Skip to main content
SpringerLink
Log in

Angewandte pragmatische Ethik in der Klinischen Ethikberatung

  • Chapter
  • First Online:
Pragmatische Urteile in der unmittelbaren Patientenversorgung

Part of the book series: Gesundheit und Medizin im interdisziplinären Diskurs ((GESUNDMED))

  • 485 Accesses

Zusammenfassung

Nachdem nun ein Überblick über die Theorieansätze zum guten und gerechten Handeln der drei namhaftesten Vertreter des klassischen Pragmatismus gegeben wurde, blicken die folgenden Ausführungen auf die ersten systematischen Konzepte Klinischer Ethikberatung. Mit ihnen zeigt sich die explizite Rezeption pragmatischen Denkens in den US-amerikanischen Theoriemodellen Klinischer Ethikberatung. Zwar reichen die Wurzeln dieser Rezeption bis in die 1970er-Jahre zurück, eigenständige Modelle pragmatisch konzipierter Klinischer Ethikberatung wurden jedoch erst ab Mitte der 1980er-Jahre veröffentlicht. Obwohl sie damit außerhalb des hier zu bearbeitenden Zeitraums liegen, unterstreichen sie die eingangs formulierte These insofern, dass mit diesen Modellen das Zusammenfließen von Pragmatismus und Klinischer Ethikberatung systematisiert wurde.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Log in via an institution
Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 49.99
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 64.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

Notes

  1. 1.

    Jonsen (1998), S. 41. Vgl. Frewer (2011), S. 423/424.

  2. 2.

    Vgl. McCormick (1999), S. 181–199. Tully (2006), S. 113/114. Fuchs (1990), S. 122/123.

  3. 3.

    McCormick (1993), S. 230. Vgl. Duffey (1990), S. 148–162.

  4. 4.

    Vgl. McCormick (1973), S. 70–106.

  5. 5.

    Vgl. Cahill (1993), S. 101.

  6. 6.

    Vgl. McCormick (1987), S. 73/74. McCormick (1984), S. 150.

  7. 7.

    Vgl. McCormick (1978), S. 262.

  8. 8.

    Ramsey (1970), S. xvii. Vgl. Churchill (1977), S. 129. Hepp (1999), S. 149/150.

  9. 9.

    Vgl. Ramsey (1952), S. xi. Meilaender (1991), S. 133–156. Werpehowski und Crocco (1994), S. x.

  10. 10.

    Vgl. Long (1993), S. 128/129.

  11. 11.

    Vgl. Ramsey (1980), S. 289–298.

  12. 12.

    Vgl. Ramsey (1983), S. 220.

  13. 13.

    Jonsen (1998), S. 55. Vgl. Jonsen und Jameton (2004), S. 1527.

  14. 14.

    Vgl. Ramsey (1968), S. 125–135.

  15. 15.

    Jonsen (1998), S. 68.

  16. 16.

    Vgl. Toulmin (1997a), S. 102.

  17. 17.

    Moreno (2005), S. 66.

  18. 18.

    Marshall (1993), S. 36.

  19. 19.

    Vgl. Marshall (1993), S. 41/42.

  20. 20.

    Schockenhoff (2013), S. 39. Vgl. Fletcher (1979), S. 3–33.

  21. 21.

    Vgl. Fletcher (1966), S. 7 und 11.

  22. 22.

    Fletcher (1966), S. 26.

  23. 23.

    Vgl. Fletcher (1968a), S. 260. Fletcher (1968b), S. 329–333.

  24. 24.

    Vgl. Fletcher (1967), S. 11–21. Fletcher (1982), S. 9/10. McCormick (1968), S. 140/141.

  25. 25.

    Vgl. Loewy und Springer Loewy (2005), S. 43. Outka (1968), S. 57.

  26. 26.

    Vgl. Jonsen (2001), S. 119. Fletcher und Brody (1995), S. 401.

  27. 27.

    Fletcher (1966), S. 40.

  28. 28.

    Vgl. Smith (1990), S. 167–169.

  29. 29.

    Vgl. Fletcher (1966), S. 159.

  30. 30.

    Vgl. Oppenheim (2005), S. 237.

  31. 31.

