Teaching practical wisdom in medicine through clinical judgement, goals of care, and ethical reasoning

Journal of Medical Ethics 36 (9):558-562 (2010)
  Copy   BIBTEX

Abstract

Clinical decision making is a challenging task that requires practical wisdom—the practised ability to help patients choose wisely among available diagnostic and treatment options. But practical wisdom is not a concept one typically hears mentioned in medical training and practice. Instead, emphasis is placed on clinical judgement. The author draws from Aristotle and Aquinas to describe the virtue of practical wisdom and compare it with clinical judgement. From this comparison, the author suggests that a more complete understanding of clinical judgement requires its explicit integration with goals of care and ethical values. Although clinicians may be justified in assuming that goals of care and ethical values are implicit in routine decision making, it remains important for training purposes to encourage habits of clinical judgement that are consciously goal-directed and ethically informed. By connecting clinical judgement to patients' goals and values, clinical decisions are more likely to stay focused on the particular interests of individual patients. To cultivate wise clinical judgement among trainees, educational efforts should aim at the integration of clinical judgement, communication with patients about goals of care, and ethical reasoning. But ultimately, training in wise clinical judgement will take years of practice in the company of experienced clinicians who are able to demonstrate practical wisdom by example. By helping trainees develop clinical judgement that incorporates patients' goals of care and ethical reasoning, we may help lessen the risk that ‘clinical judgement’ will merely express ‘the clinician's judgement.’.

Links

PhilArchive



    Upload a copy of this work     Papers currently archived: 91,998

External links

Setup an account with your affiliations in order to access resources via your University's proxy server

Through your library

Similar books and articles

Whither our art? Clinical wisdom and evidence-based medicine.Malcolm Parker - 2002 - Medicine, Health Care and Philosophy 5 (3):273-280.
Wisdom in clinical reasoning and medical practice.Ricca Edmondson, Jane Pearce & Markus H. Woerner - 2009 - Theoretical Medicine and Bioethics 30 (3):231-247.
Medicine as a form of practical understanding.Ineke Widdershoven-Heerding - 1987 - Theoretical Medicine and Bioethics 2 (2).
What is diagnosis? Some critical reflections.Caroline Whitbeck - 1981 - Theoretical Medicine and Bioethics 2 (3):319-329.
Clinical reasoning: New challenges.William E. Stempsey - 2009 - Theoretical Medicine and Bioethics 30 (3):173-179.
Ethical problems in clinical practice: the ethical reasoning of health care professionals.Søren Holm - 1997 - New York: Distributed exclusively in the USA by St. Martin's Press.
Phronesis, clinical reasoning, and Pellegrino's philosophy of medicine.F. Daniel Davis - 1997 - Theoretical Medicine and Bioethics 18 (1-2):173-195.
Theoretical aids in teaching medical ethics.Michael H. Kottow - 1999 - Medicine, Health Care and Philosophy 2 (3):225-229.

Analytics

Added to PP
2010-09-13

Downloads
48 (#331,676)

6 months
11 (#238,333)

Historical graph of downloads
How can I increase my downloads?

References found in this work

The virtues in medical practice.Edmund D. Pellegrino - 1993 - New York: Oxford University Press. Edited by David C. Thomasma.
Concepts of health and disease: interdisciplinary perspectives.Arthur L. Caplan, Hugo Tristram Engelhardt & James J. McCartney (eds.) - 1981 - Reading, Mass.: Addison-Wesley, Advanced Book Program/World Science Division.

Add more references