Tag: Ethics and Morality

Blog Posts (8)

September 27, 2016

A Concerning Time For America: No Time To Be Politically Silent

Bioethics as a field emerged in post WWII America during an era of American political stability and international economic and military dominance. Those of us working in the field of bioethics for past few decades, as beneficiaries of this setting, take for granted the American democratic political system and its traditions as the natural context and moral framework for scientific discovery and ethical decision-making. Though we might invoke normative ethical approaches at times on particular issues, from both various philosophical and religious traditions, generally speaking most major ethical dilemmas both at the broader policy level and in particular settings of individual patient care and research issues, must proceed according to well-established procedural rules and standards. The goal of ethical resolution in our democratic context is not to arrive at the ultimate, final, or “the” canonical ethical answer, but to reach a consensus between opposing moral perspectives that preserves a plurality of moral values based on well-established moral and legal democratic principles and values. Thus, bioethics as a field that deals with living, practical ethical conflicts depends on a stable, democratic political system in which people with diverse values and beliefs can find non-violent, indeed peaceful means of finding resolutions to their moral differences. It is in this light that bioethicists should find very concerning what is happening in our presidential election cycle.

Bombast and lack of substance have always been part of American political rhetoric. Normally I would see the role of bioethicists to advocate for policy positions within the political process, but try to remain relatively neutral in attacking or supporting particular political candidates and speaking out so candidly about issues. But in my judgment, this election cycle is an exception. Now is the time for all thoughtful people who value democracy and, in particular, bioethicists should speak out strongly. We are not in a position to take our political order and indeed the framework for moral decision making for granted.

For the first time in post-WWII America, we see ideas under consideration, like deporting 12 million undocumented aliens, which is not only unconstitutional, but, even if it were logistically possible, would cause untold physical and emotional suffering, not to mention in all likelihood an economic crisis; barring Muslims from entering our country, or requiring an ideological test for all immigrants; building a wall between our country and Mexico (in spite of the fact that there are as many people leaving the U.S. as entering); in general we see fabrication of information, character assassination, innuendos, shifting views and talking points, nothing resembling a test of ideas and reasonable exchange of competing views. Some may see such rhetoric and tactics as just more bombast and nothing that could fundamentally change the character of our country. On the contrary, this is one of those potentially disruptive times, much like the McCarthy era, in the life of a nation that could render our basic social and political institutions unrecognizable. 

There are growing numbers of citizens in the US with legitimate gripes, who feel their interests have been ignored. As the economy has grown in many specialized areas, as companies have become more efficient in terms of using automation and technology requiring fewer workers, the jobs that built the great middle class in post-WWII America for decades have been eviscerated. Too many of the policies of the past thirty years designed to address these issues, such as lowing taxes on the rich, which many of which these same suffering workers supported, have left them without the skills to participate in a fundamentally different kind of economy and standing little chance to achieve a similar level of wealth as their parents did with the same skills. 

This partly explains why a segment of voters are responding positively to extreme proposals even as many admit they cannot actually be accomplished. Because of their fading hope and trust in the system, some of these voters have become iconoclasts—literally someone who seeks to blow up the system regardless of the consequences. Tragically, their despair, as expressed currently in political terms, approaches nihilism. For them the message is clear, the American way of life no longer provides them meaning and purpose.

However, flagging economic conditions alone cannot account for all of what is happening politically. Another part of the explanation also involves evolving cultural and religious norms over the past few decades governing same sex marriage, women’s roles and their reproductive rights, along with greater ethnic and religious inclusion and tolerance—changes that we liberals celebrate as progress and essential to a growing democracy—that are anathema to many on the political and cultural right. 

These complex macro economic and sociocultural trends are warning signs and indicative of a vulnerable moment in our history, where a wrong outcome at the presidential level could change the character of our nation for generations, if not forever.  

