ABSTRACT
It is often assumed that, when ethicists work with cases, they are taking a narrative approach to clinical ethics. In this essay I argue that this is typically not true, at least for cases that find their way into print. In the commentary on the case, which is where the ethical analysis takes place, the commentator typically acts as a judge, applying lawlike principles deduced from one or several of the standing moral theories to the situation described in the case; so applied, the principles serve to prescribe the right course of conduct. Judging skillfully and well in accordance with some theory involves a consideration of the economic, cultural, class, gender, and religious contexts in which the participants operate, as these social contexts might have some bearing on which principles to select and how much relative importance to assign to conflicting principles. However, once the commentator has gotten hold of the correct principles and a rationale for ranking them, context is of no further interest. The commentator can now judge impartially what ought to be done in any similar set of circumstances.
