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Med Health Care Philos. 2019 Sep;22(3):427-438. doi: 10.1007/s11019-018-09882-3.

A pragmatist approach to clinical ethics support: overcoming the perils of ethical pluralism.

Author information

1
Department of Medical Humanities, EMGO+ Institute for Health and Care Research, VU University Medical Centre (VUmc), Amsterdam, The Netherlands. g.inguaggiato@vumc.nl.
2
Department of Medical Humanities, EMGO+ Institute for Health and Care Research, VU University Medical Centre (VUmc), Amsterdam, The Netherlands.
3
Clinical Ethics Unit, Bern University Hospital 'Inselspital', Inselgruppe AG, Bern, Switzerland.

Abstract

In today's pluralistic society, clinical ethics consultation cannot count on a pre-given set of rules and principles to be applied to a specific situation, because such an approach would deny the existence of different and divergent backgrounds by imposing a dogmatic and transcultural morality. Clinical ethics support (CES) needs to overcome this lack of foundations and conjugate the respect for the difference at stake with the necessity to find shared and workable solutions for ethical issues encountered in clinical practice. We argue that a pragmatist approach to CES, based on the philosophical theories of William James, John Dewey, and Charles Sanders Peirce, can help to achieve the goal of reaching practical solutions for moral problems in the context of today's clinical environment, characterized by ethical pluralism. In this article, we outline a pragmatist theoretical framework for CES. Furthermore, we will show that moral case deliberation, making use of the dilemma method, can be regarded an example of a pragmatist approach to CES.

KEYWORDS:

Clinical ethics support; Dilemma method; Ethical pluralism; Moral case deliberation; Pragmatism

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