I conclude that this political season is not a normal cycle in the American democratic experiment. It is not a time for thoughtful people and thought-leaders like bioethicists, to remain silent. We must speak out individually and make ourselves heard. Then we must make an effort to better understand the current political conditions and incorporate that understanding into our professional discourse and thinking. Otherwise, we will be ignoring a most fundamental concern, i.e. the very democratic character of our ethical framework grounded in the American political system. We cannot now, or ever, simply take for granted that it will remain intact for future generations. 

The Alden March Bioethics Institute offers a Master of Science in Bioethics, a Doctorate of Professional Studies in Bioethics, and Graduate Certificates in Clinical Ethics and Clinical Ethics Consultation. For more information on AMBI's online graduate programs, please visit our website.


April 28, 2016

Expanding The Moral Community: Why is it so hard?

Much of American history can be described as the struggle to expand the moral community in which an increasing number of human beings are seen as having basic rights under the constitution. We forget sometimes that though the inclusion of all people was perhaps implied in our early documents, as in “We hold these truths to be self-evident, that all men are created equal…” from the Declaration of Independence, it has taken historical time and struggle to come closer to realizing that ideal. This struggle has been the quest for recognition of more and more individuals not assumed initially to have the right to vote and exercise control over their lives, which included African Americans, women, minorities, and more recently the LGBT community. The growing recognition of more and more individuals as being full fledged citizens has been a slow, often painful, birthing process of freedom, in the sense of unleashing human potential and possibilities, within the democratic process.

 

The recent uproar over the Anti-LGBT law passed in North Carolina is a reminder of how difficult it is for many states and communities to accept and accommodate historically marginalized people into the mainstream of society. This law was a quick reaction by the right wing North Carolina legislature and governor to an ordinance passed in Charlotte, similar to what other cities around the country are doing, allowing transgender people to use restrooms according to their gender identity. Perhaps this law also should be seen as a reaction to the Supreme Court ruling in 2015 legalizing same-sex marriage, which has been propelling society toward greater openness and acceptance of LGBT life styles, integrating them into the mainstream. Many who favor the Anti-LGBT law claim that individuals born as male, but are now identifying as female, could pose a risk to women and girls in public bathrooms, though there seems to be no substantial evidence whatsoever of such a risk. My sense is that the individuals who support this law in fact are using risk as a smokescreen in attempting to preserve what they perceive as waning values and norms in society: In the name of conservatism they hang on to an exclusionary vision of society that no longer fits the conditions of expanding freedom and opportunity.

 

So what some see as waning values and norms, others see as moral progress toward more robust democratic ideals and values. This inherent, historical struggle of opposing social and political forces has resulted with unexpected rapidity in the social and legal acceptance of gays and lesbians in the past 20 years in the United States. Most young people today especially those living in metropolitan areas, like Charlotte, where cultural diversity is a daily reality, readily accept that people naturally have different sexual orientations and gender identities, which people should be free to express in their lives. This liberal openness to diversity likely stems from the fact that they live in the midst of, and have normal interactions and friendships with, people of diverse sexual orientations and gender identities, which prompts them to look upon them as neighbors and as normal people. On the other hand, my guess is that many of the advocates of the Anti-LGBT Bill in North Carolina have little or no contact (of which they are aware) and no or limited relationships with LGBT individuals. Also, part of the resistance to greater inclusion of the LGBT community could be stem from the anxiety of having to recognize one’s own uncomfortable feelings and inclinations about sexuality and gender.

 

An additional factor to explain the reluctance of many self-identified conservatives to accept alternative sexual and gender orientations may be related to religion. Particularly, in the “bible belt” regions, regardless of whether or not they are followed by church leaders and members, clear notions of basic moral norms of right and wrong are assumed. Sadly, religious morality has been historically integrated with and used to justify a range of regional cultural values and norms—even heinous ones such as the use of Christianity to justify the institution of slavery. But in fairness even many Christians outside the bible belt follow Catholic natural law theory based on certain features about human nature from which basic norms are predicated about what is “normal” as well as “right” and “wrong” in a content rich, objective sense. In short, the point is if one believes that members of the LGBT community are engaging in a personal life style that is assumed to be inherently immoral, a barrier to inclusion is created.

