The collection of essays edited by Mark J. Cherry and Ana S. Iltis is dedicated to the work and life of Baruch A. Brody. Brody has contributed a great part of his work to questions about biomedical ethics; consequently, the focus of this Festschrift is on bioethical issues, too. What Brody is famous for is the attempt to establish an account of ethics that does justice to the fact that classical ethics does not provide answers if applied to concrete cases, also because the system of values in modern societies is pluralistic. "Pluralistic moral casuistry" has become the name of his account that stands in a particular relationship to his religious convictions.

Pluralistic Casuistry is a collection of 15 essays divided more or less equally in four sections: pluralistic moral casuistry, Jewish medical ethics, biomedical public policy, and critical application and analysis. The last part of this book consists in Brody's own comments on the various contributions.

The first section provides an overview of Brody's account of pluralistic moral casuistry that represents it as a reaction to methodological problems that have dominated biomedical ethics for centuries. To put these problems into a form of a dilemma: on the one hand, physicians and medical scientists aim at advancing medical practice for the sole purpose of the patient's health, on the other hand, their activities are under various constraints such as economical requirements, religious constraints, and uncertainties that arise out of the limited knowledge of medical science itself. Bioethics, therefore, seeks to provide practical solutions for physicians where it is not obvious which norms are to be employed in order to find decisions that can be said to be good for the patients. But bioethics deals with questions that exceed questions about the relationship between physicians and patients, namely questions about how life and death-decisions could be justified, which principle could be accounted for the allowance of human-embryo transfer and how clinical researchers ought to be undertaken. Brody's suggestion here is that the process of establishing norms in concrete cases has to be thought of as an appeal to various elements from ethical theories. Why Brody prefers a pluralistic moral casuistry to any principle oriented moral theory is the topic of Laurence McCullough's article. Janet Malek's contribution emphasizes the difficulties that are involved in what McCullough describes as the requirement to appeal to multiple morals because of the deficiencies. Although the idea here is that moral views complement each other, Brody's "model of conflicting appeals" leaves it ultimately open how the conflicts could be overcome.

It would have been interesting to compare Brody's idea of norms for concrete cases with other accounts that regard consensus-achieving procedures as a method for biomedical ethics. "Pluralistic moral casuistry" in Brody's cases seems to be grounded in a view about a possible particular relationship between Jewish ethics and secular bioethics. For this reason, the second section of this book consists in an examination of religious views of bioethical issues. B. Andrew Lustig, Laurie Zoloth, and H. Tristram Englehardt, Jr. try to give the reader a better understanding of the question how religious arguments could dissolve dilemmatic situations and how something like a divine law could be in accord with pluralistic moral casuistry. H. Tristram Engelhardt's contribution is in this section probably the most interesting one showing that the requirements of God and the requirements of a secular moral rationality cannot be said to coincide. If this were true, the relationship between pluralistic moral casuistry and Jewish ethics would not be a very close one. This certainly cannot provide a strong argument against Brody's pluralistic account but nonetheless raises doubts about the conditions under which Jewish ethics could be understood as a kind of biomedical ethics. This problem is in no way left unconsidered in this book.

The last two sections show how controversial the application and deployment of moral theories are. The topics discussed here are of a wide range including public health care policies questions, questions about the right or good way to treat patients, and questions concerning the value of life. Frances M. Kamm's article, which is the last one, is a well-argued and very critical contribution to Brody's distinction between "killing" and "letting die". It shows that even for authors who promote a pluralistic account, it is often not easy to account for all the relevant factors in a situation when it comes to argue for a decision in a concrete case.

© 2008 Stefan Riegelnik

Stefan Riegelnik, Research Assistant, Philosophy Division, at the Vienna University of Economics.

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