To Stretch toward without Reaching: Moral Expertise as a Paradox in Clinical Ethics Consultation

  • Salla Saxén
Part of the Philosophy and Medicine book series (PHME, volume 129)


Irrespective of whether the practice of clinical ethics consultation (CEC) is generally accepted or not, the nature of moral expertise behind it continues to be a contestable concept. In this essay, instead of arguing for whether clinical ethics consultants possess such expertise or not, I envision a third way of understanding the nature of moral expertise in ethics consultation: as the locus of an inherent paradox. I argue that moral expertise in clinical ethics consultation is built on an inner ideological struggle between pluralism and expertise—inclusion and exclusion—and that this inbuilt tension forms the core of the paradox. However, I claim that this paradox does not have to lead into a paralyzing contradiction, but instead, it could be embraced positively as a guarantee of keeping the moral space open. Moreover, I argue that putting too strong emphasis on consensus as a professional ideal of CEC may, surprisingly, threaten the fostering of open social space for moral discussions. As the baseline of this argument I utilize Mouffe’s theory of agonistics. In the end of the chapter, I conclude that recognizing the division of values, and opening social space for struggle, can in itself be seen as both a goal and a justification for clinical ethics consultation.


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Copyright information

© Springer International Publishing AG, part of Springer Nature 2018

Authors and Affiliations

  • Salla Saxén
    • 1
  1. 1.University of Eastern FinlandKuopioFinland

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