Theory and methodology of empirical ethics: a pragmatic hermeneutic perspective

Abstract

Empirical science and ethics are traditionally viewed as distinct disciplines. Empirical science deals with facts; ethics deals with norms and values. Empirical science is descriptive; ethics is prescriptive. Yet, if ethics wants to say things about the real world, it has to take into account facts. Medical ethics has been developed in close interaction with medical practice. Its problems come from practice, and solutions for these problems are found through interaction between ethicists and physicians.Whereas interaction between ethicists and physicians has always been important in medical ethics, the notion of empirical ethics is more recent. Combining empirical research and philosophical analysis has become more accepted in twentieth century philosophy, such as ordinary language philosophy, phenomenology, and philosophy of science. In medicine, the plea for evidence-based practice has become prominent, implying the need for empirical research in all medical disciplines. These developments have influenced the rise of empirical ethics in the area of medicine (see Borry et al., Chapter 4 in this volume).Although empirical ethics has gained considerable attention over the past years, traditional doubts about merging facts and values have not vanished. It is not clear for everyone that empirical research and ethics can be combined in a productive way, without committing the naturalistic fallacy (see McMillan and Hope, Chapter 2 in this volume). Systematic reflection upon the theoretical and methodological issues involved in combining empirical research and ethics is scarce. Facts evidently matter for ethics, but how can the results of empirical research be integrated into ethical reasoning? How can normative conclusions be based upon empirical studies?In this chapter, we will attempt to find an answer to these questions. We will first explain what it means to see practice as a source of ethics. Next, we sketch our theoretical perspective, combining two philosophical approaches: pragmatism and hermeneutics. In line with the view that practice is important for understanding and developing theory, we will present an example of an empirical ethical project in psychiatry, making use of a pragmatic hermeneutic approach. Reflecting upon this example, we will discuss the role of method in empirical ethics. We will argue, along with Gadamer, that truth is more fundamental than method. Furthermore, we explain the role of general rules and principles. Referring to Aristotle's notion of practical wisdom (phronèsis), we will argue that understanding general rules requires knowledge of their application to concrete situations. Finally, we will discuss the way in which our approach combines facts and norms. We will show that the normative outcome of the project is related to the process of negotiation about the claims of the participants.