MORAL CONSENSUS IN PUBLIC ETHICS - PATIENT AUTONOMY AND FAMILY DECISION-MAKING IN THE WORK OF ONE STATE BIOETHICS COMMISSION

Focusing on the work of one bioethics commission, the New York State T ask Force on Life and the Law, this article explores the role played b y moral consensus in public ethics. Task Force members, who were appoi nted to represent diverse interests in New York State, identified a cu lturally strong value of individual autonomy as the ethical basis for their work on life-sustaining treatment. This moral consensus permitte d the members to unite across their differences and develop public pol icy recommendations that substantially reformed a highly troubling New York law. However, the principle of autonomy insufficiently guides de cisions by caring family members for incompetent adults in cases where little is known of patient preference. A different, more innovative m oral vision is required - one that grants a more robust moral authorit y to the family. While government efforts that rely on moral consensus developed in a broad-based and well-reasoned manner can serve us well , in some cases the consensus will provide inadequate moral guidance. Government bioethical efforts must guard against the limits of moral v ision in light Of their disproportionate societal power.