Moral Problems, Moral Inquiry, and Consultation in Clinical Ethics

"We examine the significance and necessity of introducing applied drama into clinical ethics education to build ethics competency. Case-based clinical ethics, distant from abstract theory-based discursive ethics, pays close attention to emotions of persons involved in a given case, and of participants in deliberation. Some authors have sensibly emphasized this point. For example, CURA, a reflective method puts forward the crucial step to become aware of own emotions and physical reactions to each difficult situation. These suggest that we should not stay just in rational reasoning to resolve moral problems in clinical settings. Such a stream seems to lead us to the next stage of clinical ethics education. Applied drama is an umbrella term for the various ways to use theatrical elements, outside of theaters, in educational settings. The basic conception is playing. It includes two meanings: gaming and acting. Generally, we stop playing when we grow up. Applied drama encourages us to play again. Playing promotes communications in verbal and physical. In acting like an acting person, we are to put ourselves in another person’s standpoint. Through acting a role, we may live her life and feel vividly his emotion but by imagination. Thus, applied drama has great potentiality to change the mode of discussion – or deliberation-based clinical ethics. As applied drama comprises various ways such as improvisation, forum theatre, and so on. We will explore their features and application in actual teaching settings. "

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Ethical Theories as Methods of Ethics

10.1093/oso/9780192856913.003.0013 ◽

2021 ◽

pp. 247-269

Author(s):

Jussi Suikkanen

Keyword(s):

Theory Choice ◽

Normative Ethics ◽

Moral Inquiry ◽

Ethical Theories ◽

First Order ◽

Moral Problems ◽

Ways Of Thinking

This chapter presents a new argument for thinking of traditional ethical theories not as criteria of rightness and wrongness, but rather as methods that can be used in first-order moral inquiry. It begins from outlining how ethical theories such as consequentialism and contractualism are flexible frameworks in which different versions of these theories can be formulated to correspond to different first-order ethical views. This chapter then argues that, as a result, the traditional ethical theories cannot be evaluated in terms of their truth or correctness. Instead, it suggests that these theories should be understood as providing different kinds of ways of thinking about difficult moral problems. Finally, the chapter recommends a certain kind of an attitude of pragmatic pluralism as something that should guide our theory choice in normative ethics—it may well be that different moral problems are better approached through different ethical theories.

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Preventing moral conflicts in patient care: Insights from a mixed-methods study with clinical experts

Clinical Ethics ◽

10.1177/14777509211057254 ◽

2021 ◽

pp. 147775092110572

Author(s):

Jan Schürmann ◽

Gabriele Vaitaityte ◽

Stella Reiter-Theil

Keyword(s):

Risk Factors ◽

Patient Care ◽

Clinical Ethics ◽

Process Model ◽

Healthcare Professionals ◽

Preventive Measures ◽

Clinical Ethics Support ◽

Ethics Support ◽

Moral Problems ◽

Early Indicators

Background and aim Healthcare professionals are regularly exposed to moral challenges in patient care potentially compromising quality of care and safety of patients. Preventive clinical ethics support aims to identify and address moral problems in patient care at an early stage of their development. This study investigates the occurrence, risk factors, early indicators, decision parameters, consequences and preventive measures of moral problems. Method Semi-structured expert interviews were conducted with 20 interprofessional healthcare professionals from 2 university hospitals in Basel, Switzerland. A Likert scale questionnaire was completed by the interviewees and analysed using descriptive and inferential statistics. Results Healthcare professionals are frequently exposed to a variety of moral problems, such as end-of-life decisions, resource allocation and assessing the patient's will or decisional capacity. Thirty-four different risk factors for moral problems are identified, e.g. patient vulnerability, divergent values or world views, inadequate resources or poor ethical climate. Twenty-one early indicators are recognised such as disagreement between healthcare professionals, patients and relatives, emotional disturbances, gut feeling or conflict of conscience. A variety of preventive measures are suggested and presented in a preventive clinical ethics support process model. The most helpful measures are early ethical conversations with colleagues, early team-internal ethical case discussions and an ethics-trained contact person on the ward. Ethics training, kerbside consultations, proactive ethics consultations, ethics screening and rounds are also considered helpful. Conclusions Clinical ethics support services should not only offer reactive and complex, but also proactive and low-threshold support for healthcare professionals, patients and relatives.

