If someone asked me: What is my philosophy of clinical ethics? I would initially be dumbstruck for an answer. In response, I would probably try to define an answer from my background in bioethics and philosophy. I would pick frameworks in philosophy that represent my approach. For example, I would be inclined to refer to pragmatism and casuistry, as frameworks that determine my clinical ethics approach. My last blogpost about Marlise Munoz, the brain dead woman in Texas is a good example of this. My philosophy as a clinical ethicist is based on the facts of the case, a subsequent calculation of rights and wrongs. The outcome of this sum guides my ethics advice about what is practically possible, conform short-handed pragmatism. In responding to a case, I start with the specifics of a case and formulate answers that may be acceptable by multiple stakeholders, instead of relying on general theoretical outcomes, as a short-handed casuist. Finally, I reason along the lines of several relevant principles, such as autonomy, beneficence, non-maleficence, justice and dignity, and seek to apply these principles to the specifics of a case.
However, given that the background of clinical ethicists lies over a broad spectrum, I doubt that this answer would be satisfactory. If I hadn’t had a background in bioethics, what would I have answered to this question? Does the fact that I am an ethicist in the clinic mean that I have to frame my answers along philosophical and ethical theories? Would a social worker, an accountant or an attorney equally have a philosophy in their work? Asking myself this latter question, I think that those professions do have a professional philosophy, but that they would be less likely to phrase it in philosophical language. Instead, probably they would describe their philosophy in more layman’s terms and would narrate about their approach in the different cases they see. So how do I approach my cases as a clinical ethicist?
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