Hartman Laura, Metselaar Suzanne, Widdershoven Guy, Molewijk Bert
Department of Medical Humanities, University of Amsterdam, the Netherlands.
Centre for Medical Ethics, University of Oslo, Norway.
Bioethics. 2019 Nov;33(9):1012-1021. doi: 10.1111/bioe.12617. Epub 2019 Jul 24.
Although moral case deliberation (MCD) is evaluated positively as a form of clinical ethics support (CES), it has limitations. To address these limitations our research objective was to develop a thematic CES tool. In order to assess the philosophical characteristics of a CES tool based on MCDs, we drew on hermeneutic ethics and pragmatism. We distinguished four core characteristics of a CES tool: (a) focusing on an actual situation that is experienced as morally challenging by the user; (b) stimulating moral inquiry into the moral concepts, questions and routines in the lived experience of the CES tool user; (c) stimulating moral learning by exploring other perspectives; and (d) incorporating contextual details. We provide an example of a CES tool developed for moral dilemmas over client autonomy. Our article ends with some reflections on the normativity of the CES tool, other application areas and the importance of evaluation studies of CES tools.
尽管道德案例审议(MCD)作为临床伦理支持(CES)的一种形式得到了积极评价,但它存在局限性。为了解决这些局限性,我们的研究目标是开发一种主题性的CES工具。为了评估基于MCD的CES工具的哲学特征,我们借鉴了解释学伦理学和实用主义。我们区分了CES工具的四个核心特征:(a)关注用户在道德上感到具有挑战性的实际情况;(b)激发对CES工具用户生活经历中的道德概念、问题和常规的道德探究;(c)通过探索其他观点来促进道德学习;(d)纳入背景细节。我们提供了一个为客户自主权方面的道德困境开发的CES工具的示例。我们的文章最后对CES工具的规范性、其他应用领域以及CES工具评估研究的重要性进行了一些思考。