get a look in.  And that’s something that I really don’t understand.  I genuinely don’t understand what theology can offer to ethics.  Theological ethics tends, as far as I can see, simply to collapse into an argument from authority – either “Do this because an invisible man says so”, or “Do this because a man with a beard and a hotline to an invisible man says so”.  But the belief in the invisible man is not obviously morally important – the idea that speculation about the nature and existence of a divinity can tell us anything morally useful was definitively exploded by Plato two and a half millennia ago, in the Euthyphro: it’s not recovered from that blow, and I’m not expecting it to soon - and if you take the invisible man out of it, you’re left with either philosophy of a higher or lower quality, or a bit of a mess.

Not so long ago, I was at an ethics workshop at which a number of theologians spoke about theological bioethics.  These were theologians from big, venerable universities from all over Europe, so I’m assuming that they were among the best in their field.  And yet what they said was either nothing that could not be said by a philosopher, or nothing that would be said by a philosopher because it was basically mystical fluff.  This is a reflection of other attempts at ethics that I’ve seen from theologians: they’re just like philosophers, except – let’s be brutal – not as good.

I know that religion thinks that it’s a source of moral authority; but what’s truly bizarre is that so many people accept this.  (Granted, theology and religion aren’t the same, but the former does rather presuppose the latter…)  Indeed, outside of academia, there seems to be a perception that you can’t have a moral argument without at least inviting a religious perspective.  I don’t understand why.  (Have you noticed that the BBC runs religion and ethics programming together, as though they go fit as naturally as beer and regret?  I feel an open letter coming on…)

If anyone could explain to me (a) exactly what can be brought to the table by theologians that cannot be brought by anyone else, and (b) why this something is worth having, I’d appreciate it.  My hunch is the answer to (a) is “Very little, if anything”, and to (b) is “It really isn’t”.  Maybe I’m wrong; maybe someone can correct me.  But I’ve not come across a compelling reason to change my mind yet; and in the absence of one, quite why Georgetown places theology higher than philosophy on its list of priorities for an ethics gig is – at best – puzzling.

Now, do you think I’ve got a chance with the job?

*Is that the tradition whereby it’s better that mother and foetus die than that an abortion be provided that might save the mother?  Oh, right, OK.

**I don’t want to appear to blow my own trumpet here, but I reckon I’m at least a passable ethicist, and I have no medical education at all.  Hell, I have practically no scientific education: my GCSE physics teacher spent most of 18 months’ worth of lessons telling a long, deeply involved and ultimately moving shaggy-dog story about an octopus and a set of bagpipes, and my biological knowledge goes no further than making potato-prints.

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  • Keith Tayler

    ….and another thing – why is the philosophy section (if there is one) in book shops next to religion and the mind-body crystal healing new age crap?

  • Iain Brassington

    *Grits teeth*
    I know… It's either dreamcatchers or Alain de Boton…

  • Nathan Emmerich

    You realise, of course, that “Georgetown is the nation’s (USA's) oldest Catholic and Jesuit university” and it maintains such an ethos (like our own 'faith' schools?). This must go some way to answering your questions. Also *you* might not recognise what theology in general and Catholicism in particular has to contribute to ethics, but obviously Georgetown University does. Furthermore I would suggest that there is little chance of agreement on the grounds to solve such a problem between yourself (as, presumably, a committed atheist?) and a theologian regarding settling this dispute, and therefore you are just talking past them.

    As for preferring a MD to head up their clinical bioethics centre which is organised within the medical school: It seems to me that practising physicians do have some deeper insight into the practice of medicine than lay people. One only needs a passing acquaintance with research into the nature of professional medical expertise and practice to realise that medical practice is greater than the sum of its parts (medical science). Given that Georgetown also has the Kennedy Institute for Ethics, which is full of philosophers and theologians and run by them, it doesn't seem to be an overly pressing concern. One might suppose that this primary preference for a Clinician with a second knowledge of ethics (of whatever stripe) is facilitated by the larger independent bioethics centre full of philosophers. Unless you think all medical ethics should be philosophy led, that there is no deeper ethical or moral understanding or perspective attached to practice,* then it doesn't look like a problem in the grand scheme of things.

