Item Details

Communicating moral reasoning in medicine as an expression of respect for patients and integrity among professionals

Issue: Vol 10 No. 2 (2013)

Journal: Communication & Medicine

Subject Areas: Healthcare Communication Linguistics

DOI: 10.1558/cam.v10i2.177

Abstract:

The communication of moral reasoning in medicine can be understood as a means of showing respect for patients and colleagues through the giving of moral reasons for actions. This communication is especially important when disagreements arise. While moral reasoning should strive for impartiality, it also needs to acknowledge the individual moral beliefs and values that distinguish each person (moral particularity) and give rise to the challenge of contrasting moral frameworks (moral pluralism). Efforts to communicate moral reasoning should move beyond common approaches to principles-based reasoning in medical ethics by addressing the underlying beliefs and values that define our moral frameworks and guide our interpretations and applications of principles. Communicating about underlying beliefs and values requires a willingness to grapple with challenges of accessibility (the degree to which particular beliefs and values are intelligible between persons) and translatability (the degree to which particular beliefs and values can be transposed from one moral framework to another) as words and concepts are used to communicate beliefs and values. Moral dialogues between professionals and patients and among professionals themselves need to be handled carefully, and sometimes these dialogues invite reference to underlying beliefs and values. When professionals choose to articulate such beliefs and values, they can do so as an expression of respectful patient care and collaboration and as a means of promoting their own moral integrity by signalling the need for consistency between their own beliefs, words and actions.

Author: Lauris Christopher Kaldjian

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References :

American College of Physicians (2012) Ethics Manual. Sixth Edition. http://www.acponline.org/running_practice/ethics/manual/manual6th.htm
American Medical Association (2013) Code of Medical Ethics. http://www.ama-assn.org/ama/pub/physician-resources/medical-ethics/code-medical-ethics.page
Audi, R. and Wolterstorff, N. (1997) Religion in the Public Square. Lanham, MD: Rowman & Littlefield.
Beauchamp, T. L. and Childress, J. F. (2009) Principles of Biomedical Ethics. Sixth Edition. New York, NY: Oxford University Press.
British Medical Association (2012) Medical Ethics Today: The BMA’s Handbook of Ethics and Law. Third Edition. London: BMJ Books.
Brock, D. W. (1991) Facts and values in the physician–patient relationship. In E. D. Pellegrino, R. M. Veatch and J. P. Langan (eds) Ethics, Trust, and the Professions: Philosophical and Cultural Aspects, 113–130. Washington, DC: Georgetown University Press.
Cahill, L. (1990) Can theology have a role in ‘public’ bioethical discourse? Hastings Center Report 20 (4): S10–S14. http://dx.doi.org/10.2307/3562778
Curlin, F. A., Lawrence, R. E., Chin, M. H. and Lantos, J. D. (2007) Religion, conscience, and controversial practices. New England Journal of Medicine 356 (6): 593–600. http://dx.doi.org/10.1056/NEJMsa065316
Engelhardt, H. T. (2000) The Foundations of Christian Bioethics. Lisse, Netherlands: Swets & Zeitlinger.
Frankena, W. (1973) Ethics. Englewood Cliffs, NJ: Prentice Hall.
Geach, P. (1977) The Virtues. Cambridge, UK: Cambridge University Press.
Gillon, R. (1994) Medical ethics: Four principles plus attention to scope. British Medical Journal 309 (6948): 184–188. http://dx.doi.org/10.1136/bmj.309.6948.184
Habermas, J. (2005) Religion in the public sphere. Holberg Prize Lecture. http://www.holbergprisen.no/images/materiell/2005_symposium_habermas.pdf
Hastings Center (1999) Project report: Setting new priorities. In M. J. Hanson and D. Callahan (eds) The Goals of Medicine: the Forgotten Issues in Health Care Reform, 1–54. Washington, DC: Georgetown University Press.
Kaldjian, L. C. (2012) Patients and borders, money and mission: Responding to medically needy persons from other countries who lack financial resources. Perspectives in Biology and Medicine 55 (2): 186–200. http://dx.doi.org/10.1353/pbm.2012.0022
Kaldjian, L. C., Jekel, J. K., Bernene, J. L., Rosenthal, G. E., Vaughan-Sarrazin, M. and Duffy, T. P. (2004) Internists’ attitudes toward terminal sedation in end-of-life care. Journal of Medical Ethics 30: 499–503. http://dx.doi.org/10.1136/jme.2003.004895
MacIntyre, A. (1989) Whose Justice? Which Rationality? Notre Dame, IN: University of Notre Dame Press.
Nagel, T. (1977) The fragmentation of value. In H. T. Engelhardt and D. Callahan (eds) Knowledge, Value and Belief, 279–294. Hastings-on-Hudson, NY: Institute of Society, Ethics and the Life Sciences.
Ramsey, P. (1978) Ethics at the Edges of Life: Medical and Legal Intersections. New Haven, CT: Yale University Press.
Rawls, J. (1997) The idea of public reason revisited. University of Chicago Law Review 64 (3): 765–807. http://dx.doi.org/10.2307/1600311
Reeder, J. P. (1998) What is a religious ethic? Journal of Religious Ethics 25 (3 [suppl. S]): 157–181.
Stout, J. (2001) Ethics after Babel: The Languages of Morals and Their Discontents. Princeton, NJ: Princeton University Press.
Taylor, C. (1982) The diversity of goods. In A. Sen and B. Williams (eds) Utilitarianism and Beyond, 129–144. Cambridge, UK: Cambridge University Press.
Taylor, C. (1989) Sources of the Self. Cambridge, MA: Harvard University Press.
Taylor, C. (1991) The Ethics of Authenticity. Cambridge, MA: Harvard University Press.
Walzer, M. (1994) Thick and Thin: Moral Argument at Home and Abroad. Notre Dame, IN: University of Notre Dame Press.