Where the ethical action is

Abstract

It is common to think of medical and ethical modes of thought as different in kind. In such terms, some clinical situations are made more complicated by an additional ethical component. Against this picture, we propose that medical and ethical modes of thought are not different in kind, but merely different aspects of what it means to be human. We further propose that clinicians are uniquely positioned to synthesise these two aspects without prior knowledge of philosophical ethics.

Stigma respecified: Investigating HIV stigma as an interactional phenomenon

“…My practice in what follows will take the form of Situation Analysis , an approach which Doug Hardman and I are developing together 7 which is derived from the philosophical method of Frank Ebersole 8–10 . I take this to be a companion to the philosophy‐as‐case‐studies or field‐philosophy of Harold Garfinkel 4,5 and its development at the level of conversation in the work of Harvey Sacks and his collaborators 11 .…”

Where the ethical action also is: a response to Hardman and Hutchinson

“…Thus, when Hardman and Hutchinson suggest that ‘cultivating a greater understanding of and sensitivity towards their patients’ everyday lives’1 should be central to medical education, they are advocating for the development of a moral culture or ethos that implicitly recognises and values the significance of patient’s perspectives. Of course, it would be difficult to find a modern medical school that does not seek to cultivate such sensitivities, at least to some degree.…”

“…Such ideas are central to discourses of professionalism as well as notions of cultural competency and it is therefore the case that something of the required ethos already exists within the culture of medicine. Furthermore, it is arguably the case that the emergence and development of this ethos is itself tied to the ‘special principles’ that supposedly ‘estrange clinicians from everyday human concerns’ 1…”

“…The result is that patient autonomy has become a key part of the ethos of contemporary healthcare 9. The practice of ethical medicine requires more than ordinary moral development and ‘specialised biological knowledge’ 1. Not only must those who seek to become medical professionals come to inhabit the moral culture of healthcare, they must also develop certain reflective and analytic abilities characteristic of modern, which is to say philosophical, medical ethics, or so I suggest in the following section.…”

“…In Where the ethical action is, Hardman and Hutchinson make some interesting and compelling points about the way in which ‘the ethical’—various values and various kinds of values—are embedded in everyday life, including the everyday life one finds in clinical interactions, understood as scientific or scientifically informed activities 1. In so doing, they contribute to what is now a substantial body of work that views medicine as cultural enterprise as well as the need for empathy and cultural competence when it comes to providing healthcare to all patients in a given population.…”