Prof. Clare Delany1
1The University of Melbourne, Carlton, Melbourne, Australia
Biography:
Professor Clare Delany is a Clinical Ethicist at Peter MacCallum Cancer Centre and has 15 years experience as a Clinical Ethicist at the Children’s Bioethics Centre at the Royal Children’s Hospital, Melbourne. Clare works as a consultant clinical ethics to health institutions who do not have an embedded clinical ethicist.
Abstract:
In clinical ethics consultations, ethicists bring moral reasoning to bear on concrete and complex clinical ethical problems by undertaking ethical deliberation in collaboration with others. The reasoning process involves identifying and clarifying ethical values which are at stake, and guiding clinicians and sometimes patients and families to think through ethically justifiable courses of action. There is however ongoing discussion about methods ethicists use to do this ethical deliberation and facilitation work.
This paper discusses the ‘Critical Dialogue’ method of ethics facilitation, refined over a period of 15 years of running a clinical ethics service within a large tertiary paediatric hospital in Melbourne. The model comprises seven facilitation steps a clinical ethicist can follow to critically – using systematic and deliberative analysis, and collaboratively – using specific dialogue approaches, generate shared understanding and resolution of an ethical problem.
The facilitative steps aim to not only identify ethically justified responses but also assist participants to gain greater moral clarity and understanding of the ethical problem, and confidence to respond as independent moral agents.
Through detailed description of ethics facilitation methods, we demystify the process of how ethicists engage in and empower others to undertake ethical reasoning. We also propose that the critical dialogue method shares goals with ethics education – both aim to scaffold a participant/learner’s prior knowledge, promote critical and reflective thinking and build new insight and understanding. These shared goals open up the possibility of drawing from educational pedagogy literature to advance the scholarship of clinical ethics facilitation methods.
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