Ricoeur's "Petite éthique": an ethical epistemological perspective for clinician-bioethicists

The passage from a posture of clinician to that of clinician-bioethicist poses significant challenges for health professionals, most notably with regards to theoretical or epistemological views of complex ethical impasses encountered in clinical settings. Apprehending these situations from the only clinical perspective of the nurse or the doctor, for example, can be very unproductive to help solve this kind of situation and certainly poses great limits to the role of the clinician-bioethicist. Drawing on my own experience as a former nurse who, following graduate studies in bioethics has begun providing ethics consultation services, I argue that clinicians must undergo an epistemological transformation in order to become clinician-bioethicists. A source of inspiration or framework for would-be clinician-bioethicists is, I suggest, the "Petite éthique" developed by the contemporary French philosopher Paul Ricoeur. Specifically, clinician-bioethicists should develop specific core ethical competencies (in line with the conclusions of the American Society for Bioethics and Humanities (Core competencies for health care ethics consultation, 1998); namely: savoir or knowing, savoir faire or knowing how to do, and savoir être or knowing how to be.