Introduction

Empirical ethics is based upon the idea that empirical research can be used to develop new and better ethical theories. Empirical research can elucidate the relevance of ethical issues in daily life, and show which problems require normative analysis. It can also give insight into the considerations of practitioners, which might be morally relevant because they embody experience. In the literature, various methods for integrating empirical research on the considerations of practitioners in ethics have been proposed. One is the method of Wide Reflective Equilibrium (Delden and Thiel, 1998), which is based upon Rawls’ method for developing a theory of justice. Another one is pragmatic hermeneutics (Scheer and Widdershoven, 2004), which is inspired by Gadamer’s analysis of human experience.

Ebbesen and Pedersen (2007) combine hermeneutics and Wide Reflective Equilibrium. The article gives a theoretical analysis of the two methods, exploring their common features. It also describes how the two methods were applied in a research project. The combination of hermeneutics and Wide Reflective Equilibrium, and their joint application in a concrete research project, is relevant for the discussion on empirical ethics. Yet, some questions can be raised concerning the way in which the authors relate both approaches to one another. In my comment I will first go into the theoretical comparison of the two methods. I will argue that on a theoretical level, the two approaches are in certain aspects more similar, and in other aspects more different than the authors claim. Next I will go into the practical application of hermeneutics and Wide Reflective Equilibrium in the research project. I will question the design of the project from the perspective of both hermeneutics and Wide Reflective Equilibrium. My conclusion will be that a successful combination of hermeneutics and Wide Reflective Equilibrium in empirical ethics requires further theoretical and practical efforts.

Comparing hermeneutics and Wide Reflective Equilibrium in theory

Hermeneutics and Wide Reflective Equilibrium share the view that in order to develop a theory about moral understanding and moral reasoning, one should start from the way in which experienced practitioners handle practical cases. According to Gadamer, philosophical hermeneutics makes explicit processes of interpretation in everyday life. People interpret their situation from a specific perspective or background of practical expectations. This horizon of meaning structures understanding. It is normally taken for granted. Yet, one’s perspective can be put into question, if it is being confronted with other perspectives. Understanding not only means applying one’s perspective to a specific case, but also being open to other perspectives. The process of hermeneutic understanding is a dialogue between perspectives, resulting in a fusion of horizons. This hermeneutic process is at work in everyday life. The aim of philosophical hermeneutics is to make clear what is at stake in practical processes of understanding and use this as a basis for a philosophical theory of interpretation. Likewise, Rawls starts from the assumption that experienced people, such as judges, can show us what is crucial for moral reasoning. The way in which they come to a considered moral judgment can serve as a model for a philosophical theory about moral reasoning. Wide Reflective Equilibrium aims to make explicit what procedures are involved in the process of moral reasoning of competent people. These procedures include, amongst others, comparing one’s judgments with background principles, and subject moral principles to other perspectives.

According to hermeneutics and Wide Reflective Equilibrium, everyday moral understanding and reasoning is relevant for philosophy in two ways. In the first place, it can serve as a model for philosophical understanding and reasoning. The way in which experienced people in daily life handle moral questions can guide ethics. For Gadamer, philosophy and ethics are dialogical, just as moral life is dialogical. For Rawls, ethical theory should balance considered moral judgments and principles, like judges do in their practice. Secondly, everyday moral life is the source for philosophical notions and concepts. Moral notions that are used in practice in medicine and health care are relevant for medical ethics, and should be taken into account in moral theory. The two ways in which practice is relevant for theory are related. For hermeneutics, ethical theory should be developed in a dialogue with practitioners about their moral considerations and concerns. For Rawls, developing ethical theory requires balancing considered moral judgments of practitioners with ethical principles.

The parallels between hermeneutics and Wide Reflective Equilibrium imply that both approaches combine descriptive and normative elements. Hermeneutic understanding not only means knowing the perspective of the other in a descriptive way, it also and more fundamentally means understanding what the other has to say, that is investigating the validity of the other’s perspective for oneself. That is not to say that the perspective of the other is simply accepted as valid. The process of hermeneutic understanding entails that one critically examines the point of view of the other, and does not stop doing so until a common understanding is reached. In a similar way, Wide Reflective Equilibrium combines knowing the considered judgments of the other and investigating their validity. In the light of this parallel between the two approaches, the characterization by the authors of hermeneutics as descriptive and Wide Reflective Equilibrium as normative is unjustified. Both entail a combination of descriptive and normative elements, with an emphasis on the normative issue of validity or justifiability.