 

So we in America today are in the midst of a culture war between conservative communities in rural and smaller towns on the one side espousing religious assumptions about human nature (which affects how they perceive risks) and liberals celebrated diversity in more progressive, metropolitan areas on the other. Advocates on either side of this divide bring to bear ideas and theories in an effort to convince others of their position. However, my sense is that articulating arguments to defend the root moral assumptions of either side is unlikely to change the minds of individuals on the other side. The result seems to be communities of individuals living in parallel universes with alternate moral vocabularies who “talk at” each other. Though I am for a liberal, moral vocabulary to account for moral progress within the democratic process, the real change that many of us liberals seek really is at the emotional, and even spiritual, level relating to how human beings are able to show empathy and respect for their fellow human beings in their communities.

 

We know human identity is based largely on social identity within a particular group or groups related to broad social categories such as religion, race, ethnicity, social class, etc. and to more specific ones such as professions, sports teams, political parties, etc. One of the inherent features of social identity is that individuals have a sense of self-identity by virtue of their group affiliations, which is also defined in terms of groups with which they are not affiliated and to which they stand in opposition. When group identities become rigid, to the point of engendering animus toward other groups, barriers are created which can marginalize the rights of individuals in those groups. But through exposure to, and openness to personal relationships with, individuals outside one’s own group, group identity becomes more flexible and open to change—this is an inner change of heart and disposition toward others.

 

Perhaps many of those who self-identify as conservatives in North Carolina who favor the Anti-LGBT law, and who also are predominantly Christian, should remember the ministry of the central character of their faith tradition. The thrust of Jesus’ ministry as defined by scholars like John Dominic Crossan is one of radical inclusion and hospitality. Jesus spent his time interacting with, eating with, and drinking wine with those on the margins of society who were outcasts and viewed as unclean and dangerous according the prevailing hygiene laws. His message to these people was that they too can be included in the moral community and be loved like all others. This is a robust message of compassion and love.

 

Ultimately, struggle for expanding inclusion can only succeed when opponents of bills like the Anti-LGBT Bill are able to show members of the LGBT community the kind of compassion and love Jesus showed to those on the margins of society in his day. The struggle of inclusion really is the struggle to expand what one thinks of as the moral community, or more simply, the neighborhood.

 

 

 

The Alden March Bioethics Institute offers a Master of Science in Bioethics, a Doctorate of Professional Studies in Bioethics, and Graduate Certificates in Clinical Ethics and Clinical Ethics Consultation. For more information on AMBI's online graduate programs, please visit our website.

