Most moral dilemmas in medicine are analysed using the four principles with some consideration of consequentialism but these frameworks have limitations It is not always clear how to judge which consequences are best When principles conflict it is not always easy to decide which should dominate They also do not take account of the importance of the emotional element of human experience Virtue ethics is a framework that focuses on the character of the moral agent rather than the rightness of an action In considering the relationships, emotional sensitivities, and motivations that are unique to human society it provides a fuller ethical analysis and encourages more flexible and creative solutions than principlism or consequentialism alone Two different moral dilemmas are analysed using virtue ethics in order to illustrate how it can enhance our approach to ethics in medicine

https://jme.bmj.com/content/medethics/29/5/297.full.pdf

A virtue ethics approach to moral dilemmas in medicine

We explore the process through which people in organizations, especially those in leadership positions, in circumstances marked by ambiguity, surprise, and conflicting values, come to, or arrive at, judgment. Briefly reviewing the (somewhat limited) literature on judgment in management studies, we conclude that its mainly rationalist orientation prevents us (scholars and practitioners alike) from properly grasping important features of the hermeneutical–developmental process involved in coming to a judgment. In particular, the role of emotions, moral agency, language use, and, especially, the selective and integrative nature of perceptual processes, are far too easily ignored. We make the case for a particular notion of judgment understood as Aristotelian “phronesis” (practical wisdom). Phronetic leaders, we argue, are people who, in their search for a way out of their difficulties, have developed a refined capacity to intuitively grasp salient features of ambiguous situations and to constitute a “landscape” of possible paths of response, while driven by the pursuit of the notion of the common good. We seek to shed light on how this is accomplished, by drawing on neo-Aristotelian, phenomenological, and Wittgensteinian philosophy.

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In Search of Phronesis: Leadership and the Art of Judgment

Recent developments in personality research point to an alchemy of character composed of five elements: extroversion, agreeableness, conscientiousness, neuroticism, and openness to experience. This paper surveys this research for its implications to the study of the virtues in organizational ethics. After subjecting each of these five character traits to several tests as to what constitutes a virtue, the empirical evidence supports an organizational virtue of agreeableness and an organizational virtue of conscientiousness. Although the empirical evidence falls short, an argument is mobilized on behalf of an additional organizational virtue of openness to experience.

The Big Five and Organizational Virtue

This article contends that an ethics of care has a particular moral ontology that makes it suitable to argue for the normative significance of relational responsibilities within professional health care. This ontology is relational. It means that moral choices always have to account for the web of relationships, the relational networks and responsibilities that are an essential part of particular moral circumstances. Given this ontology, the article investigates the conditions for health care professionals to be partial and to act on the basis of particular responsibilities to their patients. We will argue that priorities could be partial in three ways: first, because there may be exceptional circumstances that allow for giving priority to one patient over another; second, because the integrity of the patient and a health care worker may be connected in special ways; and, finally, even if impartiality is essential, the institutional basis of health care must always give ample space for an ethically qualified individual and personal care for patients. Even if difficult priorities may be necessary, the conditions of institutional health care should always seek to create the prerequisites for nurses and doctors to administer proper care.

The ethics of care: Role obligations and moderate partiality in health care

Strategy-as-practice research has usefully built on earlier strategy process research by taking into account the social embeddedness of strategy making. While such an approach has generated valuable insights, it has curiously left unexplored the moral dimension of practice. In this article, we show how the potential of strategy-as-practice research may be more fully realized if the moral dimension of practice is conceptualized through virtue ethics (especially MacIntyre’s version). Specifically, we first reconceptualize, through virtue ethics, the three main concepts of strategy-as-practice—practice, praxis, and practitioners—underscoring the inherently moral constitution of actions undertaken in strategy-related work. Moreover, we suggest that strategic management is viewed as a particular kind of practice (what we call “competitive institutional practice”), charged with “values articulation work” and “balancing work.” While the former articulates a good purpose for the organization, the latter seeks to ...

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Strategy and virtue: Developing strategy-as-practice through virtue ethics:

The Fabric of Character

Aristotle on the Human Good

Essays on Aristotle's De Anima

The Basic Principle of Emile's Education

This paper considers the place of anger in human development and culture, as discussed by Rousseau in Emile. It is argued that Rousseau presents anger as intimately associated with imperious self-assertion, and with a representation of others as malign and obstructive. If this pattern of thought and expectation is consolidated, the will to dominate these supposedly obstructive others becomes the central preoccupation. The madness lies in the idea contained in this that failure in having one's desires satisfied signals a wrong, an abuse one has suffered. Regulation of anger is necessary to achieving a proper sense of our finitude, limitation and a reasoned sense of our dependence on others.

N. J. H. Dent

Papers

The Fabric of Character

Aristotle on the Human Good

Essays on Aristotle's De Anima

The Basic Principle of Emile's Education

‘Anger is a Short Madness’: Dealing with Anger in Émile's Education