Bioethics
Online ISSN : 2189-695X
Print ISSN : 1343-4063
ISSN-L : 1343-4063
Preference satisfaction and desicion-making in clinical settings
Atsushi ASAIShizuko NAGATATsuguya FUKUI
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JOURNAL FREE ACCESS

1999 Volume 9 Issue 1 Pages 42-47

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Abstract
The purpose of this paper is to demonstrate how to resolve the conflicts between various plural ethical principles in the clinical setting. The following three elements were discussed. First, ethical decision-making requires principles which are universalizable as a minimal condition. We believe that a principle which allows for double standards has to be abandoned. Even widely accepted traditional principles suggest be discarded when they allw biased and arbitrary conclusions. Second, sound ethical consideration requires us to regard general ethical principles as prima facie. An ethical dilemma would never be untangled when a given principle is considered absolute and overriding. Neither of sanctitiy of life nor autonomy should be held as an unblemished norm under any circumstances. Third, rational and consistent preferences of patients should be deemed as the ground of moral judgements. Patient's preference must be medically relevant, well informed and stable. The most appropriate principle should maximize the extent of preference-satisfaction of patients. We have to choose one principle from several conflicting ones based on the probability to bring out the best consequence, i.e., the maximal satisfaction of patient's preferences in the clinical setting. Recent clinical studies conducted in Japan showed that individualistic and autonomy-based western moral theories cannot fully solve ethical problems. Our traditional partial and relation-based morality has also failed to prevent patients from agonising unnecessary physical and psychological predicaments. Therefore, it is crucial to know the health care Japanese people really desire and determine which ethical principle to employ to fulfil their preferences.
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1999 Japan Association for Bioethics
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