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February 12, 1992

Medical Ethics in Review-Reply

Author Affiliations

George Washington University Washington, DC

JAMA. 1992;267(6):807. doi:10.1001/jama.1992.03480060052023

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In Reply.  —I would like to respond briefly to Dr Shenkin's letter in order to acknowledge some common ground and clarify a few points. While I think he is still mistaken on nearly every specific issue he readdresses, to pursue these points would be largely self-indulgent. Let me instead take up Shenkin's contention that the "medical ethics establishment" (1) eschews empirical approaches to ethics and (2) ignores the fact that, "down in the trenches, most physicians are pretty good seat-of-thepants ethicists."To my knowledge, no medical ethicist eschews empirical approaches to empirical problems. Ethics is partly empirical, partly nonempirical—just as ethical arguments generally depend on both distinctively ethical premises (which are not empirical) and empirical claims to the effect that the present case falls under the scope of some ethical premise. So, for example, an argument that abortion should be legal because illegalization would lead to disastrous consequences relies on