title: The normativity of clinical health care: perspectives on moral realism.
abstract: The paper argues that a particular version of moral realism constitutes an important basis for ethics in medicine and health care. Moral realism is the position that moral value is a part of the fabric of relational and interpersonal reality. But even though moral values are subject to human interpretations, they are not themselves the sole product of these interpretations. Moral values are not invented but discovered by the subject. Moral realism argues that values are open to perception and experience and that moral subjectivity must be portrayed in how moral values are discovered and perceived by the human subject. Moral values may exist independent of the particular subject's interpretative evaluations as a part of reality. This epistemological point about normativity is particularly significant in medical care and in health care. The clinician perceives moral value in the clinical encounter in a way that is important for competent clinical understanding. Clinical understanding in medical care and health care bears on the encounter with moral values in the direct and embodied relations to patients, with their experiences of illness and their vulnerabilities. Good clinical care is then partly conditioned upon adequate understanding of such moral realities.
authors.affiliation: Center for Medical Ethics, Institute of Health and Society, The Faculty of Medicine, University of Oslo, Oslo, Norway. p.nortvedt@medisin.uio.no
authors.forename: Per
authors.initials: P
authors.lastname: Nortvedt
mesh_terms: D004645:Empathy; D026690:Ethics, Clinical; D006801:Humans; D007398:Interpersonal Relations; D009014:Morals; D010686:Philosophy, Medical