Search results matching tag 'bioethics'

Clinical reasoning: new challenges

wattawa — Wed, 01 Jul 2009 05:00:00 GMT

William E. Stempsey

This article is an introduction to a special issue of Theoretical Medicine and Bioethics on clinical reasoning. Clinical reasoning encompasses the gamut of thinking about clinical medical practice-the evaluation and management of patients' medical problems. Theories of clinical reasoning may be normative or descriptive; that is, they may offer recommendations on how clinicians ought to think or they may simply attempt to describe how clinicians actually do think. This article briefly surveys these approaches in order to show the complexity of clinical reasoning and the inadequacy of any one theory for capturing the full richness of clinical reasoning. The authors of this issue offer both normative and descriptive elements in their accounts. Topics discussed include the importance for clinical reasoning of tacit knowing, risk assessment, narrative and hermeneutics, wisdom, and virtue epistemology.

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Kass Backwards

wattawa — Tue, 02 Jun 2009 15:28:00 GMT

By Scott McLemee

"Last week Leon Kass, chairman of the Council of Bioethics under President Bush, took to the podium to deliver the Jefferson Lecture of the National Endowment for the Humanities -- an event I did not go to, though it was covered by one of IHE's intrepid reporters.

My reluctance to attend suggests that, without noticing it, I have come to accept Kass’s best-known idea, “the wisdom of repugnance.” There is, alas, all too little evidence I am getting any wiser with age -- but my visceral aversion to hearing a Bush appointee talk about human values is inarguable.

As you may recall, Kass wrote in the late 1990s that biotechnological developments such as cloning are “the emotional expression of deep wisdom, beyond reason’s power fully to articulate it.” In our rising gorge, he insisted, “we intuit and feel, immediately and without argument, the violation of things that we rightfully hold dear.... Shallow are the souls that have forgotten how to shudder...”

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Psychology and Medical Decision-Making

wattawa — Mon, 01 Jun 2009 05:00:00 GMT

Christopher Suhler and Patricia Churchland

"In the target article discussion of the Changing Ethical Norms category, Kon (2009) rightly highlights the contributions psychological research can make to bioethics. In this commentary, we suggest that psychology can be relevant not only at the Changing Ethical Norms level of work, but also at the Ideal versus Reality and Improving Care levels. Thus, our aim is not to suggest potential criticisms or refinements of Kon's proposed framework, but rather to elaborate on the potential contributions of one particular domain of empirical research, psychology. We provide two examples of research relevant to the sorts of decisions encountered in the medical context: findings concerning 1) probabilistic reasoning and 2) framing effects. We then conclude by sketching the broader bioethical implications of such findings..."

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Empirical Ethics as Dialogical Practice

wattawa — Wed, 01 Apr 2009 05:00:00 GMT

Widdershoven, G (Widdershoven, Guy), Abma, T (Abma, Tineke), Molewijk, B (Molewijk, Bert)

Abstract: In this article, we present a dialogical approach to empirical ethics, based upon hermeneutic ethics and responsive evaluation. Hermeneutic ethics regards experience as the concrete source of moral wisdom. In order to gain a good understanding of moral issues, concrete detailed experiences and perspectives need to be exchanged. Within hermeneutic ethics dialogue is seen as a vehicle for moral learning and developing normative conclusions. Dialogue stands for a specific view on moral epistemology and methodological criteria for moral inquiry. Responsive evaluation involves a structured way of setting up dialogical learning processes, by eliciting stories of participants, exchanging experiences in (homogeneous and heterogeneous) groups and drawing normative conclusions for practice. By combining these traditions we develop both a theoretical and a practical approach to empirical ethics, in which ethical issues are addressed and shaped together with stakeholders in practice. Stakeholders' experiences are not only used as a source for reflection by the ethicist; stakeholders are involved in the process of reflection and analysis, which takes place in a dialogue between participants in practice, facilitated by the ethicist. This dialogical approach to empirical ethics may give rise to questions such as: What contribution does the ethicist make? What role does ethical theory play? What is the relationship between empirical research and ethical theory in the dialogical process? In this article, these questions will be addressed by reflecting upon a project in empirical ethics that was set up in a dialogical way. The aim of this project was to develop and implement normative guidelines with and within practice, in order to improve the practice concerning coercion and compulsion in psychiatry.

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