Health Care Analysis 17 (3):217-235 (2009)

Guy Widdershoven
VU University Amsterdam
Recently, moral deliberation within care institutions is gaining more attention in medical ethics. Ongoing dialogues about ethical issues are considered as a vehicle for quality improvement of health care practices. The rise of ethical conversation methods can be understood against the broader development within medical ethics in which interaction and dialogue are seen as alternatives for both theoretical or individual reflection on ethical questions. In other disciplines, intersubjectivity is also seen as a way to handle practical problems, and methodologies have emerged to deal with dynamic processes of practice improvement. An example is responsive evaluation. In this article we investigate the relationship between moral deliberation and responsive evaluation, describe their common basis in dialogical ethics and pragmatic hermeneutics, and explore the relevance of both for improving the quality of care. The synergy between the approaches is illustrated by a case example in which both play a distinct and complementary role. It concerns the implementation of quality criteria for coercion in Dutch psychiatry
Keywords Coercion  Dialogical ethics  Dialogue  Moral deliberation  Pragmatic hermeneutics  Responsive evaluation  Psychiatry
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DOI 10.1007/s10728-008-0102-z
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Principles of Biomedical Ethics.Tom L. Beauchamp - 1979 - Oxford University Press.
The Fragility of Goodness.Martha Nussbaum - 1986 - Journal of Philosophy 85 (7):376-383.

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