The author – a European “companion” of H. T. Engelhardt during the two last decades of the 20th century – describes his meetings with and impressions of Tris Engelhardt. He clarifies how open mindedness was the main concern in their common activities.

This article retraces progression of Engelhardt’s work so as to place After God in broader context. In The Foundations of Bioethics, Engelhardt argues that given the moral pluralism that is at the core of postmodernity, only a merely formal morality of permission can bind moral strangers in peaceful coexistence. In The Foundations of Christian Bioethics, Engelhardt presents a bioethics that binds Orthodox Christian moral friends. After God shows itself more pessimistic about the possibility of a merely formal (...) morality of moral friends and calls traditional Christians to wage a culture war. These reflections close with some criticisms of Engelhardt’s philosophical-theological project. (shrink)

En 1986, H.T. Engelhardt justifiait l'autonomie de la bioéthique à l'égard des éthiques religieuses en partant du fait que les hommes de notre temps sont « moralement des étrangers », les uns pour les autres. En 1991, il entreprit de mieux discerner les relations entre éthiques séculière et religieuse, en gardant la même orientation de pensée, mais en s'attaquant à l'idéologie d'un humanisme athée. Il cherche à établir sur les bases d'une rationalité universelle un « cadre de référence neutre (...) », commun à l'ensemble des partenaires du débat éthique contemporain, mais qui laisserait la place à une pluralité de visions philosophiques, religieuses et morales. Car ce serait ruiner toute éthique que de vouloir fonder la bioéthique sur le seul recours au consentement libre et éclairé du malade et sur le respect de son autonomie, à l'exclusion de toute recherche de « buts transcendants ». – La pensée d'Engelhardt n'est pas exempte d'ambiguïtés sinon de contradictions : il ne dit pas comment son humanisme séculier donnera satisfaction aux partisans des éthiques religieuses ni quel sera le statut institutionnel de ce cadre de référence commun ni quelle issue il propose entre le nihilisme et le relativisme moral ni sur quelle base pourrait se faire une hiérarchisation des valeurs dans une bioéthique séculière. Sa pensée devrait se prolonger en direction des droits de l'homme, mieux distinguer entre principes premiers et principes dérivés, creuser davantage le concept de subjectivité.In 1986 H. T Engelhardt justified the autonomy of bioethics as regards religious ethics by starting with the fact that people in our day are “moral strangers” in regard to each other. In 1991 he studied further the relations between secular and religious ethics while keeping the same line of thougbt, but in attacking the ideology of atheistic humanism. He is trying to establish, on the basis of a universal rationality, a “neutral framework “ that would be shared by all those debating contemporaneous ethics. It would leave room for a plurality of philosophical, religious, and moral visions, For it would destroy all ethics if one wished to base bioethics only on trying to get a free and enlightened agreement from the patient and on the respect of his autonomy, in exclusion of every search.for « transcendental ends ». The thougbt of Engelhardt is not free from ambiguities, if not contradictions: he doesn't say how his secular humanism will give satisfaction to the supporters of religious ethics; nor what the institutional status of tbis common framework would be; nor what he proposes as the way out between nihilism and moral relativism; nor on what basis a hierarchy of values could be created in secular bioethics. His ideas call for further reflection : found etbics on the rights of man; distinguish more clearly between first principles and principles that are derived ; and dig deeper into the concept of subjectivity. (shrink)

This paper is a tribute to H.T. Engelhardt Jr. for the intellectual resources he provided to challenge cosmopolitan liberalism as the foundation for an overarching global bioethics in the post-modern world. It is a also a tribute to the moral pluralism and cultural diversity which he argued so forcefully in all his works and which have inspired the flourishing of fierce bioethical debates across the world, including in the non-Western and Asian societies.

