The term methodology may be too formal a word to describe how casuistry works. The casuists of the past left almost no formal description of their way of working; the casuists of the present, pressed by their critics based in moral philosophy, are still asking themselves questions about methodology. Still, certain characteristics of the casuistic approach can be noted. These characteristics appear to have their origins in the classical discipline of rhetoric rather than in philosophy as such. The historical casuists had, like all educated persons of their time, been educated thoroughly in rhetoric. Aristotle and Cicero, the authors from whom they learned rhetoric, also taught them ethics. Classical rhetoric was defined as having a moral purpose: the persuasion of persons toward right and just action. Indeed, the classical books of rhetoric, because they were so rich in comments about and examples of moral behavior, were often used as texts in ethics. In the centuries during which casuistry flourished, moral philosophy was not a clearly defined discipline. Thus, it is not surprising to find the historical casuists implicitly using the techniques of rhetoric in their analysis of cases of conscience. Both rhetoric and casuistry had morally correct attitudes and action as their ultimate goal.
Two characteristics of rhetorical technique are particularly important for casuistry: topics and the comparison of paradigm and analogy. Rhetoricians taught that discourse in general could be divided into a set of common ideas, such as "causality," "temporal sequence," and so on, which they called "topics." Each of these topics had sets of definitions and forms of argumentation that were invariant. Also, each special realm of discourse, such as discourse about politics, art, or economics, has its own set of "special topics," the features of the field that must be understood and discussed if an adequate argument is to be made about what should be done. A casuistic approach to an ethical problem, then, requires that the field of discourse be analyzed to designate the invariant features. For example, it has been suggested that the topics of clinical ethics are: (1) medical indications, (2) patient preferences, (3) quality of life, and (4) contextual features, such as costs of care and allocation of resources (Jonsen, Siegler, and Winslade). Each of these topics has certain definitions, maxims, and arguments that must be taken into account in discussion of any case. The particular circumstances of time, place, personal characteristics, various behaviors, and so on that are the details of any case are viewed in the light of these topics.
Once the particular case is described by its circumstances and topics, casuistical analysis seeks to place this case into a context of similar cases. The classical casuists were accustomed to line up cases of similar sorts, so that cases describing various sorts of homicide, for example, were aligned in order that the similarities and differences between cases would become clear. This enabled the casuist to see those cases in which the moral principles and maxims appeared to lead to an unambiguous resolution. Thus, the prohibition against killing another human being seemed most obviously to hold if the circumstances described a vicious, unprovoked attack on an unoffending person; the prohibition would allow an exception if the circumstances described a killing that resulted from that unoffending person's self-defense against a lethal attack. This technique of lining up cases, rather than seeing them in isolation, is the essence of casuistical analysis. It is called by some authors the technique of paradigm analogy: The paradigm case is the case in which circumstances allow moral maxims and principles to be seen as unambiguously relevant to the resolution of the case; the analogies are those cases in which particular circumstances justify exceptions and qualifications of the moral principles. A high degree of assurance, or moral certitude, pertains to the resolution of paradigm cases, while varying degrees of moral probability, or probabilism, attach to the resolution of analogous cases.
Finally, the resolution of each case depends on what Aristotle called phronesis, or moral wisdom: the perception of an experienced and prudent person that, in these circumstances and in light of these maxims, this is the best possible moral course. As one commentator on modern casuistry has written, "for casuistry, moral truth resides in the details ... the meaning and scope of moral principles is determined contextually through the interpretation of factual situations in relation to paradigm cases" (Arras, p. 37).
Bioethics is the most prominent field in which casuistry is beginning to be reintroduced as a method for ethical analysis. This is not surprising, since a strong interest of bioethics is the clinical care of patients, and many cases that came to the early attention of bioethicists involved life-and-death decisions arising from the use of new medical technologies. Cases about whether life-supporting technologies should or should not be continued for particular patients lend themselves to casuistic analysis. The differing circumstances of individual patients, the topics (the significant categories into which a medical-ethical decision can be factored), and the maxims (such as "do no harm" or "respect the patient's informed choices") are each in their own way crucial to the resolution of any case. The placing of the case in a lineup of paradigm and analogy, from the most obvious— in which the patient is brain dead, or continued care is manifestly futile—to the problematic, in which diminished quality of life or unclear preferences are at issue, allows for discretionary judgment between cases (Jonsen). This sort of casuistry can also be applied to questions of healthcare policy, such as those surrounding the various programs proposed for allocation of resources, although relatively little of such analysis has been done.
Casuistry, then, keeps moral reflection close to cases. Neither classical nor modern casuistry repudiates principles: Casuistry is not merely another name for situationism or contextualism. Rather, principles are seen to be relevant to cases in varying degrees: In some cases, principles will rule unequivocally; in others, exceptions and qualifiers will be appropriate. Modern casuists dislike the description of casuistry as "applied ethics," since they explicitly repudiate the notion that an ethical theory must be elaborated and then "applied to" the circumstances of the case. Still, the relationship between cases and ethical theory is unclear and poses the principal speculative problem that casuists and moral philosophers must ponder, just as the historical casuists pondered the problem of the certitude of practical judgment. On the one hand, casuistry is not simply applied ethical theory; on the other, it is not simply immersion in the factual circumstances of cases, which would reduce it to situationism. Casuistry is not tied to any single theory of ethics but can be comfortable with selected elements of multiple theories. For example, a casuistic argument might draw on utilitarian, deontological, and contractual justifications in a single case. Also, the designation of topics and the selection of paradigms have theoretical presuppositions. Finally, the normative nature of principles and maxims, which must be clarified in order to specify the obligatory nature of casuistic resolutions, requires reference to theory. Casuistry, then, is not "theory free" but is rather, as one commentator has suggested, "theory modest" (Arras, p. 41). Theories, for contemporary casuistry, are not mutually exclusive, a priori foundations for practical ethical discourse but limited and complementary perspectives that illuminate practical judgment. Much work remains to be done on the relationship between theory and practical judgment. Still, as suits the style of casuistry through its history, it can grapple effectively with difficult cases even though all speculative and theoretical questions about its methods and presuppositions have not yet been answered.
ALBERT R. JONSEN (1 995)
SEE ALSO: Bioethics; Conscience; Conscience, Rights of; Ethics: Normative Ethical Theories; Narrative; Natural Law; Principlism; Responsibility
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