    * and I would also suggest that a deeper understanding should not be taken to mean that all medical ethics should be decided by doctors as they understand more but that there are various kinds of knowledge and perspectives relevant to medical ethics that ought to be included in the larger picture: nurses, ethicists, philosophers, theologians, expert patients etc.

  • Iain Brassington

    You say “Faith school” like it's a good thing… Part of the problem is that it's unclear whether it's the “Catholic” or the “University” that's in the driving-seat here. And to say that “obviously Georgetown University does” recognise what theology (or Catholicism, or whatever) is a cop out – a person or institution may believe that they recognise the importance of something, but there's no reason to think that that belief is necessarily true, or even warranted. “Important to me” is not the same as “important”. Bluntly: it won't do to answer a question about why something matters simply to reassert that it clearly matters to someone and that's all there is to it.

    I think that you've missed something about the expertise of medics, too. For sure, they quite possibly have an insight into medical practice that others don't. But that looks like a version of an ad hominem argument, and it's compatible with saying that others have an insight that medics may lack: if the medic's claim against the layman is that the latter's view is too distant, the layman may prima facie be able to counterclaim that the medic's is not distant enough. And, more importantly, having an insight into medical practice is not the same as having an insight into medical ethics; this shouldn't be a surprise, given that being a medic and being an ethicist are different things. I admitted in the OP that a decent medical ethicist probably ought not to detach himself from the state of the art too far – but that's a fairly trivial requirement, though, and many moral debates very quickly move away from the real-world situations that provoked them anyway into examinations of principle; you don't have to be a medic to handle an if xthen y argument. The point is that being or having been a medic is not a predictor in any way of how good an ethicist someone turns out to be. A lot of very good ethicists have medical training; but they're good ethicists because they're good at ethics.

  • Nathan Emmerich

    I reserve the right to remain opaque on whether I think faith schools a 'good thing' or not!

    I think my point is that there *are* such things as faith schools and Catholic Universities and, contra your implication, I do not think that given specific case we can successfully separate out the 'faith' from the 'school' or the 'Catholicism' from the 'University'. Indeed I don’t think you can separate out the secular (in contrast to Christian, agnostic or atheist) from the UK government or ‘Manchester bioethics’ and similarly for Islam and Iran, say. They are greater than the sum of their parts.

    The issue is not what is the correct answer regarding the importance of Catholicism or theology to ethics – we can all fight about that until the end of time. Rather, given there is disagreement on this, and given that Catholicism is an inherent aspect of this institution it is clearly understandable why they behave in the way that they do: i.e. advertising the position of clinical bioethics director with certain criteria. Since you either fail to recognise this fact (the diversity of opinions on the matter), or insist on returning to an argument which cannot be practically settled, then the consequence is going to be talking past one another.

    As for the more interesting issue of medical practice and ethical insight. I once saw a doctor (and ethicist) debating Margaret Pabst-Battin on the issue of euthanasia. He suggested that experience of practice was relevant, she suggested this ‘defence’ was an ad hominim (as you do). I wasn’t sure it worked then, and I am less sure it works now. Surely the suggestion is not merely I am X and you are not? Even if it were, it begs the question of ethical relevance i.e. if X were ‘an applied philosophical ethicist’ this is a good justification, whereas if X is ‘a medical doctor’ and we are both ethicists, it is not?). Regardless the assertion of the ethical relevance of clinical practice is, in this case at least, down to the claim that caring for people at the end of their lives gives you an insight into the ethical questions that pertain to not only *caring for people* at the end of their lives but also those raised by the end of life (your own, a loved one’s) per se. I don’t really see why this is an ad hominim. It seems perfectly comprehensible to me. Indeed the formulation of the questions seems to initially to rely on the reported experiences of those doctors, at least in our culture how else would we know what occurs and what the questions are?

