Abstract

Many clinical ethics services issue recommendations about ethical controversies that arise in patient care. Their role is configured to be arbiters of moral permissibility, rendering verdicts on which option of those available constitute the morally superior course of action. They produce moral judgements on questions, such as: Should dialysis be started or foregone? Should life-sustaining care be withdrawn or continued? Is it permissible for the clinician to refuse a course of treatment desired by a particular patient or family? But decisions in such cases presume a type of expertise that ethics consultants do not plausibly possess: i.e., the insight to know whose values – which ethical priorities – should trump in situations that are morally ambiguous and normatively contested. This is especially worrisome against the backdrop of the values-pluralism that exists in diverse, heterogeneous societies. This kind of authoritative response to moral uncertainty teeters on hubris, and can have a profoundly negative impact on the lives touched by these decisions. This chapter will argue that the moral arrogance that stems from a conviction of expertise is one of the gravest dangers of contemporary clinical ethics consultation.