Accounting for context: Future directions in bioethics theory and research

Abstract

Many physicians have found that the traditional approach to bioethics fails to account for important aspects of their moral experience in practice. New approaches to bioethics theory are challenging the traditional application of universal moral principles based in liberal moral theory. At the same time, a shift in both the goals and methods of bioethics education has accompanied its "coming of age" in the medical school curriculum. Taken together, these changes challenge both bioethics educators and theorists to come closer to the details and nuances of real clinical encounters. The emerging trend emphasizes the importance of context in bioethics education and in the moral theory and research undergirding it. This article introduces one research approach examining the practical life contexts of medical students' ethical experiences and learning. It calls for increased attention to research and theory in bioethics that more adequately accounts for the ways different contexts produce significant changes in meaning and understanding in medical encounters.

Patient autonomy in nurse‐led shared care: a review of theoretical and empirical literature

“…In biomedical ethics, patient autonomy is the core of the concept of informed consent and dominates the relationship between patients and healthcare professionals. Some theorists, however, emphasize the importance of the healthcare context (Moody 1992, Tronto 1993, Agich 2003), highlighting the significance of individual circumstances, and ways in which interaction between participants constitute part of the context (Douglas‐Steele & Hundert 1996). As a result, it is not clear what fostering patient autonomy consists of in daily practice.…”

Turning the tables: When the student teaches the professional — A case description of an innovative teaching approach as told by the students

“…This understanding is gaining ground in medical education research. For example, understanding context plays a vital role in designing educational interventions (Douglas-Steele & Hundert, 1996;Gess-Newsome, et al, 2003;Ogrinc, Nierenberg, & Batalden, 2011), in introducing an intervention (Genn, 2001a(Genn, , 2001bMcGaghie, 2011), scaling-up an intervention (McDonald, Keesler, Kauffman, & Schneider, 2006) as well as evaluating an intervention (J. B.…”

Context in medical education: the informal ethics curriculum

“…These alternatives to the reigning theoretical model include the new casuistry (Toulmin 1981; Jonsen & Toulmin 1988; Jonsen 1989a, 1989b; Jonsen 1991), feminist approaches (Miller 1976; Gilligan 1987; Carse 1991), and narrative analysis (Mishler 1986; Bamberg, 1991; Budwig 1991; Charon 1992). We have discussed in some detail elsewhere the ways these alternative theoretical approaches demonstiate a deeper appreciation of context (Douglas‐Steele & Hundert 1996).…”