It was Tosca's apartment, really. The living room was uncarpeted for greater ease of sliding and chasing, should she care to bat her catnip mice under the sofa. Two large cardboard boxes also lay on the hardwood floor, should she care to lurk inside. A pole with perches set at different heights stood before the picture window, should she care to survey the passing scene. And while two scratching posts were available for her use, the state of the furniture clearly proclaimed that she preferred to sharpen her claws on the upholstery. The only concession to her besotted keeper's own taste and convenience was an elaborate sound system flanked by rows of vinyl recordings of baroque and nineteenth-century music, heavy on the Italian composers.

I looked in on Edmund and Tosca about once a week, sometimes bringing a new CD, sometimes just bringing faculty gossip. It had been twenty years since the old gentleman retired, but he liked to keep abreast of departmental politics even though he'd outlived all the professors of his generation, and besides, he enjoyed having me to talk to. The gray tabby would jump onto his lap and demand to be petted, with special attention to the white bib under her chin, and Edmund would tell me all about how clever she was, which operas she liked best, and what the vet had said at her last checkup.

As the chapters in this collection show, naturalizing bioethics is a dynamic business: it requires us to move continually from theory to practice and back again. Theory is overhauled, adjusted, and fine-tuned in the light of practice and practice in the light of theory, and justification rests on the norms that have been tested and found good in critical and self-reflexive deployments of this process. The essays gathered here offer many examples of how bioethicists might build better theory by understanding individuals in context, attending to the web of relationships in which we all live, appreciating the reality of power, and — a not unimportant point to which we will return — situating themselves within their own work. But what does all this mean for bioethicists in clinical settings? In this epilogue, written specifically for bioethicists working in health care institutions, we set out an agenda for a naturalized bioethics in practice.

The agenda can be thought of as a call for three closely interconnected kinds of change. First, bioethicists will have to alter how they engage in — and teach clinicians to engage in — moral deliberation. Second, because working conditions greatly affect how well health care professionals can exercise their moral agency, bioethicists may need to initiate changes in those conditions. Third, bioethicists will have to change how they understand their own role in the clinical setting. We take up each of these in turn.