The high technology and the costs involved in critical care disclose the implausibility of applying the American standard version of bioethics in the developing world. The American standard version of bioethics was framed during the rapid secularization of the American culture, the emergence of a new image for the medical profession, the development of high technology medicine, an ever greater demand in resources, and a shift of focus from families and communities to individuals. This all brought with it a particular (...) ideology of health care which promised Americans (1) the best of care, (2) equal care, and (3) physician/patient choice, without (4) runaway costs. This essay argues that this moral project is impossible in practice. This impossibility is especially salient in developing countries. In addition to the fact that it is financially impossible to provide all in the developing world with the standard of care accepted by law, policy, and convention in developed countries, different moral perspectives with different orderings of values will seem more or less plausible in different cultures. Indeed, such an approach would be harmful. A concrete bioethics applicable across the world does not appear possible. (shrink)

Tristram Engelhardt, Jr. offers erudite and compelling arguments for the view that all families should try to realize the traditional family. Although I tend to agree with him from my personal standpoint, I doubt that this view can be justified to those with whom we are in reasonable disagreement about the family. I make three critical points. First, though Engelhardt stops short of saying that the state should encourage people to form traditonal families, or discourage those who do (...) not, some state perfectionists might do so. From the perspective of public reason, it is unjust for the state to favor some conceptions of the good over others, if these conceptions are all reasonable. Moreover, those whose conceptions of the good are not favored would feel that they are disrespected. Second, insofar as Engelhardt thinks that all families should try to realize the traditional families, the traditional family would not be a good to those who do not like children. Moreover, it would be difficult to persuade those who have decided not to have children for reasons of career, burden, or more altruistic concern. Third, against Engelhardt’s stance against the “egalitarian aspirations” of liberalism, I argue that too often women sacrifice their possible careers for the sake of the family, even should they hold advanced degrees from prestigious universities, or professional qualifications. This kind of injustice is too uncomfortable to ignore. (shrink)

This collection of essays examines the ways in which disputes and controversies about the application of scientific knowledge are resolved. Four concrete examples of public controversy are considered in detail: the efficacy of Laetrile, the classification of homosexuality as a disease, the setting of safety standards in the workplace, and the utility of nuclear energy as a source of power. The essays in this volume show that debates about these cases are not confined to matters of empirical fact. Rather, as (...) is seen with most scientific and technical controversies, they focus on and are structured by complex ethical, economic, and political interests. Drs. Engelhardt and Caplan have brought together a distinguished group of scholars from the sciences and humanities, who sketch a theory of scientific controversy and attempt to provide recommendations about the ways in which both scientists and the public ought to seek more informed resolutions of highly contentious issues in science and technology. Scientific Controversies is offered as a contribution to the better understanding of the roles of both science and nonscientific interests in disputes and controversies pertaining to science and technology. (shrink)

The term `bioethics' was coined in 1971, just as interest in the medical humanities claimed a prominent place in medical education. Out of this interest, a substantial area of research and scholarship took shape: the philosophy of medicine. This field has been directed to the epistemological, ontological, and value-theoretical issues occasioned by medicine and the biomedical sciences. Bioethics is nested in this field and can only be fully understood in terms of the foundational issues it addresses. This collection of essays (...) in honor of Stuart F. Spicker, one of the individuals who gave shape to the philosophy of medicine, lays out the broad scope of concerns from the philosophy of embodiment, to issues of the role of ethics consultants, to concepts of disease, equity and the meaning of history. (shrink)

The spectacular development of medical knowledge over the last two centuries has brought intrusive advances in the capabilities of medical technology. These advances have been remarkable over the last century, but especially over the last few decades, culminating in such high technology interventions as heart transplants and renal dialysis. These increases in medical powers have attracted societal interest in acquiring more such knowledge. They have also spawned concerns regarding the use of human subjects in research and regarding the byproducts of (...) basic research as in the recent recombinant DNA debate. As a consequence of the development of new biomedical knowledge, physicians and biomedical scientists have been placed in positions of new power and responsibility. The emergence of this group of powerful and knowledgeable experts has occasioned debates regarding the accountability of physicians and biomedical scientists. But beyond that, the very investment of resources in the acquisition of new knowledge has been questioned. Societies must decide whether finite resources would not be better invested at this juncture, or in general, in the alleviation of the problems of hunger or in raising general health standards through interventions which are less dependent on the intensive use of high technology. To put issues in this fashion touches on philosophical notions concerning the claims of distributive justice and the ownership of biomedical knowledge. (shrink)

This chapter explores the view that religious claims have no legitimate place in the public forum. This exploration involves a critical re-examination of the public versus private distinction that would place religious commitments and grounds for action in a sphere isolated from that of public discourse and public choice. In the process, this chapter brings into question John Rawls's defense of a public discourse that seeks to marginalize religious commitments.

