Abstract

Ethical concerns present in the clinical setting are recognised as important and therefore addressed formally in ethics rounds, in ethics committees and by ethicists. If ethical issues are getting more attention now than they have in the past it is important to understand what approach would be most effective for ethicists and ethics committees in clinical ethical decision-making. In this thesis, I shall critically examine a theory based, casuistic and consultative approach to clinical ethical decision-making and conclude the consultative approach is most likely to lead to appropriate decisions. I show that a theory based and casuistic approach to clinical ethical decision-making are insensitive to morally relevant details of particular situations, potentially biased and in some cases not able to arrive at closure, hence, not yielding appropriate decisions. I argue that a necessary component for clinical ethical decision-making is consideration of the particular values of the patient and that an effective approach to clinical ethical decision-making must be able to reveal and incorporate patients' values. Such an approach is 'consultation' because it is process oriented, facilitates maximum communication and incorporates a diversity of views