"In her work on the relationship between cultural traditions and the formation of policy on stem cell research, Hauskeller shows how 'the predominant type of ethical reasoning in a nation or culture finds expression in social and political decisions and practices' (Hauskeller, 2004). Across Europe, styles of ethical reasoning differ considerably and thus so also does the character of the legitimacy of the bioethical rule formulation process when dealing with human ESC science (Bender, Hauskeller and Manzei, 2005; see also Beckmann, 2004 (Germany); Maio, 2004 (France); Mauron and Baertschi, 2004 (Switzerland); Schmidt et al, 2004). It is likely, therefore, that within the transnational network of bioethics there are competing national modes of bioethical discourse and legitimation. "
[Show abstract][Hide abstract] ABSTRACT: The possibility of content-full, universal, bioethical norms is assessed. The literature brings into question a global bioethics. A salient moral and bioethical pluralism undermines the plausibility of imposing of uniform bioethical norms on critical care. Addressing the tension between the aspiration to a global bioethics and the presence of moral pluralism is timely, given the United Nations Educational, Scientific and Cultural Organization's development of universal, bioethical norms. The practice of critical care in the 21st century will be influenced by the tension between bioethical pluralism and counter-assertions on behalf of a global bioethics.
A growing literature reflects a bioethical pluralism with significant implications for critical care. Much of the literature supporting pluralism is rooted in a reaction in the Pacific Rim against North American and Western European moral and philosophical commitments. These voices of moral dissent join an already salient moral diversity in the West regarding issues ranging from abortion to end-of-life decision-making, physician-assisted suicide, and euthanasia, as well as conflicting understandings of the bioethics of appropriate approaches to the allocation of scarce medical resources. This literature acknowledging bioethical diversity contrasts with announcements of universal bioethical norms.
Clinicians need to appreciate the sources of moral controversy that divide them from their patients and from their colleagues and to recognize that moral and economic differences may lead to different standards of care. Taking bioethical diversity seriously supports focusing on procedural moral approaches that allow peaceable collaboration in the face of substantive moral disagreement.
Current Opinion in Critical Care 01/2006; 11(6):605-9. DOI:10.1097/01.ccx.0000184166.10121.c1 · 2.62 Impact Factor
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