Legalism and Medical Ethics

Abstract

This essay is concerned with some general questions about methodology in medical ethics. As such it belongs under what is generally called “metaethics” or the “logic of ethics,” that is, the second-level inquiry into moral concepts, rules, and principles and their logical interrelations. I believe that it is important to develop an understanding of some of these methodological questions as a propaedeutic to an inquiry into more substantive moral issues. My position, which I have defended elsewhere, is that metaethics cannot, in the final analysis, be separated from normative ethics: for metaethics itself is a normative enterprise and any metaethical theory necessarily has implications for normative ethics, albeit of a very general nature¹ On the other hand, it is impossible to think clearly and coherently about issues in normative ethics, medical ethics, for example, unless one is cognizant of the logical relationships and implications of the concepts and principles that one is using in analyzing these issues. Much of the purport of this essay will be critical, for I believe that discussions of issues in medical ethics have frequently been on the wrong track; in particular, they have been too legalistic. I shall suggest a new approach, as an alternative to legalism, although what I have to say will necessarily be largely programmatic.