    I see why some might think it is an ad hominim. If you fail to agree that such experiences are relevant to the analysis of ethical issues at the end of life then it looks like an irrelevant concern. But if you think that it is relevant, then it doesn’t appear to be an ad hominim. Again the grounds for deciding are all important. However, I would suggest that this disagreement is premised on a particular (thin) version of ethics competing with another (thicker) version. The first being based in philosophy and a particular kind of philosophy known as applied ethics and founded on deontology[1] and/ or utilitarianism. In contrast a virtue ethics approach can acknowledge the importance of experience. There are of course other accounts of ethics based in other forms of ethical philosophy: Levinas, Jonas, and Logstrop, existentialism (being a humanism), feminism, narrative ethics, even Habermas could recognise the value of the experienced voice. Obviously there are also specifically theological accounts; less obviously there are accounts from sociology, anthropology, the new synthesis in moral psychology. All have interesting things to say about ethics and applied ethics and all, I would suggest, would give weight to specific moral and ethical experiences. Although, obviously, to say as much is not to grant it absolute priority.

    Further, there is value pertaining to the ethical judgement of those who have not studied any of these things, ethical expertise only carries so far. This is particularly true in liberal democracies as opposed to theocracies. (I am presuming you value liberal democracy over theocracy, or the *applied philosopher king*-ocracy?). Philosophical applied ethics has a particular methodology, but we live in a democracy, a culture and a social context where (thankfully) we are not required to cleave to the methodological rules of philosophical applied ethics. Indeed I would suggest that it is ethical to reject the notion that philosophical applied ethics should be given priority outside of its own disciplinary practice. So, for example, one might give it some weight in matters of policy and policy formation, but that other issues also have to be taken into account. Similarly one might give it some weight as a doctor in deciding what to do, but there are other factors at play. Similarly for individuals in their day to day lives.

    I suppose we are faced with the question of what makes a good (medical) ethicist? I would suggest that giving a singular answer is wrong, indeed ethically wrong. So I think a better question is ‘what range of individuals, training and experiences would make up a good academic and practical field such as medical and bio- ethics? Here I think it is pretty obvious that, all things being equal, a range of individuals – philosophers, theologians, clinicians, nurses, expert patients in appropriate debates. – is a preferable answer to ‘just philosophers’ or ‘just applied ethicists.’ I think diversity (and respect for that diversity) is preferable to the suggestion that, in matters of ethics, we should defer to a singular account of what ethics is given there is wide disagreement on the matter both in everyday life and in the arcane disputes of those residing in universities.

    [1] I also think there are versions of deontology that would give weight to experience.

  • Keith Tayler

    The MD requirement is quite common for US medical ethics jobs (after the invisible man, the man in a white coat is the next most deified man in the American psyche). I half agree with Iain that being an MD does not make you a better ethicists, and I also agree with Arthur Caplan when he says that his contribution to hospital practice, that the patients’ privacy could be better respected if doctors waited until a patient had finished using a bedpan before they crowded around the patient’s bed, was well founded. However, as Caplan notes, he did not need his Ph.D. in philosophy to make such a recommendation. (‘Can Applied Ethics be Effective in Health Care, and Should It Strive to be?’, Ethics 93 (1983), 311-12.)

    Caplan’s example may seem trivially true. It is nonetheless worth remembering when we consider Iain’s contention, that ‘many moral debates very quickly move away from the real-world situations that provoked them anyway into examinations of principle; you don't have to be a medic to handle an if x then y argument’ This is indeed a factually correct observation made from within the confines of a bioethics department. The problem is, to put it in Aristotelian terms, it lacks Phronesis. Being able to handle an if x then y argument does not mean you can apply it in a given situation, or, more importantly, understand when to reject it in another. That requires experience. Being an MD will give you that experience which might, when coupled with a knowledge and understanding of ethics, make you a better “applied” ethicists than an academically trained bioethicist with no medical experience. Of course packing these jobs with experienced MDs will create another distortion. We need experience from all areas of medicine and from other occupations where casuistry is common. To maintain balance a few jobs should go to professional ethicists because we need to debate the principles. But ethicists must realise that being good at ethics does not mean they will be good in real-world situations.

