Debates about theory and practice are ancient. Each generation considers the dynamics that surround issues about the interdependency of theory and praxis to be uniquely challenging. Complexity is a variable closely linked with knowledge. As science has added layer upon layer of knowledge, decision-making dilemmas have been confounded by new and staggering concomitant factors. In concert, theoretical frameworks for social science disciplines have been adapted to accept newly identified moral imperatives and ethical considerations.
This paper offers a discussion about the nexus of epistemology, ethics / morality, and praxis. An examination of the historical development of the paradigm and the assumptions of post-positivism is presented as an introductory foundation for the discussion. Next, is a discussion about ethical theory, followed by an exploration of the increasing division between philosophical frameworks and evolving modern science. Particular note is made of the theory-practice gap in healthcare, which stands in stark contrast to the apparent need for integration, given the substantive and compelling decisions that are now commonplace in the field. The application of ethical theory and moral practice to multiple disciplines is addressed in several sections of the paper, highlighting the relation with law, education, psychology, and other social sciences. Ethics in medicine and healthcare is a thread which runs though the body of the paper, in part as a heuristic, and also because ethical theory and moral practice are at the heart of medical science. The paper concludes with a retrospective on the axiological assumptions regarding ethical theory and the moral practice in medicine and healthcare.
Paradigm and Assumptions
This section provides some definitions of terms and basic philosophical orientation relevant to the subsequent discussion of ethical theory and moral practice (Musschenga & Heeger, n.d.). That the two distinct components are joined -- referred to as thought they are one construct -- is indicative of the interplay between the two conceits. Ethical theory and moral practice is a multidisciplinary and multifaceted theory that allows for almost any epistemological paradigm. However, post-positivism is a unifying epistemological paradigm in which ethical theory and moral practice may be grounded. Post-positivism, or post-empiricism, is a meta-theoretical position of critical theory that amends positivism. Post-positivism is meta-theoretical in the sense that it is a theory about theories. According to positivism, authentic knowledge is acquired through the senses, through experience, and through positive verification -- which is synonymous with empirical science.
Although post-positivists assert that knowledge is based on conjecture, they also tend to hold to the construct of objective truth. From a post-positivist perspective, extant knowledge can be challenged and constructed through scientific investigation, the process of which is driven by conjectural thinking. A variant of post-positivism, the popular notion of paradigm shift is fundamentally a critique of positivism which carries the ideas of post-positivism to the level of scientific worldview -- or more, loosely, to the popular zeitgeist -- a state vulnerable to alteration based on evidence.
The scientific method is not rejected by proponents of post-positivism -- nor do post-positivists discard the foundational positivist assumption of ontological realism. In other words, empiricism is healthy but limited. Practitioners should expand their locus of understanding about ethics and morality without becoming too rigid, as it is impossible to know anything with complete certainty.
The epistemological foundation of post-positivism undergirds the position of ethical theory and moral practice as valuing many different types of ontological input. In fact, a central tenet of the theory is that there is no one right or wrong way of looking at a moral issue. Post-positivism is not inherently ethical, but its axiology does suggest that values are almost always based on assumptions. It is impossible to measure or quantify value. Ethical theory and moral practice is multifaceted and welcoming of points-of-view that are undervalued or devalued in other fields, which makes the post-positivist axiological position an excellent fit for multidisciplinary endeavors. There are many ways of reaching the truth, and multidisciplinary inquiry is fruitful. The post-positivist position encourages the use of as many different methods as possible. From this, it can be seen that ethical theory and moral practice welcomes a range of diverse perspectives on issues related to applied ethics.
Ethical Theory in Modern Science
Ethical theory and moral practice have a direct and strong bearing on the social sciences. The theory comprises two distinct but interconnected components: theory and practice. The dual focus of ethical theory and moral practice give rise to a plethora of possible applications in the social sciences. Ethical theory and moral practice is a "remarkably heterogeneous" area and one that includes "many positions and theories, approaches and questions," ("Ethical Theory and Moral Practice: How do they Relate?" 2008).
The ethics component of ethical theory and moral practice has roots in philosophy, but is "rapidly becoming a field of disciplinary cross-pollination," ("Ethical Theory and Moral Practice: How do they Relate? 2008). In fact, philosophy alone no longer forms the fundamental foundation of ethical theory and moral practice, just as religion no longer forms a single foundation for a rational ethical theory. But, philosophy does offer the logic and rhetorical tools within which to frame an ethical theory. And from this base, "research is being done in biology, psychology and sociology, as well as in educational science," that can inform the totality of a moral code ("What Makes Us Moral?"). For this reason, an academic foundation in both Western and Eastern philosophical traditions can aid in the development of cogent ethical arguments. Those arguments in turn can inform moral behavior on the personal or community level. Moreover, philosophy of ethics helps social scientists present coherent arguments that underwrite policy and international law in order to reflect emerging trends in social justice.
There is always a double component to ethical theory and moral practice, after all. The theory must have in the end a moral practice application, one that is practical and hopefully measurable. While not all moral action or ethical theory can be measured empirically, the social scientist endeavors to make it so. Social science research that is rooted in ethical theory gives rise to unique hypotheses that might not bear fruit without a holistic understanding of philosophy. Those hypotheses also have real and practical applications in politics, economics, or social work. The cross-pollination of multiple fields also enables fruitful research in every area of the social sciences. For example, the introduction of ethical theory and moral practice in the area of psychology or sociology sparks questions related to altruism and benevolence outside of the context of religion. When ethical theory and moral practice are applied to biology, neuroscientists are better able to formulate hypotheses related to the organic underpinnings of morality. Applied to gender studies, ethical theory and moral practice can inform policy related to parity. The potential for future research is practically limitless, which is why ethical theory and moral practice is an emerging international trend in social science scholarship.
Ethics in real life. Beauchamp (2007) has explored the problematic relationship between ethical theory, which is a mainly intellectual and philosophical endeavor, and moral practice, which is the application of ethics to real-life situations. Bioethics is a field in which ethical theory and moral practice are particularly salient. Specifically, Beauchamp's (2007) review of the literature examined the role and relevance of ethical theory on healthcare practice. The primary questions Beauchamp sought to answer emphasized the relation between professional healthcare endeavors and philosophical theory. As practitioners and the public become increasingly conflicted about both the potential benefits and problems inherent in healthcare, there is a growing awareness about the tension between ethical theory and moral practice. The idea of bioethics existing without a philosophical underpinning is sobering, and certainly brings to the forefront concerns about the dangers of abandoning theory altogether (Beauchamp, 2007).
Gastmans (1998) employed a philosophical-ethical interpretation of nursing in order to present a comprehensive view of nursing from the perspective of ethical theory and moral practice. Gastmans reviewed the literature with an eye toward exploring the evolution of the theory of care in the nursing field. A particular goal was to determine the role played by ethical theory and moral practice on this evolution. Ethical theory and moral practice became especially relevant in the nursing profession because of the evolution of the theory of care, which transformed nursing from a pragmatic profession only to one imbued heavily with ethical merits and concerns (Gastmans, 1998). The "fundamental ethical view on nursing care considered as moral practice" makes ethical theory and moral practice meaningful to the healthcare professions (Gastmans 1998, p. 43).
An important issue that Gastmans targeted was if it is even possible to distinguish ethical theory from moral practice in the field of nursing. In pursuit of clarity regarding these objectives, Gastmans reviewed the philosophical works of Anne Bishop and John Scudder, Alasdair MacIntyre, Lawrence Blum, and Louis Janssens. The study findings demonstrated illustrate a strong relationship and absolute relevance between ethical theory and moral practice and the nursing profession.