Editor’s Introduction

James Childress’s “Who Shall Live When Not All Can Live?” first appeared in Soundings in 1970. The article was one of Childress’s first in the area of bioethics. As it turned out, the piece served as a kind of springboard for an outstanding contribution. In subsequent years, Childress produced numerous publications, perhaps the best known his coauthored book with Tom Beauchamp (Principles of Biomedical Ethics). Now in its seventh edition, that work became a standard point of reference for scholars working in the field.

One of the reasons for continuing interest in Childress’s work in this area, as in other areas, of ethics has to do with his distinct approach. One may speak about this in terms of moral theory, in connection with which his approach— one I have described elsewhere as a kind of “pluralistic deontology”—depicts practical reasoning in terms of deliberating about the fit between norms and particular contexts when the latter indicates that one cannot honor all of the former. One may also speak about a vision of the moral life in which conflicts of duty are not only possible but play an important role in the development of character. In “Who Shall Live?” the problem set by the fact that some forms of medical care are in short supply, or are simply not available in equal measure to all who are in need, is analyzed in relation to various conceptions of justice. The idea is to evaluate various proposals regarding the allocation or regulation of resources, in an attempt to move toward policies that, while imperfect, may nevertheless be deemed responsible.

The articles collected here dwell on these and other aspects of Childress’s 1970 article, as well as on such questions as the impact of his proposals on medical practice and the relationship of the argument to his ongoing project. With respect to Soundings, one of the more noteworthy features of the work has to do with the way literary references are woven together with philosophical, religious, and policy perspectives. In this, Childress’s work was and is truly multidisciplinary, in the spirit of this journal’s stated aim “to publish articles that open disciplines to each other, and [to look] for readers who sense in such openings some prospect for greater coherence and amplitude in public discourse.”

The authors featured in this volume (as well as the editor) are all students of Childress. Their reflections on his work may serve as an invitation to others to respond to a Soundings article and an ongoing program of scholarship that may justly be described as strong and rich.