  • Iain Brassington

    I stick by my principles claim – as will doubtless completely fail to surprise you.

    Caplan's point is, as you say, trivial; and if ethics is not about significantly more complex matters than that, there's no point doing it. Fortunately, it is. For example, there's no amount of clinical experience that can tell you what would be the just way to settle conflicting claims about a limited resource; experience can't tell you whether an advance directive ought to be followed; it can't tell you about the moral importance of the foetus. More importantly, it can't even frame the question, and I can't see how it could.

  • Keith Tayler

    My point is Aristotelian – you need principles and experience. As for Caplan – I have experienced some very silly rules in a clinical situation that have come staright from a bioethics book (you will be please to hear I ignored most of them).

    I really do think you take this armchair philosophy too seriously. I suppose the point is that if it does not work in the real world it is not much good. Anyway – again we will have to agree to disagree.

  • Iain Brassington

    Phew! There’s tons of stuff here…
    I think that you can separate the Christian (or Muslim, or Hindu, or whatever) from the secular, just because there’s no dogma in secularism. To be secular is to say that a person’s beliefs make absolutely no odds (a secularist advert would say something along the lines of “The successful candidate can have any beliefs whatsoever. We don't care. That's not what the job's about”. And there’re plenty of ethicists who’re believers outside of office hours but whose belief makes no discernable difference to the arguments they make in office hours. For the record, there’s no dogma in atheism, any more than there’s a dogma in not believing in unicorns or the Flying Spaghetti Monster.
    And while it’s understandable that the institution has the preferences it has, I think that there’s something very strange about advertising for an ethicist post on the understanding that there will be a certain position and approach that is to be taken as a given. That, to me, seems to undermine the enterprise of ethical enquiry. An ethicist may be led to certain positions by the argument; but the idea that you can be employed to articulate and speak on behalf of them seems to me to indicate that it’s not really an ethicist that GU is after. Where’s the doubt?
    This isn’t a matter of recognising a diversity of opinions; it’s a matter of what ethicists do. Besides – why should a diversity of opinions matter in itself? I’m interested in correct opinion, or at least rooting out the hokey ones. That leads to less diversity. Good.
    I’m not sure what the debate you mention is supposed to demonstrate. If someone is a good ethicist, they’re a good ethicist. That’s all there is to it; I don’t see what being a medic adds. After all, the big ethical arguments in medical and bioethics very quickly depart from the ward or lab – see my reply to Keith on this. You don’t have to have had any experience of – to use your example – end of life medicine to be able to talk meaningfully and comprehensively about the ethical questions. You possibly have fewer personal recollections – but it’s not clear why that makes a difference to the quality of the ethical argument.
    I’m honestly at a loss to see what you’re getting at when you’re talking about the ad hominem: I may have missed something, but your position seems to be that if I disagree with you about the importance of personal experience, then I’ll disagree with you. There must be more to your position than that, though.
    Look – irrespective of whether or not experience can be coopted by virtue ethicsists or deontologists (and I’ve no clue how that might work), all of these approaches need some rubric to be able to tell us how important these anecdotes are going to be. They need to be able to separate the important stuff from the unimportant. They need to be able to put it to work. That’s where the important action lies; that’s why ethics-by-survey is a strange beast indeed – just because there’s a danger that all the important questions have been begged before the answers are even collated. And when they are collated: well, what then? You still need some means to interpret them – and, vitally, to squeeze normativity from them. And that’s a very hard thing to do – to get the ought from the is. As for introducing Levinas… eeek. How would he be able to help us think about the rights and wrongs of turning off the life-support machine? And existentialism? Again, that seems to offer no help: Sartre effectively tells his puzzled student to sod off!
    You claim that “there is value pertaining to the ethical judgement of those who have not studied any of these things” – but you don’t explain what it is. As things stand, you look to be advancing the position that there are times when being less informed about a given matter on which you’re expected to make a decision is better than being more informed. That’s nuts.
    The appeal to liberal democracies seems like a red herring (but, cards on the table, I don’t have any particular love for them; a philosophocracy has its attractions). But why should the fact that we live in a democracy make any difference at all? How does an appeal to the way we do do things relate to a question about how we ought to?
    Your claim that “it is ethical [do you mean desirable? Plausible?] to reject the notion that philosophical applied ethics should be given priority outside of its own disciplinary practice”. True, but trivially true. Ethicists are probably terrible at making judgements about oncology; oncologists – by virtue of being vaguely socialised creature – probably have some insight into ethics, but academic ethics is about refining and questioning the moral intuitions of the day.
    Is your claim that it is morally blameable to try to give an account of what makes a good ethicist? That’s all I can read into your claim that “I would suggest that giving a singular answer is wrong, indeed ethically wrong.” That’s a truly bizarre claim. Noone is saying that we should defer to a singular account – not yet, anyway; there is no singular account of The Right Thing To Do. It doesn’t follow from that that all accounts are of equal value, any more than it follows from disagreement about the nature of fundamental physics that we can legitimately just believe any old thing. There is still such a thing as expertise.
    The question I’m addressing in the OP is whether theology makes a difference to ethical expertise. And I can’t see for the life of me that it does.