October 5, 2015

Elective or Life-Saving? Catholic Hospitals and the Ban on Tubal Ligation

<p style="font-size: 11.2px; line-height: 19.04px;"><span style="font-size: 11.2px; line-height: 19.04px;">A Catholic hospital </span><a style="font-size: 11.2px; line-height: 19.04px;" href="https://www.rt.com/usa/315359-catholic-hospital-denies-sterilization-request/">came under fire recently</a><span style="font-size: 11.2px; line-height: 19.04px;"> for stating that it would not permit doctors to perform a tubal ligation during a c-section scheduled for October.  According to news reports (including an</span><a style="font-size: 11.2px; line-height: 19.04px;" href="http://www.thedailybeast.com/articles/2015/09/23/a-catholic-hospital-says-it-s-evil-for-me-to-get-my-tubes-tied.html">article written by the patient herself</a><span style="font-size: 11.2px; line-height: 19.04px;">), the pregnant patient has a brain tumor, and her doctor have advised her that another pregnancy could be life-threatening.  Her doctor has recommended that she have a tubal ligation at the time of her c-section.  While my knowledge about this hospital, this case, and the participants is limited to what has been reported in the media, it raises an interesting question: in our pluralistic society, where conscientious objection is respected while maintaining a patient’s right to a certain standard of care, is it ethical to allow a religiously-affiliated health care institution to refuse to provide certain treatments it finds morally objectionable?</span></p> <p style="font-size: 11.2px; line-height: 19.04px;"><span style="font-size: 11.2px; line-height: 19.04px;">As background, the Catholic Church has historically been outspoken on bioethical issues and has a strong and robust bioethical teaching.  Catholic hospitals are governed by the </span><a style="font-size: 11.2px; line-height: 19.04px;" href="http://www.usccb.org/issues-and-action/human-life-and-dignity/health-care/upload/Ethical-Religious-Directives-Catholic-Health-Care-Services-fifth-edition-2009.pdf">Ethical and Religious Directives for Catholic Health Care Services</a><span style="font-size: 11.2px; line-height: 19.04px;"> (ERDs), a document promulgated by the United States Conference of Catholic Bishops (USCCB) that clearly articulates the bioethical policies that must be followed in a health care institution based on the Church’s moral teachings.  It explains the Church’s teaching against direct sterilization as a method of birth control based on the </span><a style="font-size: 11.2px; line-height: 19.04px;" href="http://plato.stanford.edu/entries/double-effect/">principle of double effect</a><span style="font-size: 11.2px; line-height: 19.04px;">.  “Direct sterilization of either men or women, whether permanent or temporary, is not permitted in a Catholic health care institution.  Procedures that induce sterility are permitted when their direct effect is the cure or alleviation of a present and serious pathology and a simpler treatment is not available.” (Directive 53).  In other words, if the sterilization procedure directly treats a pathology, it is licit; if it is used as a form of birth control to prevent a pregnancy, even if that pregnancy would be life-threatening, it is not licit.</span></p> <p><span style="color: #34405b; font-family: Arial, Helvetica, sans-serif; font-size: 12px; line-height: 19.04px;"><strong>The Alden March Bioethics Institute offers a Master of Science in Bioethics, a</strong> </span><strong style="color: #34405b; font-family: Arial, Helvetica, sans-serif; font-size: 12px; line-height: 19.04px;">Doctorate of Professional Studies in Bioethics, and Graduate Certificates in Clinical Ethics and Clinical Ethics Consultation. For more information on AMBI's online graduate programs, please visit our <a style="color: #000099; text-decoration: underline;" href="/Academic/bioethics/index.cfm">website</a>.</strong></p>
August 21, 2015

Some Reflections On Summer Vacation Reading

<p style="font-size: 11.1999998092651px; line-height: 19.0400009155273px;">I love to read novels and works of non-fiction in concentrated sittings so I can really lose myself in what I am reading. Because I am so busy during the course of my work-a-day professional life I rarely have such luxury. This is why vacation for me means a time when I can find a few really interesting books on my reading list and just devour them. Having recently returned from vacation and being overdue for my AMBI Blog, I thought I would share a few thoughts on my vacation reading, and even see if there is a lesson for bioethics.</p> <p style="font-size: 11.1999998092651px; line-height: 19.0400009155273px;"><span style="font-size: 11.1999998092651px; line-height: 19.0400009155273px;">This summer my reading was unusual in that it was all non-fiction, which included “The Return of George Washington” by Edward J. Larson, “The Warmth of Other Suns” by Isabel Wilkerson, and “Between the World and Me” by Ta-Nehisi Coates. I really didn’t plan to be reading these books together. But as it turns out, after finishing all three, I found a theme of interesting, often disturbing, questions about the past and present treatment of African Americans in the United States—questions that challenge the moral foundation and integrity of American democracy from its origins to the present.</span></p> <p style="font-size: 11.1999998092651px; line-height: 19.0400009155273px;"><span style="color: #34405b; font-family: Arial, Helvetica, sans-serif; font-size: 12px; line-height: 19.0400009155273px;"><strong>The Alden March Bioethics Institute offers a Master of Science in Bioethics, a</strong> </span><strong style="color: #34405b; font-family: Arial, Helvetica, sans-serif; font-size: 12px; line-height: 19.0400009155273px;">Doctorate of Professional Studies in Bioethics, and Graduate Certificates in Clinical Ethics and Clinical Ethics Consultation. For more information on AMBI's online graduate programs, please visit our <a style="color: #000099; text-decoration: underline;" href="http://www.amc.edu/Academic/bioethics/index.cfm">website</a>.</strong></p>
August 3, 2015

