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H. Tristram Engelhardt, Jr.'s critical gaze has come to rest more than once on the practice of clinical ethics consultation; he has articulated potent arguments against the intellectual coherence of the field, labeling it a "conceptive ideology." In this essay, I discuss Engelhardt's critiques and explore what implications they have for the practice. I also argue that his critiques themselves rely on contestable metaethical/metaphysical assumptions about the need for certainty in moral justification. An alternative metaethical assumption, that we cannot have certainty regarding moral decisions (in the absence of stipulated metaphysical foundations such as religion), implies that we must search for what constitutes "non-certain justification." A full articulation of such "non-certain foundations' is beyond the scope of this paper, but I do explore some implications for the practice of clinical ethics consultation of an acceptance that moral judgments in a pluralist society cannot be taken as certain.

DOI: 10.1007/978-3-319-18965-9_11

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