  • Nathan Emmerich

    Ok, I shall *try* to keep it short, and sweet.

    I am not sure we are using secular in the same way. I am using it to indicate an institution that is ecumenical with regard to belief, and I would include atheism in that (non-belief being a form of belief). Secularism and atheism do have its own commitments and these can descend into dogma (that it is by definition free from dogma being an egregious example of their ability to be dogmatic).

    I disagree that all the big questions in medical ethics quickly depart from the ward.

    (At risk of repeating myself!) Your position is dictated by a certain account of what ethics is and how it ought to be done. However it seems evident that there are many such accounts. You may have settled the matter to your own satisfaction but clearly there is not one settled opinion on the matter. Consequentially from inside your account the importance and relevance of theology or clinical experience (being much more than a set of anecdotes) to ethics will not go through and so you make your judgement on what constitutes a good ethicist. From inside other accounts different judgements’ regarding what constitutes a good ethicist are made. I would say that in the face of this lack of consensus cleaving to one account, at the level of society or bioethics as a whole, *is* morally suspect. It amounts to a dogmatic prescription of one’s own definition of what ethics is and ought to be for those who disagree with that definition. Such a thing would be symbolically violent and an expression of moral or ethical dominance in the same as church authority was previously (in public, private and university life). It is not good enough to suggest you may have these views in private but you are not allowed to bring them to your academic work as a bioethicist. That is dogmatic.

    Obviously we can continue to debate various accounts of ‘ethics,’ what it is and whether just one account can, or should, be given. Indeed I think the matter of ethical expertise an extremely important and neglected topic.

    The “value pertaining to the ethical judgement of those who have not studied any of these things” means that there is value in respecting people autonomous, even if ill informed or ill formed, ethical judgements. To not do so would be symbolically violent, an expression of dominance and remove an aspect of their humanity (their ethical autonomy, if you will).

    My problem is that you are extending your disciplinary day-job as an ethicist, someone who engages in argumentation according to certain methodological principles on substantive matters identified as ‘ethical’, to prescribing what ethics itself is. Having done so you then seek to prescribe this conclusion for all; as if it is certain and as if there is no dispute. This is another debate and, under conditions of liberal democracy, as opposed to theocracy (or philosophocracy for that matter), there is a ethical need to grant people their ethical and moral ‘rights’ and freedoms to their own ethical and moral judgements. It doesn’t matter if you can see “whether theology makes a difference to ethical expertise” the question is do you wish to live in a society that grants it, regardless of whether it understands it?

