David Bourget (Western Ontario)
David Chalmers (ANU, NYU)
Rafael De Clercq
Jack Alan Reynolds
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Medicine, Health Care and Philosophy 6 (3):247-254 (2003)
The debate and implementation of Clinical Ethics Consultation (CEC) is still in its beginnings in Europe and the issue of the patient's perspective has been neglected so far, especially at the theoretical and methodological level. At the practical level, recommendations about the involvement of the patient or his/her relatives are missing, reflecting the general lack of quality and practice standards in CEC. Balance of perspectives is a challenge in any interpersonal consultation, which has led to great efforts to develop “technical”approaches, e.g., in psychological counseling or psychotherapeutic treatment. In ethics, unbalance or partiality is a matter of justice and has provoked significant theoretical work, also relevant for practical medical ethics. A lack of balance seems to be particularly serious in those situations, where ethical conflict is triggering a consultation and where the “parties” involved may try to persuade the consultant that their particular opinion is the most convincing; but to our knowledge the connection between patient/relatives involvement and balance has not yet been discussed in the context of CEC. Central questions of access and involvement of the patient and his/her relatives will be analysed and discussed regarding the challenge of balance and the adequate role or attitude of a Clinical Ethics Consultant. It is argued that the Clinical Ethics Consultant should have a methodological awareness regarding the concepts of “neutrality” versus “advocacy” in his/her role and try to achieve a balanced procedure that allows for an optimum of change of perspectives. The argumentation is developed along the narrative of a real case study. Recommendations concerning the involvement of (the perspectives of) the patient or the relatives are formulated for the practice of CEC.
|Keywords||advocacy balance of perspectives Clinical Ethics Consultation family hospital ethics committee patient rights neutrality recommendations role of ethics consultant|
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Citations of this work BETA
Reidun Førde & Thor Willy Ruud Hansen (2014). Do Organizational and Clinical Ethics in a Hospital Setting Need Different Venues? HEC Forum 26 (2):147-158.
Stella Reiter-Theil, Marcel Mertz & Barbara Meyer-Zehnder (2007). The Complex Roles of Relatives in End-of-Life Decision-Making: An Ethical Analysis. [REVIEW] HEC Forum 19 (4):341-364.
F. C. Weidema, T. A. Abma, G. A. M. Widdershoven & A. C. Molewijk (2011). Client Participation in Moral Case Deliberation: A Precarious Relational Balance. [REVIEW] HEC Forum 23 (3):207-224.
Samia A. Hurst, Stella Reiter-Theil, Arnaud Perrier, Reidun Forde, Anne-Marie Slowther, Renzo Pegoraro & Marion Danis (2007). Physicians' Access to Ethics Support Services in Four European Countries. Health Care Analysis 15 (4):321-335.
Sandra Bartels, Mike Parker, Tony Hope & Stella Reiter-Theil (2005). Wie hilfreich sind „ethische Richtlinien “am Einzelfall? Ethik in der Medizin 17 (3):191-205.
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