The birth of tragedy in pediatrics: a phronetic conception of bioethics.
Accepted standards of parental decisional autonomy and child best interests do not address adequately the complex moral problems involved in the care of critically ill children. A growing body of moral discourse is calling for the recognition of ;tragedy' in selected human problems. A tragic dilemma is an irresolvable dilemma with forced terrible alternatives, where even the virtuous agent inescapably emerges with ;dirty hands'. The shift in moral framework described here recognizes that the form of conduct called for by tragic dilemmas is the practice of phronesis. The phronetic agent has acquired a capacity to discern good agency in tragic circumstances. This discernment is practiced through the artful creation of moral narratives: stories that convey that which is morally meaningful in a particular situation; that is, stories that are ;meaning making'. The phronetic agent addresses tragic dilemmas involving children as a narrator of contextualized temporal embodied human (counter)stories.
Carnevale
Franco A
FA
School of Nursing, Wilson Hall, McGill University, Montreal, Quebec, Canada. franco.carnevale@mcgill.ca
D001675:Bioethics; D002651:Child Advocacy / Q000941:ethics*; D002675:Child, Preschool; D003422:Critical Care / Q000941:ethics*; D003657:Decision Making / Q000941:ethics; D026689:Ethical Analysis; D028781:Ethical Relativism; D028663:Ethical Theory; D005260:Female; D006801:Humans; D007600:Judgment / Q000941:ethics; D018447:Medical Futility / Q000941:ethics; D009014:Morals; D033262:Narration; D033282:Parental Consent / Q000941:ethics*; D010372:Pediatrics / Q000941:ethics*; D010686:Philosophy, Medical; D011340:Problem Solving / Q000941:ethics; D011379:Prognosis; D028722:Virtues; D028761:Withholding Treatment / Q000941:ethics*