Critics find this procedure too dependent on individual intuition, and have proposed various remedies. On one proposal, conflicting general principles are "specified" to yield compatible norms for a specific case. On another, the general principles are supplemented or replaced by a larger number of prohibitions drawn from "common sense" morality. On a "bottom up" alternative drawn from Medieval casuistry, it is richly described paradigm cases, not principles, that have the central role in moral reasoning. Other proposals would dispense with principles altogether in favor of professional virtues (integrity, fiduciary responsibility, compassion); the central concerns of "care ethics" (response to need, dependency, trust); and/or "narratives" sensitively constructed from conversations with patients, families, and other attendants.
Friedrich Nietzsche 's view of virtue is based on the idea of an order of rank among people. For Nietzsche, the virtues of the strong are seen as vices by the weak and slavish, thus Nietzsche's virtue ethics is based on his distinction between master morality and slave morality . Nietzsche promotes the virtues of those he calls "higher men", people like Goethe and Beethoven. The virtues he praises in them are their creative powers (“the men of great creativity” - “the really great men according to my understanding” (WP 957)). According to Nietzsche these higher types are solitary, pursue a "unifying project", revere themselves and are healthy and life-affirming.  Because mixing with the herd makes one base, the higher type “strives instinctively for a citadel and a secrecy where he is saved from the crowd, the many, the great majority…” (BGE 26). The 'Higher type' also "instinctively seeks heavy responsibilities" (WP 944) in the form of an "organizing idea" for their life, which drives them to artistic and creative work and gives them psychological health and strength.  The fact that the higher types are "healthy" for Nietzsche does not refer to physical health as much as a psychological resilience and fortitude. Finally, a Higher type affirms life because he is willing to accept the eternal return of his life and affirm this forever and unconditionally.