 Despite these sorts of advantages, casuistry has been met with criticism. One is that the approach seems to assume a straightforwardness when it comes to deciding what counts as a case. However, as some would have it, deciding what counts as a case (or not) might well be underwritten by the bioethicist’s picture of the sorts of problems worthy (or unworthy) of appearance on the moral agenda (O’Neill 1988). It has been argued that that agenda is overly narrow and sculpted by the interests of, for example, the medical profession, and a male outlook (Carse 1991). A related but distinct point concerns what counts as an adequate description of the issues at play in a case. Casuistry, to its detriment, seems silent on this matter. Some argue that a strike against the radical version of casuistry is its recourse to analogical reasoning. Such recourse, so the thought goes, fails to properly recognize that such reasoning is not self-standing. Analogical reasoning would seem to need pre-established principles to give it direction, and radical casuistry rejects such principles. Moderate casuistry, which does use principles or generalizations to provide some structure in identifying what is morally relevant to a case and across cases (Jonsen 1995) would not be subject to this criticism.