Health Care and Norm

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Other Title
  • 医療、規範、物語
  • イリョウ キハン モノガタリ イリョウ リンリガク ノ ホウホウロン オ メグッテ
  • An Essay on Methods in Health Care Ethics
  • 医療倫理学の方法論をめぐって

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Abstract

In this essay I argue methods in health care ethics (or biomedical ethics) so far proposed can be categorized into three approaches: principle-based, procedure-based, and narrative-based ones. Principle-based approach, widely known by the book of Beauchamp and Childress in which ethical principles (autonomy, non-maleficence, beneficence, and justice) are given the key role in moral reasoning. The second approach, mostly developed in "clinical ethics," in which moral reasoning is attempted in the context of health care profession's procedure, as Jonsen and co-authors proposed a structured method in which four topics should be analyzed in clinical case studies (medical indication, patient preferences, quality of life, and contextual features). The third approach brings moral reasoning into the patient's life context, emphasizing role, paradigm, analogy, etc. The three approaches are mutually independent but at the same time complementary to one another. Principles will acquire contents and understandings in the context of physician's procedure or patient's life, while procedure and narrative will enjoy moral foundation (e. g. accountability or universalizability) with the help of universal principles. I demonstrate the relation of three approaches using a fictional case of an ALS (amyotrophic lateral sclerosis) patient, who wanted his life-sustaining treatments withdrawn.

Journal

  • The Sociology of Law

    The Sociology of Law 2006 (64), 116-129,278, 2006

    The Japanese Association of Sociology of Law

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