Ethics Consultation and Autonomy

Abstract Services of ethics consultants are nowadays commonly used in such various spheres of life as engineering, public administration, business, law, health care, journalism, and scientific research. It has however been maintained that use of ethics consultants is incompatible with personal autonomy; in moral matters individuals should be allowed to make their own decisions. The problem this criticism refers to can be conceived of as a conflict between the professional autonomy of ethics experts and the autonomy of the persons they serve. This paper addresses this conflict and maintains that when the nature of both ethics consultation and individual autonomy is properly understood, the professional autonomy of ethics experts is compatible with the autonomy of the persons they assist

Clinical Ethics Consultation – a Particular Form of Valuation

Clinical ethics consultation is a relatively young field of expertise that supports ethically reflected decision-making. This process shakes up the existing hierarchy in two ways; first, by involving further perspectives in a structured and transparent way, and, second, by shifting the focus to a more comprehensive, interdisciplinary view. A major challenge for those providing clinical ethics consultation is building trust, which involves being considerate towards the needs of patients, relatives and healthcare professionals as well as towards customs and organizational culture. As this service emphasizes the relational aspect of medical care, it is difficult to realize within existing institutional frameworks. This paper explores how clinical ethics consultation developed and changed over the past few decades alongside an evolving understanding of respect for patient autonomy within an ethics of care approach. One of the most influential images related to clinical ethics consultation marks the beginning of this era, however, it also signifies some of the limitations and challenges of the practice still valid nearly 60 years after the first clinical ethics committee had been installed.Clinical ethics consultation is a relatively young field of expertise that supports ethically reflected decision-making. This process shakes up the existing hierarchy in two ways; first, by involving further perspectives in a structured and transparent way, and, second, by shifting the focus to a more comprehensive, interdisciplinary view. A major challenge for those providing clinical ethics consultation is building trust, which involves being considerate towards the needs of patients, relatives and healthcare professionals as well as towards customs and organizational culture. As this service emphasizes the relational aspect of medical care, it is difficult to realize within existing institutional frameworks. This paper explores how clinical ethics consultation developed and changed over the past few decades alongside an evolving understanding of respect for patient autonomy within an ethics of care approach. One of the most influential images related to clinical ethics consultation marks the beginning of this era, however, it also signifies some of the limitations and challenges of the practice still valid nearly 60 years after the first clinical ethics committee had been installed

Varieties of deception and distrust: moral dilemmas in the ethnography of psychiatry

This article considers the ethical guidelines concerning autonomy, negotiated consent and transparency in relation to an ethnography of psychiatry. It suggests that the complexities and unequal power distribution of the psychiatric consultation make these guidelines difficult to apply. Rather an attempt is made to develop an ethics of patient acknowledgement even where this presents ethical misgivings vis-à-vis psychiatrists. I argue for the importance of ethnography rather than the instantiation of abstract principles to the development of an ethical perspective

Governing Sustainable Food and Farming Production Futures using Integrated Risk Assessment Approaches

Nanofoods, 'functional foods' and biopharming are three production futures that are strongly developing despite being characterised by significant gaps in knowledge and understanding, and a peculiar scarcity of proactive processes with which to seize opportunities and minimise and manage potential risks and public concerns which could negatively impact on the industry. In order to better assess benefits and risks and to build public trust, the paper suggests the establishment of an integrated health/food and environmental risk assessment regime that also incorporates and is responsive to the ethical concerns, socio-economic realities and local demands of various stakeholders – right from the beginning of a development. In order to have a global as well as a national practical effect, the assessment regime needs to conform to national and accepted international regulations and observe fundamental principles in bioethics and public sector ethics, such as integrity, access, autonomy and choice. Such a pro-active approach might lead to improved collaborations, to constructive communication channels and to enriched and more mutually acceptable futures

Is professional ethics grounded in general ethical principles?

This article questions the commonly held view that professional ethics is grounded in general ethical principles, in particular, respect for client (or patient) autonomy and beneficence in the treatment of clients (or patients). Although these are admirable as general ethical principles, we argue that there is considerable logical difficulty in applying them to the professional-client relationship. The transition from general principles to professional ethics cannot be made because the intended conclusion applies differently to each of the parties involved, whereas the premise is a general principle that applies equally to both parties. It is widely accepted that professionals are required to recognize that clients or patients possess rights to autonomy that are more than the general rights to personal autonomy accepted in ordinary social life, and that professionals are expected to display beneficence toward their clients that is more than the beneficence expected of anyone in ordinary social life. The comparative component of professional ethics is an intrinsic feature of the professional situation, and thus it cannot be bypassed in working out a proper professional ethics. Thus, we contend, the proper professional treatment of clients or patients has not been explained by appeal to general ethical principles

And Power Corrupts…: Theology and the Disciplinary Matrix of Bioethics

What role should religion play in a religiously pluralistic liberal society? Public bioethics unavoidably raises this question in a particularly insistent fashion. As the 20 papers in this collection demonstrate, the issues are complex and multifaceted. The authors address specific and highly contested issues as assisted suicide, stem cell research, cloning, reproductive health, and alternative medicine as well as more general questions such as who legitimately speaks for religion in public bioethics, what religion can add to our understanding of justice, and the value of faith-based contributions to healthcare. Christian (Catholic and Protestant), Jewish, Islamic, and Buddhist viewpoints are represented. The first book to focus on the interface of religion and bioethics, this collection fills a significant void in the literature

Patient's autonomy, physician's convictions and euthanasia in Belgium

The aim of this paper is to show the inherent contradiction in the Belgian euthanasia practice. While stressing patient’s autonomy, medical professionals exhibit paternalism in deciding the patient’s fate. First, background information is provided. Then the 2014 Belgian Society of Intensive Care Medicine Council Statement Paper will be considered. Concerns are voiced about euthanizing people who fail to find meaning in their lives, including those who underwent unsuccessful sex-change operation and blind people, euthanizing patients who did not give their consent, and euthanizing people with dementia. Finally, some suggestions designed to improve the situation are offered