Field Notes

Stephen Edelston Toulmin. Stephen Edelston Toulmin, age eighty-seven, died on December 4, 2009. When I told four young scholars in bioethics, their responses were uniform: “The name is familiar, but . . .” Two of them recalled that Toulmin was my coauthor on The Abuse of Casuistry. I informed them that Toulmin had a profound influence on the origins of bioethics, even though his engagement with the field was relatively brief. Older scholars remember his often-anthologized 1982 article, “How Medicine Saved the Life of Ethics.” In that essay, he proposed “the fresh attention that philosophers began paying to the ethics of medicine, beginning around 1960, . . . required writers on applied ethics to go beyond the discussion of general principles and rules to a more scrupulous analysis of the particular kinds of ‘cases’ in which they find their applications.”

Toulmin was among the more distinguished “writers on applied ethics.” His books, The Place of Reason in Ethics and The Uses of Argument, had stirred moral philosophy. In an unusual move for an academic philosopher, he accepted an invitation to become “staff philosopher” to the National Commission for the Protection of Human Subjects of Biomedical and Behavioral Research. The commission had a very practical mission: It was established by Congress in 1974 to develop regulations for protection of the rights and welfare of human participants in scientific research. The commissioners were scientists, physicians, lawyers, and two ethicists, one of them myself. Stephen took on the task of leading the commission through the conceptual paths of ethical reasoning as it confronted quite unprecedented cases.

Stephen and I were seatmates on a flight home after a commission meeting. He was amused that, after a career of criticizing the absolutism of ethical principles, he had been assigned to lead the commission in the task of “identifying the ethical principles that govern research with human subjects.” He was well aware that identification of principles was not enough. Principles must meet the exigencies of practice and find their way in the diversity of circumstances that surround every practical decision.

He commented that, as the commissioners debated difficult cases of research, they frequently reached solutions without agreeing on the principles behind those solutions. I commented that this seemed rather like the long-despised approach to ethical reasoning called “casuistry.” Stephen suggested that we seek in the casuistic literature a method of case reasoning. Over the next five years, we collaborated on The Abuse of Casuistry. As we explored classical casuistry—including the arguments of its most cogent critic, Blaise Pascal—Stephen recognized the pattern he had elucidated in his earlier works. Particular cases of moral perplexity are not resolved by inference from higher principles, but by “making a case.” This involves justification of a claim by reference to circumstances and relevant warrants, a process that ends in a probable, not a certain, conclusion.

Toulmin’s contribution to bioethics was the “case reasoning” that led to the emergence of clinical ethics. This staple of legal and medical reasoning could now be brought to the ethical questions arising in clinical cases. Medicine did save the life of ethics, by drawing moral philosophy out of the realm of abstract theory and general principles into the tumult of cases in which decisions must be made amid changing, diverse circumstances. Toulmin himself was the therapist of moral reasoning.