McGill University, Canada; Douglas Mental Health University Institute, Canada; Shriner's Hospitals for Children, Montreal Children's Hospital, Canada.
Nurs Ethics. 2019 May;26(3):674-687. doi: 10.1177/0969733017722190. Epub 2017 Aug 8.
A growing number of frameworks for the practice of clinical ethics are described in the literature. Among these, hermeneutical frameworks have helped highlight the interpretive and contextual nature of clinical ethics practice.
The aim of this article is to further advance this body of work by drawing on the ideas of Charles Taylor, a leading hermeneutical philosopher.
DESIGN/FINDINGS: A Hermeneutical Rapprochement Framework is presented for clinical ethics practice, based on Taylor's hermeneutical "retrieval" and "rapprochement." This builds on existing hermeneutical approaches for the practice of clinical ethics by articulating a framework with interpretive and reconciliatory scope that extends beyond the presenting "local" context. A Hermeneutical Rapprochement Framework considers broader socio-historical horizons and imaginaries grounded on Taylor's expansive work in epistemological, ontological, political, and moral philosophy.
The framework is discussed in terms of how it can be operationalized for clinical practice as well as normative development. Implications for the educational preparation of clinical ethicists are also discussed. Although this work is directly relevant for clinical ethicists, it can also help inform the ethical practice of all clinicians.
文献中描述了越来越多的临床伦理实践框架。在这些框架中,解释学框架帮助突出了临床伦理实践的解释和语境性质。
本文旨在通过借鉴领先的解释学哲学家查尔斯·泰勒的思想,进一步推进这一领域的工作。
设计/发现:本文提出了一种临床伦理实践的解释学融合框架,基于泰勒的解释学“检索”和“融合”。这是对现有临床伦理实践解释学方法的补充,通过阐明一个具有解释和调和范围的框架,超越了呈现的“局部”背景。解释学融合框架考虑了更广泛的社会历史视野和基于泰勒在认识论、本体论、政治和道德哲学方面广泛工作的想象。
本文讨论了如何将该框架应用于临床实践以及规范发展。还讨论了对临床伦理学家教育准备的影响。尽管这项工作与临床伦理学家直接相关,但它也有助于为所有临床医生提供伦理实践方面的信息。