A Stoic on Pluto

<p class="MsoNormal" style="font-size: 11.1999998092651px; line-height: 19.0400009155273px;"><span style="font-size: 11.1999998092651px; line-height: 19.0400009155273px;">Two notable things happened this past month that I feel compelled to write about: NASA’s </span><a style="font-size: 11.1999998092651px; line-height: 19.0400009155273px;" href="http://www.nytimes.com/2015/07/15/science/space/nasa-new-horizons-spacecraft-reaches-pluto.html?ref=topics">New Horizons spacecraft reached Pluto</a><span style="font-size: 11.1999998092651px; line-height: 19.0400009155273px;">; NASA engineer and manager</span><a style="font-size: 11.1999998092651px; line-height: 19.0400009155273px;" href="http://www.nytimes.com/2015/07/20/us/claudia-alexander-nasa-manager-who-led-jupiter-mission-dies-at-56.html?_r=0">Claudia Alexander died of cancer</a><span style="font-size: 11.1999998092651px; line-height: 19.0400009155273px;">. These events highlight some very powerful lessons in bioethics, and indeed about the human condition itself.</span></p> <p class="MsoNormal" style="font-size: 11.1999998092651px; line-height: 19.0400009155273px;"><strong style="font-size: 11.1999998092651px; line-height: 19.0400009155273px;">Lesson #1: We can do so much.</strong></p> <p class="MsoNormal" style="font-size: 11.1999998092651px; line-height: 19.0400009155273px;">New Horizons is the <a href="https://www.nasa.gov/mission_pages/newhorizons/overview/index.html">first spacecraft to visit Pluto</a>, a mission taking almost ten years (or more, if you count pre-launch), traveling over <a href="http://www.nasa.gov/sites/default/files/atoms/files/nh-fact-sheet-2015_0.pdf">three billion miles</a>, and costing around <a href="http://www.forbes.com/sites/alexknapp/2015/07/14/how-do-new-horizons-costs-compare-to-other-space-missions/">seven-hundred million dollars</a>. It will be our first opportunity to truly investigate an ice <a href="http://solarsystem.nasa.gov/planets/profile.cfm?Object=Dwarf">dwarf planet</a>, and the information gleaned from it holds the potential to complete much of our knowledge of the planetary types in our own solar system. Over eighty years after its discovery by <a href="https://en.wikipedia.org/wiki/Clyde_Tombaugh">Clyde Tombaugh</a>, Pluto – our final (local) planetary frontier – is within our grasp.</p> <p><span style="color: #34405b; font-family: Arial, Helvetica, sans-serif; font-size: 12px; line-height: 19.0400009155273px;"><strong>The Alden March Bioethics Institute offers a Master of Science in Bioethics, a</strong> </span><strong style="color: #34405b; font-family: Arial, Helvetica, sans-serif; font-size: 12px; line-height: 19.0400009155273px;">Doctorate of Professional Studies in Bioethics, and Graduate Certificates in Clinical Ethics and Clinical Ethics Consultation. For more information on AMBI's online graduate programs, please visit our <a style="color: #000099; text-decoration: underline;" href="/Academic/bioethics/index.cfm">website</a>.</strong></p>
February 20, 2015

