This article describes and rejects three standard views of reason in secular clinical ethics. The first, instrumental reason view, affirms that reason may be used to draw conceptual distinctions, map moral geography, and identify invalid forms of argumentation, but prohibits recommendations because reason cannot justify any content-full moral or metaphysical commitments. The second, public reason view, affirms instrumental reason, and claims ethicists may make recommendations grounded in the moral and metaphysical commitments of bioethical consensus. The third, comprehensive reason view, also affirms instrumental reason, but encourages ethicists to make recommendations grounded in the moral and metaphysical commitments of their private worldviews. A compatibilist view of public reason is then defended, which holds that each standard view captures an important role for reason in different aspects of secular clinical ethics. The article ends by identifying three implications for enduring theoretical debates in clinical ethics.

本文描述并拒绝了世俗临床伦理学中关于理性的三种标准观点。第一种，工具理性观点，确认理性可用于绘制概念区分、绘制道德地理图和识别无效的论证形式，但禁止推荐，因为理性不能证明任何理由内容完整的道德或形而上学的承诺。第二种，公共理性观点，肯定工具理性，并声称伦理学家可以根据生物伦理共识的道德和形而上学承诺提出建议。第三种，综合理性观，也肯定工具理性，但鼓励伦理学家基于他们个人世界观的道德和形而上学承诺提出建议。然后为公共理性的相容主义观点辩护，该观点认为每个标准观点都在世俗临床伦理的不同方面抓住了理性的重要作用。文章最后确定了临床伦理学中持久的理论辩论的三个含义。