Volume 1, 2007
Against the Utilitarian Grain
Alternative Approaches to Health Care Ethics
One of the many general problems that I wish to examine is that to do with the ethics of health care practice and provision. Consequently, I aim to undertake the following: first, I examine, in the light of Rorty's famous dictum concerning suffering, the current state of international policies on health care resource provision. Second, following Brock, I argue that such policies of allocation are founded on broad utilitarian principles. Third, I lay the foundations for an argument that moral utilitarianism, like economic utilitarianism, is dependent upon a form of calculative reasoning which is a necessary feature of the broad Anglo-American analytic approach to philosophical issues, and as a means of helping us to understand both the complex moral status of persons and the way(s) in which health care policies need to be framed for such persons, that approach is found wanting. Fourth, I propose some alternative approaches to minking about health care which are informed more by the phenomenological tradition. I mention both Heidegger and Levinas, whilst concentrating on the work of Hadot, whose emphasis on spiritual exercises has close affinities to the practical health care work and research undertaken by Bradshaw. Such a phenomenological approach can, I suggest, help to lessen what Bradshaw claims is a current dependence upon a 'contract' view of care, whilst attempting to replace it with what she terms a 'covenant' view.