The Physician-Patient Relationship: The basis for moral clarity in clinical ethics

<p><span style="font-size: 11.1999998092651px; line-height: 19.0400009155273px;">It is my sense that the majority, perhaps the vast majority, of cases on which clinical ethics consultants (CECs) are asked to consult and make an ethics recommendation, there is, or would be, a general consensus on the part of the CECs about what counts as the appropriate recommendation. However, the question arises of how clinical ethics as a field should deal with issues that come up about which there is not a clear consensus, such as in cases where a basic right to have an autonomous choice respected by the patient is pitted over and against the obligation of the physician to do no harm—the traditional tension between respect for patient autonomy and beneficence/nonmaleficence. This tension or conflict often occurs in cases of alleged medical futility where the patient or the patient’s surrogate requests a treatment option the physician deems will only cause harm and no benefit to the patient. For example, consider a patient’s surrogate who insists that she will not consent to a DNR order and in fact expects the physician to perform CPR if the patient arrests. For a patient without capacity dying of metastatic disease, this directive by the surrogate presents a stark dilemma to the physician—is it a violation of the physician’s obligation to the patient to “do no harm” (nonmaleficence)? Or is respect for the patient’s wishes or her representative’s wishes so sacrosanct that the physician’s obligation to follow the patient’s wishes is paramount and outweighs the obligation to do no harm?</span></p> <p><strong style="color: #34405b; font-family: Arial, Helvetica, sans-serif; font-size: 12px; line-height: 19.0400009155273px;">The Alden March Bioethics Institute offers a Master of Science in Bioethics, a Doctorate of Professional Studies in Bioethics, and Graduate Certificates in Clinical Ethics and Clinical Ethics Consultation. For more information on AMBI's online graduate programs, please visit our <a style="color: #000099; text-decoration: underline;" href="/Academic/bioethics/index.cfm">website</a>.</strong><span style="color: #34405b; font-family: Arial, Helvetica, sans-serif; font-size: 12px; line-height: 19.0400009155273px;"> </span></p>
October 13, 2014

Belief In Ultimate Truth: Does it make for peaceful living?

<p class="MsoNormal" style="line-height: 19.0400009155273px;"><span style="line-height: 19.0400009155273px;">As I have been saying in recent blogs, most of what we do in clinical ethics, but also in most areas of bioethics, is procedural ethics. That is when we are faced with an ethical dilemma, our approach, whether consciously or unconsciously is usually to try to reach a reasonable compromise or consensus among the key participants that are in conflict consistent with well-established values and principles. This tendency reflects an obvious reality about the nature of contemporary ethics that we often ignore: in the current Western moral setting, our only viable methodology for resolving value laden disputes, whether at the micro level in clinical ethics or macro level in healthcare policy, is to attempt to craft an agreement or consensus among those with a say. Whether we are dealing with patients and families at odds with their physician on how to define the goals of care in the hospital setting or trying to build a consensus of opinion among voters in the political arena, we assume there are no final, authoritative moral answers that avail themselves to us. Whether we like it or not, we humans must figure out ethical dilemmas for ourselves and learn to get along.</span></p> <p class="MsoNormal" style="line-height: 19.0400009155273px;"><span style="line-height: 19.0400009155273px;">Yet the idea of procedural ethics remains very worrisome for many people, including such bioethicists and Tristram Engelhardt, Jr. He believes that procedural ethics, such much of what we do in clinical ethics, is not really ethics in because it is based on convention and legalistic type standards. For him ethics worthy of the name must flow from a content-rich, canonical moral tradition that provides moral authority to our everyday ethical and moral judgments. The prototype ethical tradition was the medieval Christian Natural Law perspective grounded in Aristotelian philosophy. Aristotle assumed the inherent order and intelligibility of the cosmos, which also permeated his understanding of ethics. Humans, like all natural things, had a natural function, which was to be rational. But rational did not mean to that ethics was about finding intellectual or theoretical basis for right action according to rational rules in order to know and perform one’s duty—this was Kant’s (1724-1804) ethics during the 18</span><sup style="line-height: 19.0400009155273px;">th</sup><span style="line-height: 19.0400009155273px;"> century following the rise of modern science. For Aristotle, the question was, how can one live and embody the good life; so rationality in this sense meant internal harmony between emotions and decision-making that resulted in well-established habits or states of character. This means finding in all of one’s activities the balance between excess and deficiency, or what he called the “mean”. Over time, forming the right habits according to the mean in all areas of life lead to excellence and happiness or what he called the good life. This was the natural fulfillment of the human function in practical terms consistent with the ancient Aristotelian.</span></p> <p class="MsoNormal" style="line-height: 19.0400009155273px;"><strong style="color: #34405b; font-family: Arial, Helvetica, sans-serif; font-size: 12px; line-height: 19.0400009155273px;">The Alden March Bioethics Institute offers a Master of Science in Bioethics, a Doctorate of Professional Studies in Bioethics, and Graduate Certificates in Clinical Ethics and Clinical Ethics Consultation. For more information on AMBI's online graduate programs, please visit our <a style="color: #000099; text-decoration: underline;" href="/Academic/bioethics/index.cfm">website</a></strong></p>
September 16, 2014

