Moral Expertise in Bioethics and the "Prophetic-Poetic" Ability to Name
Martin Fitzgerald, PhD, The Ohio State University, Columbus, OH
What is it that an education in bioethics is supposed to achieve? A standard account is something along the lines that bioethics education transmits a knowledge of principles of right conduct, the skill in applying them to concrete cases in medicine, and, maybe, the willingness to actually follow through with what is discerned. On this account, bioethics education neatly follows the cultivation of the virtues of justice, prudence, and fortitude. It is a compelling picture, and one that nicely follows a classical model of moral education.
However, consider the question of moral expertise in bioethics. Although the classical model of education may be largely centered on the cultivation of character, it nevertheless plausibly claims to produce moral experts as well. Even if one’s standard of conduct is nothing other than what a good person would do in a given situation (the type of circularity that is common in certain manifestations of virtue ethics), by producing good people you are producing those capable of standing-in in a situation and thereby producing good conduct! For a bioethicist, then, perhaps this is exactly right. A bioethicist would be someone who stands “in the breech”, involves themselves in a situation, and thereby discerns the right course of action. Such a person would rightly be called a moral expert.
Yet, this is not the position on moral expertise endorsed by mainstream bioethics. Whatever expertise may consist in – if indeed it is taken to exist at all – it is certainly not discerning what to do from the “book of truth.” Indeed, this observation has led some, such as Engelhardt, to write-off clinical ethicists as a sleight-of-hand “profession” which actually is several other functions packaged together under a false sign. If a clinical ethicist cannot licitly provide strong guidance for what is to be done, then what could their moral expertise consist in?
I claim that one of the important, overlooked functions of the clinical ethicist is to name those ethically-salient features which arise from the narratives spun by clinical encounters. In other words, one of the key functions of a clinical ethicist is naming. After all, precisely what ethical dilemma confronts a physician, patient, or otherwise, is often not obvious. So, for instance (and to borrow a classical bioethics framing), even if it seems clear that the prospect of a patient being given a medicine without their knowledge would be a violation of that patient’s autonomy, it still must be identified and named as such. If a family member were to simply object that “it doesn’t seem right to trick them like that,” that person would certainly be onto something. They have indeed picked out a morally-salient characteristic of the situation, but perhaps did not possess the expertise to fit that fact within a broader context such that they could adequately name the situation. A moral expert, on the other hand, would be one who is (among other things) expected to be skilled in naming situations according to their ethical content. Their function in naming is both prophetic and poetic. It does not merely identify what is, but it also constructs a narrative such that what is is comprehensible. It is not a dry recitation of fact, but a working-through that picks out what matters and in what context it matters. Thus, we should consider the prophetic-poetic ability to name as an important aspect of moral expertise.
In this presentation, I will both characterize the prophetic-poetic naming function in bioethics as well as show how that function may be cultivated using the arts, read broadly.
However, consider the question of moral expertise in bioethics. Although the classical model of education may be largely centered on the cultivation of character, it nevertheless plausibly claims to produce moral experts as well. Even if one’s standard of conduct is nothing other than what a good person would do in a given situation (the type of circularity that is common in certain manifestations of virtue ethics), by producing good people you are producing those capable of standing-in in a situation and thereby producing good conduct! For a bioethicist, then, perhaps this is exactly right. A bioethicist would be someone who stands “in the breech”, involves themselves in a situation, and thereby discerns the right course of action. Such a person would rightly be called a moral expert.
Yet, this is not the position on moral expertise endorsed by mainstream bioethics. Whatever expertise may consist in – if indeed it is taken to exist at all – it is certainly not discerning what to do from the “book of truth.” Indeed, this observation has led some, such as Engelhardt, to write-off clinical ethicists as a sleight-of-hand “profession” which actually is several other functions packaged together under a false sign. If a clinical ethicist cannot licitly provide strong guidance for what is to be done, then what could their moral expertise consist in?
I claim that one of the important, overlooked functions of the clinical ethicist is to name those ethically-salient features which arise from the narratives spun by clinical encounters. In other words, one of the key functions of a clinical ethicist is naming. After all, precisely what ethical dilemma confronts a physician, patient, or otherwise, is often not obvious. So, for instance (and to borrow a classical bioethics framing), even if it seems clear that the prospect of a patient being given a medicine without their knowledge would be a violation of that patient’s autonomy, it still must be identified and named as such. If a family member were to simply object that “it doesn’t seem right to trick them like that,” that person would certainly be onto something. They have indeed picked out a morally-salient characteristic of the situation, but perhaps did not possess the expertise to fit that fact within a broader context such that they could adequately name the situation. A moral expert, on the other hand, would be one who is (among other things) expected to be skilled in naming situations according to their ethical content. Their function in naming is both prophetic and poetic. It does not merely identify what is, but it also constructs a narrative such that what is is comprehensible. It is not a dry recitation of fact, but a working-through that picks out what matters and in what context it matters. Thus, we should consider the prophetic-poetic ability to name as an important aspect of moral expertise.
In this presentation, I will both characterize the prophetic-poetic naming function in bioethics as well as show how that function may be cultivated using the arts, read broadly.