[Discursiveness and co-authority in clinical ethics]

Area of Science:

• Bioethics
• Medical Ethics
• Health Care Ethics

Background:

• Clinical ethics committees (CECs) utilize interdisciplinary deliberation to resolve ethical dilemmas.
• Current decision-making processes in CECs may limit their broader critical potential.
• Existing narrative approaches are considered insufficient for fully realizing CECs' critical functions.

Purpose of the Study:

• To explore the heuristic and practical value of 'discursiveness' and 'co-authority' in clinical ethics.
• To re-evaluate the role and functions of CECs within healthcare institutions.
• To enhance the contribution of clinical ethics as both a deliberative process and a critical reflection of practices.

Main Methods:

• Identify limitations of current narrative proposals in clinical ethics.
• Present the concept of discursiveness, building on the ethics of discussion.
• Define co-authority within a discursive space including clinical and deliberative actors.
• Analyze consequences for a critical theory of CEC roles and functions.

Main Results:

• Discursiveness offers a more inclusive framework than narrativity for ethical analysis.
• Co-authority conceptualizes shared decision-making power among diverse stakeholders.
• These concepts provide a foundation for a more robust critical function of CECs.

Conclusions:

• Clinical ethics committees can benefit from integrating concepts of discursiveness and co-authority.
• This integration can enhance critical reflection and broaden the impact of CECs.
• A critical theory of CECs should encompass these broader discursive and collaborative dimensions.