Defense Date
10-10-2023
Graduation Date
Fall 12-15-2023
Availability
One-year Embargo
Submission Type
dissertation
Degree Name
PhD
Department
Health Care Ethics
School
McAnulty College and Graduate School of Liberal Arts
Committee Chair
Gerard Magill, PhD
Committee Member
Joris Gielen, PhD
Committee Member
Peter Ikechukwu Osuji, C.S.Sp., PhD
Keywords
Normative requirement, shared decision making, healthcare ethics
Abstract
Medicine and medical technology started to advance after World War II. During that period, the practice of medicine became technical. A lot began to happen in the biomedical world during the period after WWII that attracted comments, criticisms, and analyses from scholars. Perhaps, the 1947 Doctors’ Trial at the Nuremberg Tribunal and the Nuremberg Code may be said to be the defining moment for bioethics. These events eventually led to, in the United States, the passage of the National Research Act of 1974 that established the Institutional Review Board system and the National Commission for Protection of Human Subjects of Biomedical and Behavioral Research. This commission produced the Belmont Report that recommended the bioethical principles of respect for persons, beneficence (including nonmaleficence), and justice. These principles, though initially were to guide biomedical ethics, gradually evolved to guide clinical ethics in the analysis of Tom Beauchamp and James Childress in their phenomenal book, Principles of Biomedical Ethics, which was first published in 1979.
Autonomy, or respect for autonomy, however, has become dominant in healthcare ethics (HCE) in an era where patient empowerment and patient-centered care have become synonymous with health care delivery.
The President’s Commission for the Study of Ethical Problems in Medicine established in 1982 recommended the shared decision making (SDM) approach for clinical decisions. According to the commission, this was a preferred approach in comparison to paternalism and strict autonomy. Since then, a lot has been written exploring SDM in the physician-patient relationship. Feminist theories and their emphasis on relational autonomy in care ethics lends credence to the importance of SDM in clinical ethics.
Whilst literature in clinical ethics is replete with discussions on SDM in practical situations, none is available with respect to the application of SDM to HCE generally. Hence, the focus of this dissertation adopts the latter approach to explain the normative requirement for SDM. This dissertation, thus, fills that gap by applying SDM to end-of-life ethics, research ethics, professional ethics, and pharmaceutical ethics.
Language
English
Recommended Citation
Nornor-Quadjie, M. (2023). The Normative Requirement for Shared Decision Making (SDM) in Healthcare Ethics (Doctoral dissertation, Duquesne University). Retrieved from https://dsc.duq.edu/etd/2300