The project of articulating a coherent, canonical, content-full, secular morality-cum-bioethics fails, because it does not acknowledge sin, which is to say, it does not acknowledge the centrality of holiness, which is essential to a non-distorted understanding of human existence and of morality. Secular morality cannot establish a particular moral content, the harmony of the good and the right, or the necessary precedence of morality over prudence, because such is possible only in terms of an ultimate point of reference: God. The (...) necessity of a rightly ordered appreciation of God places centrally the focus on holiness and the avoidance of sin. Because the cardinal relationship of creatures to their Creator is worship, and because the cardinal corporate act of human worship is the Liturgy, morality in general and bioethics in particular can be understood in terms of the conditions necessary, so as worthily to enter into Eucharistic liturgical participation. Morality can be summed up in terms of the requirements of ritual purity. A liturgical anthropology is foundational to an account of the content-full morality and bioethics that should bind humans, since humans are first and foremost creatures obliged to join in rightly ordered worship of their Creator. When humans worship correctly, when they avoid sin and pursue holiness, they participate in restoring created reality. (shrink)

The concept 'health' is ambiguous [18,9, 11]. The concept 'mental health' is even more so. 'Health' compasses senses of well-being, wholeness, and sound ness that mean more than the simple freedom from illness - a fact appreci ated in the World Health Organization's definition of health as more than the absence of disease or infirmity [7]. The wide range of viewpoints of the con tributors to this volume attests to the scope of issues placed under the rubric 'mental health. ' (...) These papers, presented at the Fourth Symposium on Philos ophy and Medicine, were written and discussed within a broad context of interests concerning mental health. Moreover, in their diversity these papers point to the many descriptive, evaluative, and, in fact, performative functions of statements concerning mental health. Before introducing the substance of these papers in any detail, I want to indicate the profound commerce between philosophical and psychological ideas in theories of mental health and disease. This will be done in part by a consideration of some conceptual developments in the history of psychiatry, as well as through an analysis of some of the functions of the notions of mental illness and health. 'Mental health' lays a special stress on the wholeness of human intuition, emotion, thought, and action. (shrink)

_The Structures of the Life-World _is the final focus of twenty-seven years of Alfred Schutz's labor, encompassing the fruits of his work between 1932 and his death in 1959. This book represents Schutz's seminal attempt to achieve a comprehensive grasp of the nature of social reality. Here he integrates his theory of relevance with his analysis of social structures. Thomas Luckmann, a former student of Schutz's, completed the manuscript for publication after Schutz's untimely death.

Instead of benefitting from open meetings and public discussions, the Clintons drafted their health care plan in private and asked that it be accepted in haste. They advance an ideology that claims we can receive the best care for all without any increase in cost or rationing, and then they use "ethicists" to justify this ideology through a supposedly common morality. However, there is no such common morality. In the context of American pluralism, one must look to the actual consent (...) of the governed and recognize the limits on state authority. The result will be a two tiered system of health care, with a basic tier focusing on cost-effective care for the poor that eliminates suffering rather than equalizing inputs, and a space for collateral private insurance. Keywords: Clinton health plan, egalitarianism of envy, egalitarianism of altrusim, limited democracy, moral pluralism CiteULike Connotea Del.icio.us What's this? (shrink)

The epistemological and sociological consequences of post-modernity include the inability to show moral strangers, in terms they can see as binding, the moral wrongness of activities such as abortion. Such activities can be perceived as morally disordered within a content-full moral narrative, but not outside of the context it brings. Though one can salvage something of the Enlightenment project of justifying a morality that can bind moral strangers, one is left with moral and metaphysical views that can be recognized as (...) impoverished and incomplete by those who live their lives within the embrace of a content-full moral narrative. The cardinal dualism of post-modemity is not that which separates mind from body, but the gulf between the morality binding moral strangers and that binding moral friends. Keywords: dualism, human embryo, personhood, post-modernity CiteULike Connotea Del.icio.us What's this? (shrink)