University of Humanistic Studies, Kromme Nieuwegracht 29, 3512 HD, Utrecht, The Netherlands.
Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, P.O. Box 85500, 3508 GA, Utrecht, The Netherlands.
BMC Med Ethics. 2021 Sep 16;22(1):124. doi: 10.1186/s12910-021-00691-7.
The use of qualitative research in empirical bioethics is becoming increasingly popular, but its implementation comes with several challenges, such as difficulties in aligning moral epistemology and methods. In this paper, we describe some problems that empirical bioethics researchers may face; these problems are related to a tension between the different poles on the spectrum of scientific paradigms, namely a positivist and interpretive stance. We explore the ideas of narrative construction, 'genres' in medicine and dominant discourses in relation to empirical research. We also reflect on the loss of depth and context that may occur with thematic or content analyses of interviews, and discuss the need for transparency about methodologies in empirical bioethics. Drawing on insights from narrative approaches in the social sciences and the clinical-educational discipline of Narrative Medicine, we further clarify these problems and suggest a narrative approach to qualitative interviewing in empirical bioethics that enables researchers to 'listen (and read) in new ways'. We then show how this approach was applied in the first author's research project about euthanasia decision-making. In addition, we stress the important ethical task of scrutinizing methodologies and meta-ethical standpoints, as they inevitably impact empirical outcomes and corresponding ethical judgments. Finally, we raise the question whether a 'diagnostic', rather than a 'problem-solving', mindset could and should be foregrounded in empirical ethics, albeit without losing a commitment to ethics' normative task, and suggest further avenues for theorizing about listening and epistemic (in)justice in relation to empirical (bio)ethics.
定性研究在经验生命伦理学中的应用正变得越来越流行,但它的实施也带来了一些挑战,例如在使道德认识论和方法保持一致方面存在困难。在本文中,我们描述了经验生命伦理学研究人员可能面临的一些问题;这些问题与科学范式光谱上不同极点之间的紧张关系有关,即实证主义和解释主义立场。我们探讨了与经验研究相关的叙事构建、医学“体裁”和主导话语的想法。我们还反思了主题或内容分析访谈可能导致的深度和背景的丧失,并讨论了在经验生命伦理学中对方法论进行透明化的必要性。借鉴社会科学中的叙事方法和叙事医学的临床教育学科的见解,我们进一步阐明了这些问题,并提出了一种经验生命伦理学中定性访谈的叙事方法,使研究人员能够“以新的方式倾听(和阅读)”。然后,我们展示了这种方法如何在第一作者关于安乐死决策的研究项目中得到应用。此外,我们强调了仔细审查方法论和元伦理观点的重要伦理任务,因为它们不可避免地会影响经验结果和相应的伦理判断。最后,我们提出了这样一个问题,即在经验伦理学中,是否可以并且应该突出“诊断”而不是“解决问题”的思维模式,尽管不会失去对伦理学规范任务的承诺,并就与经验(生物)伦理学相关的倾听和认识论(不)公正提出了进一步的理论化途径。