Inguaggiato, G., et al. (2019).
The AMA Journal of Ethic, 21(10),
E913-919.
Abstract
In clinical decision making, facts are presented and discussed, preferably in the context of both evidence-based medicine and patients’ values. Because clinicians’ values also have a role in determining the best courses of action, we argue that reflecting on both patients’ and professionals’ values fosters good clinical decision making, particularly in situations of moral uncertainty. Moral case deliberation, a form of clinical ethics support, can help elucidate stakeholders’ values and how they influence interpretation of facts. This article demonstrates how this approach can help clarify values and contribute to good clinical decision making through a case example.
Here are some thoughts:
This article discusses how moral case deliberation (MCD) supports good clinical decision-making. It argues that while evidence-based medicine and patient values are crucial, clinicians' values also play a significant role, especially in morally uncertain situations. MCD, a form of clinical ethics support, helps clarify the values of all stakeholders and how these values influence the interpretation of facts. The article explains how MCD differs from shared decision-making, emphasizing its focus on ethical dilemmas and understanding moral uncertainty among caregivers rather than reaching a shared decision with the patient. Through dialogue and a structured approach, MCD facilitates a deeper understanding of the situation, leading to better-informed and morally sensitive clinical decisions. The article uses a case study from a neonatal intensive care unit to illustrate how MCD can help resolve disagreements and uncertainties by exploring the different values held by nurses and physicians.