Can Richard Rorty provide a vision for clinical pragmatism?

Clinical pragmatism is an approach to clinical ethics that recommends an inductive process for proposing, testing, and (dis)confirming hypotheses about what would be ethical against the medical and social facts in a given clinical situation. Although there are many versions of pragmatism, there is a consensus that Richard Rorty’s ‘postmodern’ pragmatism is too shy about asserting the epistemic authority of the scientific method and too reluctant to assert ethical truths and moral principles to support a clinical pragmatism. I argue that the consensus view is incorrect, and that Rorty’s pragmatism can fit the bill. First, Rorty’s pragmatism, far from the anti-scientific relativism which his critics ascribe to him, provides a useful framing of the inductive approach proposed by existing clinical pragmatists. Rorty can support an inductive approach, when it works, because it works, and Rorty can also make sense of the divergences between clinical pragmatism in the clinical ethics context and a more traditional scientific method, such as why the pragmatist approach to clinical ethics aims to alter or reframe stakeholder’s values, rather and merely representing them, which is less plausible on standard clinical pragmatism. Second, Rorty’s pragmatism can provide a role for bioethics principles that is both theoretically plausible, insofar as it treats those principles as historical artifacts that nonetheless have deep ethical and emotional resonance for people in the health care context. In other words, Rorty can make sense of the invocation of principles as a way in which clinical ethics ‘furthers the discourse of humanity.’