Using practical wisdom to facilitate ethical decision-making: a major empirical study of phronesis in the decision narratives of doctors
| Autor: | Aisha Y. Malik, Chris Turner, Mervyn Conroy, Catherine Weir, Catherine Hale, Alan Brockie |
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| Rok vydání: | 2021 |
| Předmět: |
Practice virtue ethics
Health (social science) Virtue ethics Virtue media_common.quotation_subject Context (language use) Morals 0603 philosophy ethics and religion 03 medical and health sciences 0302 clinical medicine Empirical research Physicians Virtues Phronesis Humans Ethics Medical 030212 general & internal medicine Practical wisdom media_common Neo-Aristotelean lcsh:R723-726 Narration Health Policy Ethical decision 06 humanities and the arts Issues ethics and legal aspects Philosophy of medicine Clinical leadership Engineering ethics 060301 applied ethics lcsh:Medical philosophy. Medical ethics Psychology Medical ethics Research Article Decision-making |
| Zdroj: | BMC Medical Ethics BMC Medical Ethics, Vol 22, Iss 1, Pp 1-13 (2021) |
| ISSN: | 1472-6939 |
| DOI: | 10.1186/s12910-021-00581-y |
| Popis: | BackgroundMedical ethics has recently seen a drive away from multiple prescriptive approaches, where physicians are inundated with guidelines and principles, towards alternative, less deontological perspectives. This represents a clear call for theory building that does not produce more guidelines.Phronesis(practical wisdom) offers an alternative approach for ethical decision-making based on an application of accumulated wisdom gained through previous practice dilemmas and decisions experienced by practitioners.Phronesis,as an ‘executive virtue’, offers a way to navigate the practice virtues for any given case to reach a final decision on the way forward. However, very limited empirical data exist to support the theory ofphronesis-based medical decision-making, and what does exist tends to focus on individual practitioners rather than practice-based communities of physicians.MethodsThe primary research question was: What does it mean to medical practitioners to make ethically wise decisions for patients and their communities? A three-year ethnographic study explored the practical wisdom of doctors (n = 131) and used their narratives to develop theoretical understanding of the concepts of ethical decision-making. Data collection included narrative interviews and observations with hospital doctors and General Practitioners at all stages in career progression. The analysis draws on neo-Aristotelian, MacIntyrean concepts of practice- based virtue ethics and was supported by an arts-based film production process.ResultsWe found that individually doctors conveyed many different practice virtues and those were consolidated into fifteen virtue continua that convey the participants’ ‘collective practical wisdom’, including thephronesisvirtue. This study advances the existing theory and practice onphronesisas a decision-making approach due to the availability of these continua.ConclusionGiven the arguments that doctors feel professionally and personally vulnerable in the context of ethical decision-making, the continua in the form of a video series and app based moral debating resource can support before, during and after decision-making reflection. The potential implications are that these theoretical findings can be used by educators and practitioners as a non-prescriptive alternative to improve ethical decision-making, thereby addressing the call in the literature, and benefit patients and their communities, as well. |
| Databáze: | OpenAIRE |
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