    To me these are political questions but you are seeking apolitical answers. Such an approach is flawed, and unethical. It is also dogmatic. I have no doubt that you disagree.

    I think I did quite well at keeping that short!

  • Iain Brassington

    Non-belief is no more a form of belief than being non-goblin is a form of being a goblin. And, yes: there can be dogmatic atheists and secularists; but there is no secular or atheist catachism, no central belief to which people are expected to adhere.
    I know that there are competing accounts of what ethics is and how it should be done. I know, too, that I have certain as-yet unproven hunches and that others have other as-yet unproven hunches. Nevertheless, this fact does not tell us that we have to suspend all judgements entirely. It's still possible to argue that certain approaches are non-starters; and some of those arguments may be definitive.
    Your claims about “symbolic violence” are baffling; you still seem to be saying that there's something impermissible (violent? How the hell does that work?) about claiming that a particular approach is duff. If that's not what you're saying, you're unclear. If it is… well, that's just quietism. And of course, you can bring anything you like into any debate – just so long as it can carry argumentative weight. Not everything can. The picture that you're painting – from the little I can make out – seems to be one in which people simply describe their unexamined intuitions and expect them to be immune from (ahem) vigorous scrutiny. I don't think that any ethical position is immune from vigorous scrutiny, or ought to be. Some will survive it; others won't. No loss.
    To respect a person, or respect their autonomy (decide: they aren't the same) isn't the same as respecting their beliefs or judgements; it doesn't imply that those beliefs or judgements qua beliefs or judgements have to be taken seriously – much less accepted.
    When you talk about “an ethical”, what's the standard to which you're appealing? Irrespective of whether your claim is correct, you seem to have introduced it by fiat; and you are, of course, attacking a straw man anyway – unless you think that there's no such thing as a better or worse judgement (a position that would seem to be morally paralysing). And the kind of society in which I want to live is neither here nor there: I'll try to follow where the arguments take me, and alter my desires to fit.
    Your claim that these are political questions doesn't follow from anything you've said; nor does the claim that the answers you impute to me (would that I had any answers at all) are apolitical. But allowing that to pass, quite how attempting to give an apolitical answer to a political question is unethical… just what do you mean? Again, what's the standard to which you're appealing? How on earth could an alleged methodological or category mistake generate a claim about being unethical?

  • Nathan Emmerich

    See, I *knew* you wouldn't like it.

  • Keith Tayler

    Sorry – after reading your reply to Nathan I have to come back on this.

    You say ’You don’t have to have had any experience of – to use your example – end of life medicine to be able to talk meaningfully and comprehensively about the ethical questions…’ This is true, but by reductio ad absurdum we might conclude that ‘you don’t have to have experienced anything to able to talk meaningfully and comprehensively about ethical questions of X.’ (I have met some AI researchers who believe this to be true, but they are paid to believe this nonsense. ) Now there is a tradition among some ethicists, which has influenced AI researchers, that from this position, or damn near it, we can add back in the “experiences“ and make sense of them in a meaningful and comprehensive manner (utilitarianism tries to do this). Of course the complete opposite is often the case. I have been involved in a number of work related ethical issues that required knowledge of the situation in order to identify the problem. For example, on one occasion I consulted Bernard Williams about the gaming industry (he had sat on the Royal Commission on Gaming a few years earlier). The problem I had identified he and his colleagues had completely missed; indeed , they missed quite a lot.