We may conclude that the authors tend to overlook the shared interest of hermeneutics and Wide Reflective Equilibrium in the validity of perspectives of practitioners. Yet, the authors also overlook some fundamental differences between the two approaches. A first point of divergence concerns method. For hermeneutics, examining the validity of the perspective of practitioners implies a dialogue between theory and practice. This is a joint activity, aiming at a merger of perspectives between various parties. According to hermeneutics, truth comes about in a movement in which ethicist and practitioner take part. This is why Gadamer claims that truth is more, and more fundamental, than method. In Wide Reflective Equilibrium, the perspective of practitioners should be taken into consideration in a process of balancing judgments and principles. This is an activity of the researcher. In Wide Reflective Equilibrium, the researcher follows a (decision) procedure. The emphasis is on method, although a wider notion of truth is also recognized (since the method is not logical, but requires insight). Hermeneutics and Wide Reflective Equilibrium have different views on the relation between (dialogical) truth and (procedural) method. Since these views are not totally opposite, they might be combined. Yet, such a combination can only be achieved if one is open for the other view and is prepared to learn from it.

A second point in which hermeneutics and Wide Reflective Equilibrium diverge is their account of virtue. Although both approaches acknowledge the role of virtue in moral understanding and reasoning, they have differing views on which virtues are relevant and why. For hermeneutics, the virtue of phronesis is the core of moral understanding. A person with phronesis knows the right middle, and acts accordingly. Phronesis is practical, and based upon experience. For Rawls, the relevant virtue is reasonableness. This virtue is not directly related to moral insight, but to the ability to be open and to adjust one’s position in a case of conflict. For Rawls, virtues are necessary for balancing. The process of balancing itself is, however, not regarded as an exercise of virtue, but of reasoning. The claim of the authors that hermeneutics and Wide Reflective Equilibrium have the Aristotelian notion of phronesis in common is too strong, and obliterates the differences between the two approaches. Again, it would be more profitable to acknowledge the differences, and try to find out what both approaches could learn from one another.

Hermeneutics and Wide Reflective Equilibrium have the same aim, namely developing theory by making use of the insights of practitioners. They both combine descriptive and normative elements. Yet the approaches are also different. Rather than concluding that the two approaches are similar, one should investigate the differences, and try to see whether and, if so, how a common approach could be developed, by integrating the different perspectives on moral understanding and reasoning.

Combining hermeneutics and Wide Reflective Equilibrium in practice

The authors not only discuss the relationship between hermeneutics and Wide Reflective Equilibrium on a theoretical level, they also show how they combined the two approaches in a concrete research project. The aim of the project was to explore the ethical reasoning of physicians and molecular biologists and to compare their moral understanding. The authors have set up an interview guide inviting the subjects to talk about their practice in a narrative way, to reflect upon cases related to that practice and to reflect upon ethical principles. The first part (narrate about practice) is inspired by hermeneutics; the second and third part (reflection on cases and principles) is set up in line with Wide Reflective Equilibrium. The interviews were analyzed in three steps: naïve reading, structural analysis and comparison with existing ethical theories. The first two steps are related to hermeneutics, the third is associated with Wide Reflective Equilibrium.

