The day-to-day work of clinical ethics consultants and healthcare ethics committees can easily become overly routine. Too much routine, however, comes with a risk that morally important practices will be reduced to mere bureaucratic formalities, while practitioners become desensitized to ethically significant distinctions between cases. Clinical ethics consultation and organizational ethics must be set within the broader social and cultural context of the healthcare environment. This practice requires looking beyond mere legal compliance and the routinely false assumption that there are (...) unambiguous ethical norms that easily govern clinical ethics and hospital policy formation. Together the essays in this issue of HEC Forum challenge readers to rethink taken-for-granted assumptions regarding patient care, physician obligation, clinical ethics consultation, and organizational ethics. (shrink)

Bioethics functions within a world of deep moral pluralism; a universe of discourse debating ethical analysis, public policy, and clinical practice in which a common, generally accepted morality does not exist. While religious thinkers are often approached within a hermeneutic of suspicion for assuming moral standards that cannot be justified in rational terms, secular bioethicists routinely find themselves in exactly the same intellectual predicament. That ethical theory, proposed values, or normative content is secular, that it does not invoke God or (...) any particular religious perspective, does not mean that it is rationally grounded, necessarily true, or universally binding. As the authors in this issue of The Journal of Medicine and Philosophy make clear, this normative reality directly impacts debates regarding concepts of health, illness, and disease, accounts of socially acceptable health-risky behaviors, and the political frameworks that shape public policy. As a result, honest discussion of diverse moral, religious, and political perspectives remains essential in clarifying the intellectual challenges, ethical intuitions, and ideological judgments that shape clinical practice and healthcare policy. Depending on which moral, political, or scientific concepts are guiding bioethical analysis, careful scrutiny will tend to support rather different policies and practices, each of which is likely to be worth careful consideration. (shrink)

Power tends to corrupt and absolute power corrupts absolutely. To be clear, I do not think that blood transfusions necessarily...

Bioethicists often remind health care professionals to pay close attention to issues of diversity and inclusion. Approaches to ethics consultation, where the perspective of the bioethicist is taken to be more morally correct or necessarily authoritative, have been critiqued as inappropriately authoritarian. Despite such apparent recognition of the importance of respecting moral diversity and the inclusion of different viewpoints, authoritarianism is all too often the approach adopted, especially as bioethics has shifted evermore into concerns for public policy. Yet, secular values (...) and philosophical principles are not morally neutral; nor are the private moral convictions of bioethicists. Such analysis is always grounded in particular understandings of the right and the good, the virtuous and the just. Critical examination of common treatments and new alternatives is essential for the careful scientific practice of medicine. The same is true with regard to bioethics. Stagnating in customary or accepted claims of a common secular morality or a standard set of bioethical principles out of an unwillingness to explore the real diversity of moral thought, including traditional religious and cultural worldviews, fails to tap the human capacity to find innovative solutions to the complex challenges facing medicine. (shrink)

Healthcare delivery is an interpersonal endeavor. In every clinical interaction, providers have an ethical obligation to show respect to their patients, and ideally over time these interactions lea...