Moral Horizon Research Articles

Dorothea Dix: New England Reformer.

* Preface * Almost Alone in This Wide * Fixed as Fate * Moral Power * I Tell What I Have Seen! * This Mighty Vortex of Labor * A Happiness Which Goes with You * The Property of the People * A National Work * The Moral Horizon of a Unitarian Minister * The American Invader * Our People Need to Suffer * Downright Madness * A Huge Wild Beast Has Consumed My Life * At Last * Notes * Acknowledgments * Index

The utility of futility: the construction of bioethical problems.

The aim of this article is to analyse the contemporary 'futility discourse' from a constructivist perspective. I will argue that bioethics discourse typically disregards the context from which controversies emerge and the processes that inform and constrain such discourse. Constructivists have argued that scientific knowledge is expressive of the dominant paradigm within which a scientific community is working. I will outline an analysis of 'medical futility' as a construction of biomedical and bioethical communities (and their respective paradigms). I will trace the emergence and utilization of futility in the literature. My analysis of the context (i.e. the historical circumstances, the particular actors involved) within which the futility discourse emerged suggests that medical futility was constructed, in part, as a means of enhancing physician domination of a context wherein medical authority was threatened. The actors in this debate express widely divergent frameworks of 'the good', arguing from distinctive representations of moral agency. At times, this controversy has been argued from incommensurate moral horizons wherein the discussants debate incomparable problems. This discussion is related to a study of the 'practice' of futility in the clinical context. Further studies on the construction of bioethical problems are a necessary condition for supporting the truth claims of bioethical arguments.

MAPPING OUR MORAL HORIZONS

Philosophical BooksVolume 32, Issue 3 p. 129-136 MAPPING OUR MORAL HORIZONS STEPHEN MULHALL, STEPHEN MULHALL ALL SOULS COLLEGE, OXFORDSearch for more papers by this author STEPHEN MULHALL, STEPHEN MULHALL ALL SOULS COLLEGE, OXFORDSearch for more papers by this author First published: July 1991 https://doi.org/10.1111/j.1468-0149.1991.tb02268.xRead the full textAboutPDF ToolsRequest permissionExport citationAdd to favoritesTrack citation ShareShare Give accessShare full text accessShare full-text accessPlease review our Terms and Conditions of Use and check box below to share full-text version of article.I have read and accept the Wiley Online Library Terms and Conditions of UseShareable LinkUse the link below to share a full-text version of this article with your friends and colleagues. Learn more.Copy URL Share a linkShare onFacebookTwitterLinkedInRedditWechat Volume32, Issue3July 1991Pages 129-136 RelatedInformation

The Lawyer as Friend: The Moral Foundations of the Lawyer-Client Relation

collectivity is in certain cases not to try to favor it directly but to concentrate on those to whom one has a special relation? This does not involve tricking oneself, but only recognizing the limitations of what an individual can do and know. But that, it seems to me, is just Mill's and Sidgwick's argument all over again. There is no trickery involved, but this is still a kind of deliberate limitation of our moral horizon which leaves us uncomfortable. Do I know in a particular case whether sticking to the narrow definition of my role will in that case further the good of all? If I know that it will not further the general good, then why am I acting as the role demands? Is it to avoid setting a bad example? But for whom? I need not tell others-whether I tell or not could enter into my calculation. For myself then? But that begs the question, since if short-circuiting the role-definition of my obligation and going straight for the general good is the best thing to do in that case, then the example I set myself is not a bad example, but a good example. In short, I do not see how one can at the same time admit that the general good is one's only moral standard, while steadfastly hewing to obligations to friends, family, and clients. What we must look for is an argument which shows that giving some degree of special consideration to myself, my friends, my clients is not merely instrumentally justified (as the utilitarians would argue) but to some degree intrinsically SO.20 I think such an argument can be made. Instead of speaking the language of maximization of value over all of humanity, it will speak the language of rights. The stubborn ethical datum affirming such a preference grows out of the profoundest springs of morality: the concepts of personality, identity, and liberty. C. Self, Friendship, and Justice Consider for a moment the picture of the human person that would emerge if the utilitarian claim were in fact correct. It would mean that in all my choices I must consider the well-being of all humanityactual and potential-as the range of my concern. Moreover, every actual or potential human being is absolutely equal in his claims upon me. Indeed, I myself am to myself only as one of this innumerable multitude. And that is the clue to what is wrong with the utilitarian vision. Before there is morality there must be the person. We must attain and maintain in our morality a concept of personality such that 20. See generally D. LYONS, FORMS AND LIMITS OF UTILITARIANISM (1965); J. SMART & B. WILLIAMS, UTILITARIANISM: FOR AND AGAINST (1973); Harrod, Utilitarianism Revised, 45 MIND 137 (1936); Mabbott, Punishment, 48 MIND 152 (1939).