Medical ethics, moral philosophy and moral tradition

Medical ethics is commonly assumed to be a form of 'applied moral philosophy' in which practical moral judgments are deduced from moral theories. This account of the relationship between moral theory and moral judgment is inadequate in several respects. The deductivist approach often results in inadequate attention being given to social, historical and developmental contexts. It also fails to explain some common phenomena in practical moral reasoning. In contrast to the emphasis in deductivism, a case-centered or casuistic practical ethics insists on immersion in the particularities of cases and on interpretation of details in light of moral maxims and other mid-level forms of moral reasoning. Two features of casuistics that ought to be distinguished but frequently are not, are: (1) the emphasis on immersion and interpretation, and (2) a claim about the relation between moral judgment and moral theory as sources of moral knowledge. Once we consider case-centered moral judgments as sources of moral knowledge, we must also begin to look critically but open-mindedly to moral traditions which, upon examination, appear to be more dynamic and to have more reformist potential than is commonly assumed.