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J Med Ethics. 2008 Mar;34(3):156-61. doi: 10.1136/jme.2006.020230.

The principle and problem of proximity in ethics.

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Section for Medical Ethics, Institute of General Practice and Community Medicine, University of Oslo, PO 1130, Blindern, N-0318 Oslo, Norway.


The normative significance of proximity in ethics is considered, giving an overview of the contemporary debates about proximity in ethics and focusing on three main perspectives that take proximity to have normative significance. The first perspective is represented by meta-ethical positions, where a basic moral claim is said to originate from an irreducible, particular and unique otherness that shows up in human vulnerability. The second perspective presents a psychologically and philosophically based analysis of human emotions, which is taken to form a basis for rudimentary moral sensitivity and care. The third version of an ethics of proximity claims that personal relationships and partiality override impartialist and universalist ethical considerations. On the basis of this analysis, the sources of normativity and the essence of proximity as a normative consideration are elaborated. Finally, the relevance of an ethics of proximity to professional ethics in healthcare is discussed. From an ethics of proximity, it might be argued that institutions must attempt to organise medical care and nursing care so that a certain partiality and patient-centred care might be favoured and trump distributivist considerations of justice in healthcare.

[Indexed for MEDLINE]

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