Skip to main content
Log in

Ethical case deliberation and decision making

  • Published:
Medicine, Health Care and Philosophy Aims and scope Submit manuscript

Abstract

During the last thirty years different methods have been proposed in order to manage and resolve ethical quandaries, specially in the clinical setting. Some of these methodologies are based on the principles of Decision-making theory. Others looked to other philosophical traditions, like Principlism, Hermeneutics, Narrativism, Casuistry, Pragmatism, etc. This paper defends the view that deliberation is the cornerstone of any adequate methodology. This is due to the fact that moral decisions must take into account not only principles and ideas, but also emotions, values and beliefs. Deliberation is the process in which everyone concerned by the decision is considered a valid moral agent, obliged to give reasons for their own points of view, and to listen to the reasons of others. The goal of this process is not the reaching of a consensus but the enrichment of one's own point of view with that of the others, increasing in this way the maturity of one's own decision, in order to make it more wise or prudent. In many cases the members of a group of deliberation will differ in the final solution of the case, but the confrontation of their reasons will modify the perception of the problem of everyone. This is the profit of the process. Our moral decisions cannot be completely rational, due to the fact that they are influenced by feelings, values, beliefs, etc., but they must be reasonable, that is, wise and prudent. Deliberation is the main procedure to reach this goal. It obliges us to take others into account, respecting their different beliefs and values and prompting them to give reasons for their own points of view. This method has been traditional in Western clinical medicine all over its history, and it should be also the main procedure for clinical ethics.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  • Aristotle: 1995, ‘Nicomachean Ethics’, in: S.M. Cahn (ed.), Classics of Western Philosophy. Indianapolis, Indiana: Hackett Publishing Company.

    Google Scholar 

  • Couceiro, A.: 1999, Bioética para clínicos. Madrid: Triacastela.

    Google Scholar 

  • Emanuel, E.J. and L.L. Emanuel: 1992, ‘Four Models of the Physician-patient Relationship’, JAMA 267, 2221-2226.

    Article  PubMed  Google Scholar 

  • Gracia, D.: 1991, Procedimientos de decisión en ética clínica. Madrid: Eudema.

    Google Scholar 

  • Gracia, D.: 2001, ‘Moral Deliberation: The Role of Methodologies in Clinical Ethics’, Med Health Care Philos 4(2), 223-232.

    Article  PubMed  Google Scholar 

  • Hippocrates.: 1981, Hippocrates, with an English Translation by W.H.S. Jones, vol. 2. Cambridge, MA: Harvard University Press.

    Google Scholar 

  • Kant, I.: 1995, ‘Grounding for the Metaphysics of Morals’, in: S.M. Cahn (ed.), Classics of Western Philosophy. Indianapolis, Indiana: Hackett Publishing Company.

    Google Scholar 

  • Leibniz, W.: 1995, Monadology, no. 83, in: S.M. Cahn (ed.), Classics of Western Philosophy. Indianapolis, Indiana: Hackett Publishing Company.

    Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Rights and permissions

Reprints and permissions

About this article

Cite this article

Gracia, D. Ethical case deliberation and decision making. Med Health Care Philos 6, 227–233 (2003). https://doi.org/10.1023/A:1025969701538

Download citation

  • Issue Date:

  • DOI: https://doi.org/10.1023/A:1025969701538

Navigation