Phronesis in clinical ethics

McGee, Glenn

doi:10.1007/bf00489678

Cited by 14 publications

(8 citation statements)

References 15 publications

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“…Other proponents of narrative approaches in medicine also draw on the concept of phronesis . Kathryn Montgomery argues that clinical judgement requires “practical, interpretive reasoning, the exercise of phronesis ,” which she defines as the “flexible, interpretive capacity that enables moral reasoners to determine the best action to take when knowledge depends on the circumstance .” Several other authors recognize phronesis as a defining trait of a good physician . Some have explored how this trait can be developed through clinical experience informed by thoughtful reflection, which has been referred to as “slow” learning in medical education .…”

Section: Narrative and Virtue‐based Approaches To Clinical Judgementmentioning

confidence: 99%

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Clinical judgement in the era of big data and predictive analytics

Chin‐Yee

Upshur

2017

Evaluation Clinical Practice

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Clinical judgement is a central and longstanding issue in the philosophy of medicine which has generated significant interest over the past few decades. In this article, we explore different approaches to clinical judgement articulated in the literature, focusing in particular on data-driven, mathematical approaches which we contrast with narrative, virtue-based approaches to clinical reasoning. We discuss the tension between these different clinical epistemologies and further explore the implications of big data and machine learning for a philosophy of clinical judgement. We argue for a pluralistic, integrative approach, and demonstrate how narrative, virtue-based clinical reasoning will remain indispensable in an era of big data and predictive analytics.

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Section: Narrative and Virtue‐based Approaches To Clinical Judgementmentioning

confidence: 99%

“…57 Several other authors recognize phronesis as a defining trait of a good physician. [66][67][68] Some have explored how this trait can be developed through clinical experience informed by thoughtful reflection, which has been referred to as "slow" learning in medical education. 69…”

Section: Narrative and Virtue-based Approaches To Clinical Judgementmentioning

confidence: 99%

Clinical judgement in the era of big data and predictive analytics

Chin‐Yee

Upshur

2017

Evaluation Clinical Practice

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“…Invariably, the skills required to succeed in the profession, including empathy and communication, will need to be both modeled and taught, which is the ongoing process of exercising clinical phronesis, or practical reasoning [21,22].…”

Section: Demographics: Students and Mentorsmentioning

confidence: 99%

Initiatives for Responding to Medical Trainees' Moral Distress about End-of-Life Cases

2017

AMA Journal of Ethics

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Moral distress frequently arises for medical trainees exposed to end-oflife cases. We review the small literature on best practices for reducing moral distress in such cases and propose two areas to target for moral distress reduction: medical education and organizational ethics programs. Students require training in end-of-life dialogues and truthful prognostication, which are not generally available without skilled mentors. But physician-mentors and teachers can suffer from lingering moral residue themselves, which can affect the teaching culture and student expectations. Finally, reducing unit moral distress that affects learners requires formal educational opportunities to debrief about difficult end-of-life cases and formal institutional mechanisms for effective clinical ethics consultation.

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“…However, what caused Matt and Ronald to acknowledge the inadequacy of their actions in the fist place, and what allowed them to decide on which course of action would be the right one to take was the development of practical wisdom, that is, phronesis. Once dentists develop phronesis they not only become able to make the right decisions (McGee, 1996), but they also change the activity system to de-objectify their patients and include them as acting (decision-making) subjects. In fact, because dentists and patients now have (an interest in) a common object -treatment -their activity system is characterized by solidarity, which, by definition, is the quality on the parts of collectives of being perfectly united in some respect.…”

Section: Responsibility In Dental Praxismentioning

confidence: 99%

Responsibility in dental praxis: an activity theoretical perspective

Ardenghi

Roth

Pozzer-Ardenghi

2007

Journal of Workplace Learning

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Purpose -The purpose of this paper is to investigate the transitions practitioners undergo as they move from dental school to their first job in a dental clinic and their learning in the workplace. The paper aims to investigate their use of ethical principles as they engage in practice, providing a theoretical explanation for the gap practitioners experience when moving from the school to the workplace, and also suggesting some viable alternatives for dental education. Design/methodology/approach -The database for this study consists of videotaped interviews with dentists. To analyze our data we followed the principles of interaction analysis, analyzing the data both individually and collectively, until some hypotheses were generated. Then, discourse analysis was used to analyze the interviews. Findings -From an activity theoretical perspective, the results show that dentists can and do learn ethical principles when working in their dental clinics, interacting with patients, and the findings and suggestions are of especial interest for curriculum planning and development in educational institutions.Practical implications -This study suggests that theoretical discussions about ethics are not enough to provide practitioners with the skills necessary to work ethically when interacting with patients. From the findings a complementary approach to teach ethics in dental schools is suggested. Originality/value -Workplace learning has become a preferred topic within many disciplines, such as, for example, sociology, education, and anthropology. However, although there is an established field of medical sociology, little if any attention on workplace learning has been paid to the health sciences in general and dentistry in particular.

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Phronesis in clinical ethics

Cited by 14 publications

References 15 publications

Clinical judgement in the era of big data and predictive analytics

Clinical judgement in the era of big data and predictive analytics

Initiatives for Responding to Medical Trainees' Moral Distress about End-of-Life Cases

Responsibility in dental praxis: an activity theoretical perspective

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