Books on medical ethics often begin by praising it as a growth industry. Certainly there is a growing awareness of the importance of medical ethics, among doctors themselves, among other health care professionals – nurses, psychologists, social workers – and, most urgently of all, among those on the receiving end of health care, patients and their families. Some philosophers, too, readily acknowledge that medical ethics has provided a timely shot in the arm for their discipline: medicine, Toulmin (1978) says, has saved the life of philosophy. This book, however, was prompted not by the growth of interest in medical ethics but, on the contrary, by a premonition of decline.

The editors of this volume (respectively two physicians and a theologian) were all involved in multi-disciplinary working parties on medical ethics in Oxford between 1988 and 1990. Here was a good opportunity for medical ethics, and more particularly philosophical medical ethics, to make progress: professionals from all sides with the motivation to combine their experience and skills were tackling well-defined questions in manageable areas of practice. Here, if anywhere, was a recipe for success.

Yet our experience in these working parties was largely disappointing. On the safe ground of review there was secure scholarship and sound opinion. But when it came to new ideas, to pushing the subject forward, in place of the anticipated fusion of disciplines there was often mutual incomprehension.