principles. A second solution to this problem is to develop a scale for weighing the significance of the conflicting principles in a given case and for concluding which action should be adopted because it is supported by the weightier considerations in that case. Such a solution seems more realistic than the lexical ordering approach, but the development of such a scale is a problematic task. Still other, more complex solutions are possible. Which is the best solution to this problem of conflicting principles of bioethics? We need a moral theory to answer that question. This is the first reason for concluding that the principles of bioethics are not the true foundations of justified judgment in bioethics. What is the problem of the unclear scope and implications of the principles of bioethics and how can an appeal to moral theory help deal with that problem? The scope of a bioethical principle is the range of cases in which it applies. The implications of a bioethical principle are the conclusions to be derived from that principle in those cases in which it applies. It is clear from a review of the discussions in bioethics that there are major unclarities about the scope and implications of each of the principles. Consider, for example, the principle of autonomy.

The potential of modern medicine in a pluralistic world leads to the potential for moral conflict. The most prevalent bioethical theories often either overestimate or underestimate the amount of shared moral belief that can be used to address those conflicts. This work presents a means for taking seriously the pluralism in the modern world while recognizing the likelihood of moral “acquaintance” between persons with differing views. It criticizes moral theories that overstate the extent of the problem of pluralism as well as those that imply too much agreement between reasonable moral persons, yet it locates a means for the resolution of many moral conflicts in moral acquaintanceship. Drawing from the work of H. Tristram Engelhardt, Jr., casuists and principle-based theorists, and Erich Loewy and Kevin W. Wildes’s initial development of the concept of moral acquaintanceship, Moral Acquaintances and Moral Decisions is philosophically indepth work with direct applications for decisionmaking in real medical settings. A work in moral theory as well as a source of real world guidance, clinically oriented bioethics professionals as well as students of bioethical theory should find the theory of moral acquaintanceship provided here important to their work.

A collection examining the theoretical basis of medical ethics and the nature of moral thinking.

Philosphical medical ethics forms the basis of the codes of conduct and legal constraints involved in doctors' professional lives. This series of articles presents a British approach to the concepts, assumptions, beliefs, attitudes, and arguments underlying medico-moral decision-making in the context of medical practice. The book serves as an introduction whose aim is to encourage more rigorous analysis of the moral dilemmas confronting all physicians and to contribute to a comprehensive and coherent moral theory for medical practice.