In 1992 through 1993, when I was a fellow in the Program in Ethics and the Professions at Harvard, I was quite astounded to learn from other fellows that the field of bioethics was in a state of methodological upheaval, fractured along many fault lines, much like Los Angeles but without the sunny climate. They portrayed an intellectual war zone, reminiscent of evolutionary theory or paleontology, where there are many bones to pick. When I expressed my surprise, I was chided. How “out of it” could I be? Had I had not heard that “principlism” (a position held by Beauchamp and Childress) had been routed “from above” by advocates of “theory” (like Clouser and Gert and Green) and, more effectively, ambushed “from below” by contextualists (like Hoffmaster) and their allies, the casuists (like Jonsen and Toulmin)? Had I not heard that “theory” was out, that “deductivism” and other “top-down” approaches were defeated in favor of “bottom-up” ones? The battle was so advanced that new rescue efforts for old fortifications had already been mounted, like Richardson's “specifying norms” or DeGrazia's “specified principlism.” I was abashed. I had not noticed that I was working in a war zone and that defending or applying a moral principle put me at risk of taking a sniper's bullet.

Though I am loathe to make excuses for not being “with it,” let me offer three to start with. One is really a confession: I do not read the bioethics literature as widely as I should, except for what bears most directly on the problems on which I am working.