Deciding Together


About the book

Western society today is less unified by a set of core values than ever before. Undoubtedly, the concept of moral consensus is a difficult one in a liberal, democratic and pluralistic society. But it is imperative to avoid a rigid majoritarianism where sensitive personal values are at stake, as in bioethics. Bioethics has become an influential part of public and professional discussions of health care. It has helped frame issues of moral values and medicine as part of a more general effort to find consensus about some of the most perplexing questions of our time. But why is it thought that a moral consensus is important or that it deserves respect? How does moral consensus acquire legitimacy in a society that includes diverse value systems? How is moral consensus possible and how do small groups help create or distort consensus processes?

Written by a medical school professor trained in philosophy, this timely work tackles these questions from philosophical, historical, and social scientific standpoints. It begins by describing the traditional ambivalence about consensus in Western culture as well as the uncertain relationship in modernity between consensus and expertise. After outlining the current bioethical consensus, the book gives philosophical and political analyses of the idea of consensus, then assesses the role of consensus in national ethics commissions and in the ethics committee movement. Moreno constructs an original, naturalistic philosophy of moral consensus, referred to as “bioethical naturalism”, and then applies sociology and social psychology to actual consensus processes. The book concludes with an account of bioethics as a consensus-oriented social reform movement. This insightful volume will be essential reading for bioethicists, philosophers, physicians, members of ethics committees, and all those concerned with ethical and social issues in health care.


—Thomas May, Politics and the Life Sciences

“An important and convincing book….It should be read by all those who teach bio-ethics or chair ethics committees and by anyone who grapples with the human implications of difficult situations in health care.”
Canadian Medical Association Journal

Praise for the book

“Jonathan Moreno’s superb study provides both the empirical and conceptual analysis requisite for making progress in finding answers about the role consensus does and should play in bioethics. Moreno’s first-hand knowledge of the social and political context in which bioethical issues arise and evolve, his mastery of the key legal and philosophical sources and his ability to integrate political understanding with philosophical insight make this book the requisite starting point for anyone interested in understanding the subject of consensus in bioethics and in moral theory more generally.”
—Arthur Caplan, Trustee Professor of Bioethics and Director, Center for Bioethics, University of Pennsylvania

“Bioethics has come into its own as a mature field when it can produce a reflective and insightful work like Deciding Together….The spirit of John Dewey at his best walks through these pages.”
—Bruce Jennings, Executive Director, The Hastings Center

“Jonathan Moreno provides a masterful account of the meaning and reality of moral consensus in bioethics. Drawing on the history and current practice of bioethics, on epistemology and philosophy of science, as well as sociology and social psychology, he constructs an intriguing view of bioethics as a social reform movement….This work succeeds admirably in achieving the goal the author set for himself: to give “a comprehensive account of moral consensus in bioethics for a liberal, democratic, and pluralistic society.” It is an informative and insightful book that can be read with interest and profit both by newcomers and those with long-standing experience in bioethics.”
—Ruth Macklin, Professor of Ethics, Albert Einstein College of Medicine




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