The Power (And Limits) of Proximity

to very general-what sort Does of life is worth having? This second question, however general, Clini c al is also every bit as practical, as concerned with practice, with Ethics living a moral life, as first question. Distort With no embarrassment, I count myself in that second Discipline? camp. To do that well requires attentiveness to stories in all their particularity. But it also acknowledges ineluctable human tendency to generalize, to move from particular to general. Doing sound practical reasoning requires embracing our capacities to move intellectually in both directions, to make our moral perceptions accord with one another, to make our generalizations consistent with each other and with our moral perceptiveness. It is true, as Dan asserts, that the details of particular cases [can] distract our attention from larger issues at stake. But it is also true that moral generalizations can and do blind us to humanly, and therefore morally, significant details of story. Unnuanced moral generalizations, every bit as much as an inappropriately narrow focus on details of a case, can leave out important details about social patterns, behavior of institutions, insights into human motivation, belief, and action. But this brings us back to importance of context. Where are we? What is proper role of stories, in particular, genre of case stories typical in clinical ethics? I want to enlist aid of Martha Nussbaum here. In Love's Knowledge, she writes: Moral knowledge . . . is not simply intellectual grasp of propositions; it is not even simply intellectual grasp of particular facts; it is perception. It is seeing a complex concrete reality in a highly lucid and richly responsive way; it is taking in what is there, with imagination and feeling.2 The problem with clinical ethics arises when genre becomes formulaic, when it forces us to look only at those aspects of case decided in advance to be significant, at that most constricted of literary genres, medical record. We must never lose sight of broader world and its patterns out of which clinical story arises. We need, that is, attentiveness to context as well as attentiveness to particulars. We need stories that are rich and thick, that point to what we need to know. We need, that is,. good stories. We also need perceptive interpreters of and commentators on those stories. t e very general-what sort

Physics · Power (physics) · Ethics in medical practice

• International Ethical Safeguards

  Kate Diesfeld•Disability & Society•1999

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