    Vgl. Schermer und Keulartz (2002), S. 42.

  32. 32.

    Vgl. Martin (1978), S. 200.

  33. 33.

    Vgl. Toulmin (1964), S. 49 und 51.

  34. 34.

    Vgl. Toulmin (1964), S. 222–225.

  35. 35.

    Vgl. Toulmin (1991), S. 129/130 und 286. Toulmin (2004), S. 111. Toulmin (1996), S. 303.

  36. 36.

    Vgl. Toulmin (1987), S. 610–613. Kuczewski (1997), S. 136.

  37. 37.

    Vgl. Toulmin (1988), S. 14.

  38. 38.

    Toulmin (1997a), S. 109. Vgl. O’Neill (1988), S. 84–99. Tong (1991), S. 424.

  39. 39.

    Vgl. Baker et al. (1999), S. xxix–xxxi.

  40. 40.

    Vgl. Takala (2001), S. 76/77.

  41. 41.

    Bardon (2004), S. 398/399. Vgl. Sokol (2012), S. 9–21.

  42. 42.

    Vgl. Engelhardt (2012), S. 14.

  43. 43.

    Vgl. Beauchamp und Childress (1979), S. 3–19.

  44. 44.

    Vgl. Toulmin (1981), S. 31–39. MacIntyre (1984), S. 500–509.

  45. 45.

    Vgl. Rauprich (2005a), S. 89. Rauprich (2005b), S. 26–29.

  46. 46.

    Childress (1994), S. 83/84.

  47. 47.

    Vgl. Arras et al. (2003), S. 41.

  48. 48.

    Vgl. Childress (1985), S. 278. Winkler und Gruen (2005), S. 117/118.

  49. 49.

    Vgl. Jonsen (1988), S. 281–283.

  50. 50.

    Vgl. Jonsen und Toulmin (1988), S. 304–332.

  51. 51.

    Vgl. Toulmin (1997b), S. 48/49.

  52. 52.

    Vgl. La Puma et al. (1988), S. 124.

  53. 53.

    Vgl. LaPuma und Toulmin (1989), S. 1112.

  54. 54.

    Vgl. Toulmin (1976), S. 37. Toulmin (1994), S. 315–317. Mahowald (1994), S. 68–71.

  55. 55.

    Vgl. Drane (1994), S. 47–56.

  56. 56.

    Vgl. McGee (2003), S. xv–xvi.

  57. 57.

    Vgl. Mitchell (1976), S. 23.

  58. 58.

    Moreno (1988), S. 411. Vgl. Moreno (1990), S. 42. Moreno (1991b), S. 54/55. Moreno (1995), S. 70 und 117. Moreno (2003), S. 15/16.

  59. 59.

    Dies wird nach wie vor als Ziel Ethischer Fallberatung gesehen, Hook et al. (2013), S. 32.

  60. 60.

    Vgl. Moreno (1988), S. 428. Moreno (1991a), S. 406.

  61. 61.

    Vgl. Miller et al. (1996), S. 47–50. Fins et al. (1995), S. 565/566. Miller et al. (1997), S. 21–38.

  62. 62.

    Vgl. Fins und Miller (2000), S. 72. Fins (1998), S. 68–70. Ähnlich, Holmes (1979), S. 1131–1138.

  63. 63.

    Vgl. Hester (2008), S. 25/26.

  64. 64.

    Vgl. Hester (2001), S. 1–38.

  65. 65.

    Vgl. Hester (2009), S. 14–23 und 32–39 und 46–49.

Literatur

  • Arras JD, Steinbock B, London AJ (2003) Moral reasoning in the medical context. In: Arras JD, Steinbock B, London AJ (Hrsg) Ethical issues in modern medicine, 6. Aufl. Boston, S 1–41

    Google Scholar 

  • Baker RB, Caplan AL, Emanuel LL et al (1999) Introduction. In: Baker RB, Caplan AL, Emanuel LL et al (Hrsg) The American medical ethics revolution: how the AMA’s code of ethics has transformed physician’s relationship to patients, professionals, and society. Baltimore, S xiii–xixl