    As Williams says ‘The belief that you can look critically at all your dispositions from the outside, from the point of view of the universe, assumes that you could understand your own and other people’s dispositions from that point of view without tacitly taking for granted a picture of the world more locally familiar than any that would be available from there; but neither the psychology nor the history of ethical reflection gives much reason to believe that the theoretical reasonings of the cool hour can do without a sense of the moral shape of the world, of the kind given in everyday dispositions.’ (Ethics and the Limits of Philosophy, p.110)

    Obviously you disagree with Williams and those of us who attempt to analyse a situation from a number of approaches. To put it in your own words, ‘you look to be advancing the position that there are times when being less informed about a given matter on which you’re expected to make a decision is better than being more informed.’ That is, as you correctly say ’nuts’. What you see as being well informed appears to come down to things like a special away of ‘framing a question’ which the uninitiated are incapable of doing (see your reply to my posting). Obviously philosophy can help in framing questions, but the notion that medics or any other person cannot use their experience and understanding to frame a question about limited resource or whether an AD ought to be followed is arrant nonsense. Ethics is not some complex and esoteric region of mathematics or science (even here it should be possible to explain the essential framework). You seem to think that an ethicists is similar to the “effective manager”, i.e., I know better than you because I have been trained in “management” – you doctors , nurses, cleaners, or whatever they might be, cannot even frame the right “management” questions. Some “management” are good – others naïve and simplistic (this is what a lot of bioethics looks like).

    As Kant said ’The motto of the enlightenment is therefore: Sapere aude! Have courage to use your “own” understanding!’ You appear to think that ethicists are the ’guardians’ he warned us about – ’I need not think, so long as I can pay: others will soon enough take the tiresome job over for me’. With very few exceptions, a question or proposition in ethics that cannot be framed, understood and discussed by ordinary intelligent members of a society it is not a question in ethics – it is uninteresting nonsense. (An interpretation of the Tractatus as a work in ethics, or indeed any interpretation, might cause some problems. It is of course, as Wittgenstein declares, nonsense, but it is interesting nonsense).

    Finally, to repeat, on balance diversity leads to good decision-making. What’s the problem?

    Like Nathan I have been brief – if only.

  • Iain Brassington

    But Williams' scepticism about a gods-eye view doesn't amount to a positive endorsement of anything like Nathan's; and it leaves unaffected the idea that there are some ostensible positions that are just crazy.

    Your claim that diversity leads to good decision-making seems to be partly an empirical one – in which case, one might ask for conclusive evidence; but it also presupposes a non-empirical account of what “good” decision making actually is.

  • Keith Tayler

    Cannot argue Nathan’s corner. Obviously Williams is being critical of the rationalist/theoretical position which supports Nathan’s (and my) point about medics and ethics. Theologians have a really big problem about the gods-eye view. It does not leave unaffected the crazy idea problem, he gives an explanation as to why there are so many .

    On balance the evidence is clearly in favour of diversity – ‘…all the others are so much worse.’ It would take too long to reply properly to your last point. I would have to know what you mean by ‘non-empirical’ and the ‘is’ at the end of the sentence. There are quite a lot of accounts that purport to be non-empirical but are, as in the case of Kant, given “empirical” backing (thought experiment) in an attempt to make them look less crazy; or, as Kant warned us about, are not given to us by the nature of understanding and experience but are concepts we have invented and can therefore define, which means of course we can not be sure that what we have defined is true. Sen’s refutation of the axioms of ‘internal consistency of choice‘, the dismantling of theories of ‘intelligent pursuit of self-interest’ and ‘maximizing behaviour‘, are elegant formal demonstrations of the limits of theory in ethics and economics. In short, it’s strange old stuff – if indeed it really exists. We might be left with Sen’s ‘reasoned scrutiny’ – but I can live with that.

  • Iain Brassington

    I think I could go along with reasoned scrutiny – and this would stop short of rationalism (since there's a difference between rationalism and reasonability). But my general point stands: it'd have to be scrutiny, rather than survey, with the capacity to say that something is nonsense, useless or pernicious as the case may be.

    And I still can't see the case for granting theologians qua theologians an important role as ethicists.

  • Keith Tayler

    I think that this is near enough. Never got on with theologians qua theologians.

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