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—Dr Spital is right to be wary of a priori right or wrong. Unfortunately, current ethical theories (even utilitarianism) are based on such a priori good or evil, the principle of autonomy being one such a priori good. This state of ethical affairs is the result of the ethicist's own demand that values or "oughts" must not be derived from scientific knowledge (what is). In philosophic jargon, to ground ethics on anything other than the a priori is called the "naturalistic fallacy" or "a category mistake." We strongly disagree with the current a priori requirement in ethics, and support Dr Spital's rejection of it. We think an a posteriori, inductive bioethics is a viable alternative.That does not mean, however, that all ethical decisions are relative to the patient's perceptions and choices about what is good. In our work, we argue that an inductive bioethics can identify, probabilistically,
Sider RC, Clements CD. The New Medical Ethics-Reply. Arch Intern Med. 1986;146(8):1635-1636. doi:10.1001/archinte.1986.00360200209044