    Google Scholar 

  • Bardon A (2004) Ethics education and value priorization among members of U.S. hospital ethics committees. Kennedy Inst Ethics J 14(4):395–406

    Article  Google Scholar 

  • Beauchamp TL, Childress JF (1979) Principles of biomedical ethics. New York

    Google Scholar 

  • Cahill LS (1993) On Richard McCormick: reason and faith in post-vatican II catholic ethics. In: Verhey A, Lammers SE (Hrsg) Theological voices in medical ethics. Grand Rapids, S 78–105

    Google Scholar 

  • Childress JF (1985) Protecting handicapped newborns: who’s in charge and who pays? In: Milunsky A, Annas GJ (Hrsg) Genetics and the law III. New York, S 271–281

    Google Scholar 

  • Childress JF (1994) Principles-oriented bioethics. An analysis and assessment from within. In: DuBose ER, Hamel RP, O’Connell LJ (Hrsg) A matter of principles. Ferment in U.S. bioethics. Valley Forge, S 72–98

    Google Scholar 

  • Churchill LR (1977) Tacit components of medical ethics: making decisions in the clinic. J Med Ethics 3(1):129–132

    Article  Google Scholar 

  • Drane JF (1994) Clinical bioethics. Theory and practice in medical ethical decision making. Kansas City

    Google Scholar 

  • Duffey MK (1990) A study of the principle of double effect. Its evaluation in contemporary philosophical ethics and catholic moral theology, and especially its role in the thought of Richard McCormick. Ann Arbor

    Google Scholar 

  • Engelhardt HT (2012) Beyond the principles of bioethics: facing the consequences of fundamental moral disagreement. ethic@ 11(1):13–31

    Article  Google Scholar 

  • Fins JJ (1998) Approximation and negotiation: clinical pragmatism and difference. Camb Q Healthc Ethics 7:68–76

    Article  Google Scholar 

  • Fins JJ, Miller FG (2000) Clinical pragmatism, ethics consultation, and the elderly patient. Clin Geriatr Med 16:71–82

    Article  Google Scholar 

  • Fins JJ, Bacchetta MD, Miller FG (1995) Framing the physician-assisted suicide and voluntary active euthanasia debate: the role of deontology, consequentialism, and clinical pragmatism. J Am Geriatr Soc 43(5):563–568

    Article  Google Scholar 

  • Fletcher J (1966). Situation ethics. The new morality. Philadelphia

    Google Scholar 

  • Fletcher J (1967) Moral responsibility. Situation ethics at work. Philadelphia

    Google Scholar 

  • Fletcher J (1968a) Reflection and reply. In: Cox H (Hrsg) The situation ethics debate. Philadelphia, S 249–264

    Google Scholar 

  • Fletcher J (1968b) What’s in a rule: a situationist’s view? In: Outka GH, Ramsey P (Hrsg) Norm and context in Christian ethics. London, S 325–349

    Google Scholar 

  • Fletcher J (1979) Morals and medicine. Princeton

    Google Scholar 

  • Fletcher J (1982) Situation ethics revisited. Relig Hum 16:9–13

    Google Scholar 

  • Fletcher J, Brody H (1995) Clinical ethics. I. Elements and methodologies. In: Reich WT (Hrsg) Encyclopedia of bioethics, Bd I. London, S 399–404

    Google Scholar 

  • Frewer A (2011) Zur Geschichte der Bioethik im 20. Jahrhundert. Entwicklungen – Fragestellungen – Institutionen. In: Eissa T-L, Sorgner SL (Hrsg) Geschichte der Bioethik. Eine Einführung. Paderborn, S 415–437

    Google Scholar 

  • Fuchs J (1990) Conscience and conscientious fidelity. In: Curran CE (Hrsg) Moral theology: challenges for the future. Essays in honor of Richard A. McCormick. New York, S 108–124

    Google Scholar 

  • Hepp B (1999) Bündnisse des Lebens. Medizinethische Perspektiven in den Werken Paul Ramseys. München

    Google Scholar 

  • Hester DM (2001) Community as healing. Pragmatist ethics in medical encounters. Lanham

    Google Scholar 

  • Hester DM (2008) The „what?“ and „why?“ of ethics. In: Hester DM (Hrsg) Ethics by committee. A textbook on consultation, organization, and education for hospital ethical committees. Lanham, S 21–26

