Can applied ethics be effective in health care and should it strive to be?
KIE: Drawing upon his work in medical centers, Caplan explores the question of how well ethicists function in hospitals. He asks if their use of the “engineering model” of applied ethics, which emphasizes conceptual clarification, mastery of ethical theory, and impartiality, has made any difference in the way medicine is practiced. Noting that ethicists have been more effective in influencing heatlh policy at the national than at the institutional level, Caplan concludes that they have been less successful in teaching medical ethics, working with health personnel, and helping to formulate hospital policies. He attributes their difficulties primarily to the inadequacies of the engineering model of applied ethics for solving problems in a clinical setting. Caplan cautions ethicists to be aware both of the limitations of the engineering model and of the motives of health personnel in asking for help which may have little to do with resolving moral dilemmas.