Abstract:
This article discusses an approach to translational bioethics (TB) that is concerned with the adaptation-or \'translation\'-of concepts, theories and methods from bioethics to practical contexts, in order to support \'non-bioethicists\', such as researchers and healthcare practitioners, in dealing with their ethical issues themselves. Specifically, it goes into the participatory development of clinical ethics support (CES) instruments that respond to the needs and wishes of healthcare practitioners and that are tailored to the specific care contexts in which they are to be used. The theoretical underpinnings of this participatory approach to TB are found in hermeneutic ethics and pragmatism. As an example, the development of CURA, a low-threshold CES instrument for healthcare professionals in palliative care, is discussed. From this example, it becomes clear that TB is a two-way street. Practice may be improved by means of CES that is effectively tailored to specific end users and care contexts. The other way around, ethical theory may be enriched by means of the insights gained from engaging with practice in developing CES in a process of co-creation. TB is also a two-way street in the sense that it requires collaboration and commitment of both bioethicists and practitioners, who engage in a process of mutual learning. However, substantial challenges remain. For instance, is there a limit to the extent to which a method of moral reasoning can be adapted in order to meet the constraints of a given healthcare setting? Who is to decide, the bioethicist or the practitioners?
摘要:
本文讨论了一种与概念的适应或“翻译”有关的翻译生物伦理学(TB)方法,从生物伦理学到实践环境的理论和方法,为了支持“非生物伦理学家”,如研究人员和医疗保健从业人员,自己处理他们的道德问题。具体来说,它涉及临床伦理支持(CES)工具的参与性开发,这些工具可响应医疗保健从业人员的需求和愿望,并根据要使用的特定护理环境量身定制。这种参与性结核病方法的理论基础可以在诠释学伦理学和实用主义中找到。作为一个例子,CURA的发展,一种适用于姑息治疗的医疗保健专业人员的低门槛CES仪器,正在讨论。从这个例子中,很明显,结核病是一条双向的街道。可以通过有效地针对特定最终用户和护理环境定制的CES来改进实践。反过来,通过在共同创造的过程中参与实践开发CES所获得的见解,可以丰富伦理理论。结核病也是一条双向道路,因为它需要生物伦理学家和从业者的合作和承诺,参与相互学习的过程。然而,重大挑战依然存在。例如,为了满足给定医疗保健环境的约束,道德推理的方法可以适应的程度是否有限制?谁来决定,生物伦理学家还是实践者?