    Google Scholar 

  • Hester DM (2009) End-of-life care and pragmatic decision making. A bioethical perspective. Cambridge

    Google Scholar 

  • Holmes C (1979) Bioethical decision making: an approach to improve the process. Med Care 17(11):1131–1138

    Article  Google Scholar 

  • Hook CC, Swetz KM, Mueller PS (2013) Ethics committees and consultants. In: Handbook of clinical neurology, Bd 118. S 25–34

    Chapter  Google Scholar 

  • Jonsen AR (1998) The birth of bioethics. New York

    Google Scholar 

  • Jonsen AR (2001) Casuistry. In: Sugarman J, Sulmasy DP (Hrsg) Methods in medical ethics. Washington, DC, S 104–125

    Google Scholar 

  • Jonsen AR, Jameton A (2004) Medical ethics, history of the Americas. II. The United States in the twenty-first century. In: Post ST (Hrsg) Encyclopedia of bioethics, Bd III, 3. Aufl. New York, S 1523–1537

    Google Scholar 

  • Jonsen AR, Toulmin SE (1988) The abuse of casuistry. A history of moral reasoning. Berkeley

    Google Scholar 

  • Kuczewski MG (1997) Bioethics’ consensus on method. Who could ask for anything more? In: Lindemann Nelson H (Hrsg) Stories and their limits. Narrative approaches to bioethics. New York, S 134–149

    Google Scholar 

  • La Puma J, Toulmin SE (1989) Ethics consultants and ethics committees. Arch Intern Med 149:1109–1112

    Article  Google Scholar 

  • La Puma J, Schiedermayer DL, Toulmin SE et al (1988) The standard of care: a case report and ethical analysis. Ann Intern Med 108(1):121–124

    Article  Google Scholar 

  • Loewy EH, Springer Loewy R (2005) Textbook of healthcare ethics, 2. Aufl. New York

    Google Scholar 

  • Long DS (1993) Tragedy, tradition, transformism: the ethics of Paul Ramsey. Eugene

    Google Scholar 

  • MacIntyre A (1984) Does applied ethics rest on a mistake? Monist:498–513

    Google Scholar 

  • Mahowald MB (1994) Collaboration and casuistry. A Peircean pragmatic for the clinical setting. In: Parret H (Hrsg) Peirce and value theory. On Peircean ethics and aesthetics. Amsterdam, S 61–71

    Chapter  Google Scholar 

  • Marshall MF (1993) Fletcher the matchmacker or pragmatism meets utilitarism. In: Vaux K (Hrsg) Joseph Fletcher. Memoir of an ex-radical. Reminiscence and reappraisal. Louisville, S 25–53

    Google Scholar 

  • Martin RM (1978) A clinical model for decision-making. J Med Ethics 4:200–206

    Article  Google Scholar 

  • McCormick RA (1968) Notes on moral theology. In: Cox H (Hrsg) The situation ethics debate. Philadelphia, S 140–146

    Google Scholar 

  • McCormick RA (1973) Ambiguity in moral choice. Milwaukee

    Google Scholar 

  • McCormick RA (1978) A commentary on the commentaries. In: McCormick RA, Ramsey P (Hrsg) Doing evil to achieve good. Moral choice in conflict situations. Chicago, S 193–267

    Google Scholar 

  • McCormick RA (1984) Ethics committees: promise or peril? Law Med Health Care 12(4):150–155

    Article  Google Scholar 

  • McCormick RA (1987) Health and medicine in the catholic tradition. New York

    Google Scholar 

  • McCormick RA (1993) Zur neuen Enzyklika. Orientierung 57(21):229–231

    Google Scholar 

  • McCormick RA (1999) Proportionalism: clarification through dialogue. In: Curran CE, McCormick RA (Hrsg) Historical development of fundamental moral theology in the United States. New York, S 181–199

    Google Scholar 

  • McGee G (2003) Introduction to the second edition. In: McGee G (Hrsg) Pragmatic bioethics, 2. Aufl. Cambridge, S xi–xvi

