title: Dialogic Consensus In Clinical Decision-Making.
abstract: This paper is predicated on the understanding that clinical encounters between clinicians and patients should be seen primarily as inter-relations among persons and, as such, are necessarily moral encounters. It aims to relocate the discussion to be had in challenging medical decision-making situations, including, for example, as the end of life comes into view, onto a more robust moral philosophical footing than is currently commonplace. In our contemporary era, those making moral decisions must be cognizant of the existence of perspectives other than their own, and be attuned to the demands of inter-subjectivity. Applicable to clinical practice, we propose and justify a Habermasian approach as one useful means of achieving what can be described as dialogic consensus. The Habermasian approach builds around, first, his discourse theory of morality as universalizable to all and, second, communicative action as a cooperative search for truth. It is a concrete way to ground the discourse which must be held in complex medical decision-making situations, in its actual reality. Considerations about the theoretical underpinnings of the application of dialogic consensus to clinical practice, and potential difficulties, are explored.
authors.affiliation: Clinical Unit in Ethics and Health Law, Faculty of Medicine and Health, University of Newcastle, Callaghan, NSW, 2308, Australia. walkerp@tpg.com.au.
authors.forename: Paul
authors.initials: P
authors.lastname: Walker
authors.affiliation: Philosophy, Religion & Theology, University of Newcastle, Callaghan, NSW, 2308, Australia.|University of Oxford, Oxford, UK.
authors.forename: Terry
authors.initials: T
authors.lastname: Lovat
mesh_terms: D001290:Attitude; D001364:Awareness; D000066491:Clinical Decision-Making / Q000941:ethics*; D003142:Communication; D032921:Consensus; D003299:Cooperative Behavior; D003657:Decision Making / Q000941:ethics*; D028663:Ethical Theory; D004992:Ethics, Medical; D006801:Humans; D007398:Interpersonal Relations; D009014:Morals; D010684:Philosophy; D010817:Physician-Patient Relations / Q000941:ethics*
keywords: Consensus; Dialogue; Discourse Ethics; Habermas; Moral Decision-Making