Is It Possible To Do Bioethics In Contemporary America?

<p style="line-height: 19.0400009155273px;"><span style="line-height: 19.0400009155273px;">Ok, I realize I am being somewhat provocative. But there is a real and very serious issue, which I am groping to address in a more precise manner.</span></p> <p class="MsoNormal" style="line-height: 19.0400009155273px;"><span style="line-height: 19.0400009155273px;">In my last blog I described the contemporary moral setting from a philosophical perspective as one in which no single substantive normative moral perspective can resolve moral questions, such as the boundaries of human life and the scope of individual rights, with final moral authority. This is just to say, more simply and obviously when we reflect upon it, that in democratic, secular America, ethics, both philosophically and practically, becomes inextricably linked to public discourse in politics and public policy.</span></p> <p class="MsoNormal" style="line-height: 19.0400009155273px;"><span style="line-height: 19.0400009155273px;">When bioethicists ask questions and make arguments about abortion, physician assisted suicide, stem cell research and cloning, and many other similar issues that pertain to questions about the value of human life in relation to both individual rights and societal goals, we have no privileged moral authority from which to draw. As bioethicists we engage in procedural, persuasive discourse, based on conventional moral principles that most often conflict, which is why there is moral dilemma or problem requiring analysis and prioritization. Our purpose in defending a particular moral position is to win assent from others. In short, for a bioethicist to promote a moral position, it is implicitly an attempt to build a consensus among readers and listeners that will hopefully impact public opinion about a particular moral problem or question. Moreover, to the extent these questions have public policy ramifications, and practically all do, it means that moral discourse is also oriented to effect change and function as a medium in which bioethicists often speak as advocates about how moral options should be framed as public policy positions in a democratic society.</span><span style="line-height: 19.0400009155273px;"> </span></p> <p class="MsoNormal" style="line-height: 19.0400009155273px;"><strong style="color: #34405b; font-family: Arial, Helvetica, sans-serif; font-size: 12px; line-height: 20px;">The Alden March Bioethics Institute offers a Master of Science in Bioethics, a Doctorate of Professional Studies in Bioethics, and Graduate Certificates in Clinical Ethics and Clinical Ethics Consultation. For more information on AMBI's online graduate programs, please visit our <a style="text-decoration: underline; color: #000099;" href="/Academic/bioethics/index.cfm">website</a>.</strong><span style="line-height: 19.0400009155273px; color: #34405b; font-family: Arial, Helvetica, sans-serif; font-size: 12px;"> </span></p>