Moral clarity in Medicine: A Framework for Coherence and Consistency in Ethical Decision-Making

Abstract

In modern medical ethics, practitioners must navigate a sea of bioethical principles, including autonomy, beneficence, non-maleficence, and justice (1). Yet, one essential element has been overlooked: Moral Clarity (MC). As medical technologies evolve and ethical dilemmas persist, the absence of MC leads to inconsistent applications of ethical principles, generating confusion among healthcare professionals and patients alike. I contend that MC—a precise and transparent understanding of right and wrong in medical contexts—is the missing link to unify ethical practice and enhance patient care.

MC emerged prominently in U.S. political discourse during the 1980s, closely associated with conservative rhetoric and Ronald Reagan’s policies (2). It signifies adherence to a coherent ethical framework that withstands institutional, social, or economic pressures. Importantly, MC is not an absolutist commitment to unchanging principles; rather, it is the ability to discern right from wrong in clinical contexts, grounded in fundamental moral values and resilient to external pressures.

MC avoids the extremes of excessive relativism—where ethical decis ions depend solely on context—and rigid  dogmatism. In practice, it entails decisions grounded in enduring, defensible principles rather than expedient considerations. Too often, ethical decision-making is reduced to bureaucratic checklists instead of principled reasoning guided by clear ethical reasoning. Without such clarity, ethical frameworks become vulnerable to ambiguity, allowing moral relativism to dominate critical healthcare discussions (3).