Medical facilities as moral worlds.

Bioethics is dominated by an emphasis on rule making and quandary solving. Teaching and research in ethics often focuses upon dramatic, controversial issues at the margins of life and death. Much less attention is given to the relationship between moral reflection and the ethos of place. Medical facilities, however, are moral worlds. To discuss the ethos of place is to focus on the character or atmosphere of particular dwellings. Architecture, interior design, and the interior creation of built environments have moral, spiritual, and aesthetic dimensions. Discussions of "ethics" need to be less oriented to rules and dilemmas, and more attuned to practical matters of everyday social experience. Instead of developing all-encompassing critiques of medical facilities as impersonal, alienating institutions, scholars from various fields need to explore the incremental steps that can make particular settings more decent, humane, and caring.