Reflections of a Reluctant Clinical Ethicist: Ethics Consultation and the Collapse of Critical Distance
Theoretical Medicine. 1992 Mar; 13(1): 15-22.
The obvious appeal and growing momentum of clinical ethics in academic medical centers should not blind us to a potential danger: the collapse of critical distance. The very integration into the clinical milieu and the processes of clinical decision making, that clinical ethics claims as its greatest success, carries the seeds of a dilution of ethics' critical stance toward medicine and medical education. The purpose of this paper is to suggest how this might occur, and what potential contributions of ethics to medicine might be sacrificed as a result. Medical sociology will be used for comparison. Sociologists have found that they may function either as students and critics of established medical practices and educational philosophies, or as collaborative participants in them -- but rarely both. It may be that professional ethics is most effective when it plays the role of 'stranger' rather than insider, and is continually able to question the most basic assumptions and values of the enterprise with which it is associated. As with medical sociology, ethics and humanities must ask to what extent their desire for acceptance
Academic Medical Centers; Clinical Ethics; Communication; Conflict of Interest; Consultation; Decision Making; Education; Ethicists; Ethics; Ethics Committees; Ethics Consultation; Evaluation; Health; Health Facilities; Humanities; Interdisciplinary Communication; Interprofessional Relations; Medical Education; Medicine; Physicians; Professional Ethics; Sociology; Sociology of Medicine; Standards; Students; Technical Expertise; Values;
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