Imaginative ethics--bringing ethical praxis into sharper relief

Area of Science:

• Bioethics
• Clinical Ethics
• Moral Philosophy

Background:

• Standard ethical reasoning approaches inadequately explain the dynamics of hospital ethical rounds.
• Clinical ethical decision-making relies on a moral competence integrating personal and professional experience.

Purpose of the Study:

• To evaluate standard ethical reasoning approaches in the context of hospital ethical rounds.
• To propose 'imaginative ethics' as a more fitting framework for understanding clinical ethical reasoning.
• To explore the complementary roles of imaginative and principle-based ethics in healthcare.

Main Methods:

• Analysis of three years of experience with ethical rounds at Uppsala University Hospital.
• Examination of standard ethical reasoning theories.
• Development of the 'imaginative ethics' concept, drawing on Kantian aesthetics and Hebraic/Hellenic traditions of imagination.

Main Results:

• Standard ethical reasoning models were found to be insufficient explanations for ethical round processes.
• Participants in ethical rounds utilize a moral competence derived from lived experience and professional expertise.
• Imaginative ethics, through exploring diverse perspectives and values, enhances sensitivity to patient-specific moral situations.

Conclusions:

• Imaginative ethics provides a more satisfactory account of clinical ethical reasoning than traditional methods.
• Integrating imaginative ethics with principle-based ethics strengthens moral discourse and ethical authority in clinical practice.
• Kantian ethics, when understood with a modest role for principles, supports this complementary approach.