Although the authors refer to hermeneutics and Wide Reflective Equilibrium in their presentation of the research design, one may question whether the way in which they set up the interview guide and analyzed the results does justice to both approaches. From a hermeneutic perspective, an interview should focus on the respondent’s experience with concrete ethical issues in daily practice. The first questions of the interview guide do address daily practice, but the way in which they are formulated invites a description of activities, rather than an exploration of what makes practice meaningful. Once the topic of ethics is addressed, the interview guide does not focus on concrete experiences of the respondents. After the question: “Have you ever been faced with difficult decisions whether or not to participate in a research project? Or how to treat a patient?”, one would want to know what the decision was, and how the respondent dealt with it. This is not explicitly asked. The two cases presented are very technical and short. A hermeneutic case description would emphasize considerations and concerns of people present in the case. A short and straightforward description does not stimulate moral understanding of the case on the side of the respondent. The introduction of the ethical principles resembles a lecture on ethical theory. The question: “How do you understand these principles” might raise a theoretical explanation on the side of the respondent, rather than a story about their meaning and application in daily practice.

The interview guide can also be questioned from the perspective of Wide Reflective Equilibrium. The questions are not clearly focused on the considerations of respondents concerning ethical issues. How can we be sure that the answers provide us with considered moral judgments? Although intuitive elements do play a role in Wide Reflective Equilibrium, one might have doubts about only addressing the immediate assessment of the cases presented. Would it not be also important to know what arguments play a role, and what principles are involved? One needs to understand the principles of the respondent, in order to open up a discussion about other principles, and invite the respondents to consider these. One may doubt whether such a discussion is effectively prepared by a list of various possible principles. It seems more suitable to start with the principles addressed by the respondent, and suggest alternatives, than to start with abstract notions, such as autonomy or dignity. From the perspective of Wide Reflective Equilibrium, one would want to know how the respondents consider ethical issues they are experienced with, and how they balance their judgments with principles (both principles they endorse, and principles they are less inclined to follow). The interview guide does not focus on these issues.

From the perspective of both hermeneutics and Wide Reflective Equilibrium, one may have doubts whether the structure of the interview actually triggers respondents to elaborate on their way of meaning-making and argumentation. This does not necessarily exclude that the interviews contain information about this. People often talk extensively about their views and actions, even if they are not invited to do so explicitly by the interviewer. Thus, the analysis might shed more light on the respondents’ moral understanding than one would expect on the basis of the interview guide. The analysis described by the authors, however, does not pay much attention to the way in which people come to moral understanding by interpreting concrete cases and balancing judgments and principles. In the schedule, complex issues expressed in the interviews are reduced to general topics. The outcome is an identification of principles used by the respondents, rather than an insight into the way in which such principles are applied to the situation and modified during the process of interpretation and application.

Apart from these critical remarks concerning the interview guide and the analysis, one might also question whether the research project leads to normative conclusions, as the authors intend. The outcome seems to be an overview of the principles endorsed by two groups of practitioners. This however, does not tell us much about the validity of these principles. Is it morally right for physicians and molecular biologists to address moral issues in the way they do? An answer to this question requires a critical assessment of the moral understanding and reasoning of both groups. This is more than structuring the data by using existing bioethical theories, as the authors do. What is needed is an interaction between moral considerations found in practice and moral arguments and principles developed in theory. Following a hermeneutic approach, one could investigate the validity of the two perspectives by engendering a dialogue within each of the groups, and between the two groups (Abma and Widdershoven, 2005). These dialogues could be stimulated and enriched by bringing in perspectives from theory. Following the method of Wide Reflective Equilibrium, one should balance the considerations of both groups of practitioners with theoretical principles (Delden and Thiel, 1998). This interaction between practice and theory, which is crucial for hermeneutics and Wide Reflective Equilibrium, is lacking in the description of the research project by the authors.

Conclusion

Hermeneutics and Wide Reflective Equilibrium are two possible ways of integrating empirical research and normative analysis. The two approaches have distinct theoretical backgrounds, and have been elaborated for the practice of empirical ethics in different ways. A combination might benefit the development of empirical ethics. Yet, this requires thorough theoretical reflection, and careful steps in research practice. On a theoretical level, integration of hermeneutics and Wide Reflective Equilibrium requires attention for both the similarities and the differences. On a practical level, both approaches need to be used in such a way that the focus is on moral understanding and argumentation of practitioners, resulting in an interaction between practice and theory. The merit of the present article is that it opens a perspective on the combination of hermeneutics and Wide Reflective Equilibrium. In order to make this combination a success, however, more work needs to be done.