    Google Scholar 

  • Meilaender G (1991) „Love’s casuistry“: Paul Ramsey on caring for the terminally ill. J Relig Ethics 19(2):133–156

    Google Scholar 

  • Miller FG, Fins JJ, Bacchetta MD (1996) Clinical pragmatism: John Dewey and clinical ethics. J Contemp Health Law Policy 13(1):27–51

    Google Scholar 

  • Miller FG, Fletcher JC, Fins JJ (1997) Clinical pragmatism: a case method of moral problem solving. In: Fletcher JC, Lombardo PA, Marshall MF et al (Hrsg) Introduction to clinical ethics, 2. Aufl. Frederick, S 21–38

    Google Scholar 

  • Mitchell B (1976) Is a moral consensus in medical ethics possible? J Med Ethics 2:18–23

    Google Scholar 

  • Moreno JD (1988) Ethics by committee: the moral authority of consensus. J Med Philos 13(4):411–432

    Article  Google Scholar 

  • Moreno JD (1990) What means this consensus? Ethics committees and philosophic tradition. J Clin Ethics 1(1):38–43

    Google Scholar 

  • Moreno JD (1991a) Consensus, contracts, and committees. J Med Philos 16(4):393–408

    Article  Google Scholar 

  • Moreno JD (1991b) Ethics consultation as moral engagement. Bioethics 5(1):44–56

    Article  Google Scholar 

  • Moreno JD (1995) Deciding together. Bioethics and moral consensus. New York

    Google Scholar 

  • Moreno JD (2003) Bioethics is a naturalism. In: McGee G (Hrsg) Pragmatic bioethics, 2. Aufl. Cambridge, S 3–16

    Google Scholar 

  • Moreno JD (2005) Is there an ethicist in the house? On the cutting edge of bioethics. Bloomington

    Google Scholar 

  • O’Neill O (1988) How can we individuate moral problems. In: Rosenthal DM, Shehadi F (Hrsg) Applied ethics and ethical theory. Salt Lake City, S 84–99

    Google Scholar 

  • Oppenheim FM (2005) Reverence for the relations of life. Re-imagining pragmatism via Josiah Royce’s interactions with Peirce, James, and Dewey. Notre Dame

    Google Scholar 

  • Outka GH (1968) Character, conduct, and the love commandment. In: Outka GH, Ramsey P (Hrsg) Norm and context in Christian ethics. London, S 37–66

    Google Scholar 

  • Ramsey P (1952) Basic Christian ethics. New York

    Google Scholar 

  • Ramsey P (1968) The case of the curious exception. In: Outka GH, Ramsey P (Hrsg) Norm and context in Christian ethics. London, S 67–135

    Google Scholar 

  • Ramsey P (1970) The patient as person. Explorations in medical ethics. New Haven

    Google Scholar 

  • Ramsey P (1980) Ethics at the edge of life. Medical and legal intersections, 4. Aufl. New Haven

    Google Scholar 

  • Ramsey P (1983) Deeds and rules in Christian ethics. Lanham

    Google Scholar 

  • Rauprich O (2005a) Die Begründung medizinethischer Prinzipien – Common Sense oder Kohärenz? Zur Systematik der Principles of Biomedical Ethics von Beauchamp und Childress. In: Düwell M, Neumann JN (Hrsg) Wie viel Ethik verträgt die Medizin? Paderborn, S 87–104

    Google Scholar 

  • Rauprich O (2005b) Prinzipienethik in der Biomedizin – Zur Einführung. In: Rauprich O, Steger F (Hrsg) Prinzipienethik in der Biomedizin. Moralphilosophie und medizinische Praxis. Frankfurt am Main, S 11–45

    Google Scholar 

  • Schermer M, Keulartz J (2002) How pragmatic is bioethics? The case of in vitro fertilization. In: Keulartz J, Korthals M, Schermer M et al (Hrsg) Pragmatist ethics for a technological culture. Dodrecht, S 41–68

    Google Scholar 

  • Schockenhoff E (2013) Ethik des Lebens. Grundlagen und Herausforderungen, 2. Aufl. Freiburg i. Br.

