Is Death the Enemy? The Normative Power of Metaphor in Bioethics
Is Death the Enemy? The Normative Power of Metaphor in Bioethics

Author(s): Assya Pascalev
Subject(s): Philosophy
Published by: Trivent Publishing
Keywords: metaphor; moral reasoning; biomedical ethics; end of life care; the war metaphor;physician-patient relationship;
Summary/Abstract: This chapter explores the role of metaphors in biomedical ethics. It maintains that metaphors have an important normative function in medical and moral deliberation: they affect thought and guide actions. We use as a case study the dominant metaphors of death and dying employed by critical care physicians. We identify three prevalent metaphors in end-of-life care: the WAR, TORTURE, and ART metaphors, and demonstrate their normative functions. The metaphors shape physicians’ attitudes towards the dying, guide their reasoning and conduct, and influence their decisions on end-of-life care. We trace the moral implications of each metaphor for the treatment of the critically and terminally ill patients and show how the metaphors shape and constrain the moral deliberation of physicians. Our conclusions have far-reaching implications for bioethical reasoning and education, and could be applied in resolving ethical conflicts between patients and providers by identifying the conflicting metaphors, analysing their normative implications and actively constructing new shared metaphors.

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