Dizziness of clinical ethics



How, when you are a caregiver and faced with delicate ethical situations, do you make the right choice at the patient’s bedside? How, in the field and beyond the main theoretical and philosophical principles, to take “the” right decision, in practice? To help caregivers to discern, there are, in some hospitals, clinical ethics units, which can be contacted by teams in the midst of questioning. In a very well-designed little book, intended for professionals – but fascinating to read even if you haven’t done medicine -, Clinical ethics in 10 cases, Doctors Véronique Fournier and Nicolas Foureur analyze ten major questions (medically assisted procreation, active assistance in dying, requests for permanent sterilization, neonatal or adult resuscitation, transplantation, constraint in psychiatry, etc. ), through concrete examples.

→ CHRONICLE. Ethics in critical care

Each patient has their own unique story. To make each of the lived cases a form of lesson, the book establishes the procedure to be followed, provides methodological tools to nourish reflection, highlights the major ethical benchmarks, such as non-maleficence towards the patient, raises the right questions. to ask (such as “who is the patient?” and “what does the law say?”). Throughout the pages, the reader perceives the dizziness which must seize certain doctors before any decision and the responsibility which weighs on their shoulders. Because the practitioner does not decide for himself, but for others, a “Others who play their skin”, remind the authors. With the patient’s interest in sight, but also the possible consequences of his gesture, on him but also on his family and loved ones.

Do no harm

“Primum, non nocere” (first, do no harm), says the Hippocratic Oath. We understand that the profession of doctor is not only a technical act, but ultimately a philosophical one. In the balance, doctors of course put forward medical and clinical arguments, but not only. They are also familial, social, cultural, religious, legislative. It is by linking these different elements that the ethical approach becomes alive, embodied, both universal and particular. In this, it should irrigate all medical practice, recalls the book. But the law, sometimes, does not answer all the situations. “It is rare that an argument alone is decisive in the face of an ethical conflict posed by a singular case, even a legislative ban”, write the authors. It is at this moment that the book shakes up the most: can an act considered as illegal sometimes still be ethical?

→ READ. For future caregivers, ethics is no longer an option

In clear, accessible language, Véronique Fournier and Nicolas Foureur help to better understand the complexity of the dilemmas raised by the practice of medicine today. And point out how much scientific progress, our new relationship to the body, to freedom, to autonomy will cause new ones to emerge in the future.

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