    Google Scholar 

  • Smith GP (1990) The ethics of ethics committees. J Contemp Health Law Policy 6(1):157–170

    Google Scholar 

  • Sokol DK (2012) Doing clinical ethics. A hands-on guide for clinicians and others. Dordrecht u. a.

    Book  Google Scholar 

  • Takala T (2001) What is wrong with global bioethics? On the limitations of the four principles approach. Camb Q Healthc Ethics 10(1):72–77

    Article  Google Scholar 

  • Tong R (1991) The epistemology and ethics of consensus. Uses and misuses of „ethical“ expertise. J Med Philos 16:409–426

    Article  Google Scholar 

  • Toulmin SE (1964) An examination of the place of reason in ethics. Cambridge

    Google Scholar 

  • Toulmin SE (1976) On the nature of the physician’s understanding. J Med Philos 1(1):32–50

    Article  Google Scholar 

  • Toulmin SE (1981) The tyranny of principles. Hastings Cent Rep 11(6):31–39

    Article  Google Scholar 

  • Toulmin SE (1987) The national commission on human experimentation: procedures and outcomes. In: Engelhardt HT, Caplan AL (Hrsg) Scientific controversies. Case studies in the resolution and closure of disputes in science and technology. Cambridge, S 599–614

    Google Scholar 

  • Toulmin SE (1988) Medical ethics in its American context. An historical survey. Ann N Y Acad Sci 530:7–15

    Article  Google Scholar 

  • Toulmin SE (1991) Kosmopolis. Die unerkannten Aufgaben der Moderne. Frankfurt a. M.

    Google Scholar 

  • Toulmin SE (1994) Casuistry and clinical ethics. In: DuBose ER, Hamel RP, O’Connell LJ (Hrsg) A matter of principles. Ferment in U.S. bioethics. Valley Forge, S 310–317

    Google Scholar 

  • Toulmin SE (1996) Rationality and reasonabless: from propositions to utterances. Rev Int Philos 196(2):297–305

    Google Scholar 

  • Toulmin SE (1997a) How medicine saved the life of ethics. In: Jecker NS, Jonsen AR, Pearlman RA (Hrsg) Bioethics. An introduction to the history, methods, and practice. Boston, S 101–109

    Google Scholar 

  • Toulmin SE (1997b) The primacy of practice: medicine and postmodernism. In: Carson R, Burns CR (Hrsg) Philosophy of medicine and bioethics. A twenty-year retrospective and critical appraisal. Dordrecht, S 42–53

    Google Scholar 

  • Toulmin SE (2004) Reasoning in theory and practice. Informal Logic 24(2):111–114

    Article  Google Scholar 

  • Tully PA (2006) Refined consequentialism. The moral theory of Richard A. McCormick. New York

    Google Scholar 

  • Werpehowski W, Crocco SD (1994) Introduction. In: Werpehowski W, Crocco SD (Hrsg) The essential Paul Ramsey. A collection. New Haven, S vii–xxv

    Google Scholar 

  • Winkler EC, Gruen RL (2005) First principles: substantive ethics for healthcare organizations. J Healthc Manag 50(2):109–119

    Article  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Fakultät Angewandte Gesundheitswissenschaften, Technische Hochschule Deggendorf, Deggendorf, Deutschland

    Bernhard Bleyer

Authors
  1. Bernhard Bleyer
    View author publications

    You can also search for this author in PubMed Google Scholar

Rights and permissions

Reprints and permissions

Copyright information

© 2019 Springer-Verlag GmbH Deutschland, ein Teil von Springer Nature

About this chapter

Check for updates. Verify currency and authenticity via CrossMark

Cite this chapter

Bleyer, B. (2019). Angewandte pragmatische Ethik in der Klinischen Ethikberatung. In: Pragmatische Urteile in der unmittelbaren Patientenversorgung. Gesundheit und Medizin im interdisziplinären Diskurs. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-662-58672-3_5

Download citation

  • DOI: https://doi.org/10.1007/978-3-662-58672-3_5

  • Published:

  • Publisher Name: Springer, Berlin, Heidelberg

  • Print ISBN: 978-3-662-58671-6

  • Online ISBN: 978-3-662-58672-3

  • eBook Packages: Medicine (German Language)

Publish with us

Policies and ethics

Search

Navigation