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Establishing Clinical Ethics Committees in Primary Care: A Study from Norwegian Municipal Care

HEC Forum ◽

10.1007/s10730-021-09461-9 ◽

2021 ◽

Author(s):

Morten Magelssen ◽

Heidi Karlsen ◽

Lisbeth Thoresen

Keyword(s):

Primary Care ◽

Clinical Ethics ◽

Ethics Committees ◽

Time Frame ◽

Next Of Kin ◽

Care Services ◽

Clinical Ethics Committee ◽

Primary Care Services ◽

Moral Problems ◽

High Level

AbstractWould primary care services benefit from the aid of a clinical ethics committee (CEC)? The implementation of CECs in primary care in four Norwegian municipalities was supported and their activities followed for 2.5 years. In this study, the CECs’ structure and activities are described, with special emphasis on what characterizes the cases they have discussed. In total, the four CECs discussed 54 cases from primary care services, with the four most common topics being patient autonomy, competence and coercion; professionalism; cooperation and disagreement with next of kin; and priority setting, resource use and quality. Nursing homes and home care were the primary care services most often involved. Next of kin were present in 10 case deliberations, whereas patients were never present. The investigation indicates that it might be feasible for new CECs to attain a high level of activity including case deliberations within the time frame. It also confirms that significant, characteristic and complex moral problems arise in primary care services.

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Emotions and Clinical Ethics Support. A Moral Inquiry into Emotions in Moral Case Deliberation

HEC Forum ◽

10.1007/s10730-011-9162-9 ◽

2011 ◽

Vol 23 (4) ◽

pp. 257-268 ◽

Cited By ~ 14

Author(s):

Bert Molewijk ◽

Dick Kleinlugtenbelt ◽

Scott M. Pugh ◽

Guy Widdershoven

Keyword(s):

Clinical Ethics ◽

Moral Case Deliberation ◽

Moral Inquiry ◽

Clinical Ethics Support ◽

Ethics Support ◽

Moral Case

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Resisting Empathy Bias with Pragmatist Ethics

Contemporary Pragmatism ◽

10.1163/18758185-0161126 ◽

2019 ◽

Vol 16 (1) ◽

pp. 65-83

Author(s):

William Kidder

Keyword(s):

Moral Judgment ◽

Central Component ◽

Moral Inquiry ◽

Group I ◽

Moral Problems

The paper employs a pragmatist perspective on ethics to address the problem of empathy bias, an empirically documented phenomenon in which one’s ability to empathize with another is diminished simply because of that other’s membership in a perceived out-group. I first argue that the philosophical commitments that I take to be distinctive of pragmatism, specifically fallibilism, anti-absolutism, and democracy, require proactive empathetic engagement as a central component of moral inquiry. While this may initially seem to leave pragmatism vulnerable to concerns about empathy bias, I argue that the pragmatist is uniquely equipped to provide a particular sort of response to the problem: a response that does not jettison empathy from moral judgment, but rather seeks to utilize awareness of bias to appropriately correct empathetic engagement when addressing moral problems.

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The faces of pessimism

Behavioral and Brain Sciences ◽

10.1017/s0140525x1800273x ◽

2019 ◽

Vol 42 ◽

Author(s):

John M. Doris

Keyword(s):

Moral Inquiry

Abstract In this commentary on May's Regard for Reason in the Moral Mind, I argue that many of the interdisciplinary moral psychologists whom May terms “pessimists” are often considerably more optimistic about the prospects for progress in moral inquiry than he contends.

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