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In Favour of Medical Dissensus: Why We Should Agree to Disagree About End‐of‐Life Decisions
End‐of‐life decision‐making is controversial. There are different views about when it is appropriate to limit life‐sustaining treatment, and about what palliative options are permissible. One approach to decisions of this nature sees consensus as crucial. Decisions to limit treatment are made only i...
Autores principales: | , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
John Wiley and Sons Inc.
2015
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4864446/ https://www.ncbi.nlm.nih.gov/pubmed/25908398 http://dx.doi.org/10.1111/bioe.12162 |
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author | Wilkinson, Dominic Truog, Robert Savulescu, Julian |
author_facet | Wilkinson, Dominic Truog, Robert Savulescu, Julian |
author_sort | Wilkinson, Dominic |
collection | PubMed |
description | End‐of‐life decision‐making is controversial. There are different views about when it is appropriate to limit life‐sustaining treatment, and about what palliative options are permissible. One approach to decisions of this nature sees consensus as crucial. Decisions to limit treatment are made only if all or a majority of caregivers agree. We argue, however, that it is a mistake to require professional consensus in end‐of‐life decisions. In the first part of the article we explore practical, ethical, and legal factors that support agreement. We analyse subjective and objective accounts of moral reasoning: accord is neither necessary nor sufficient for decisions. We propose an alternative norm for decisions – that of ‘professional dissensus’. In the final part of the article we address the role of agreement in end‐of‐life policy. Such guidelines can ethically be based on dissensus rather than consensus. Disagreement is not always a bad thing. |
format | Online Article Text |
id | pubmed-4864446 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2015 |
publisher | John Wiley and Sons Inc. |
record_format | MEDLINE/PubMed |
spelling | pubmed-48644462016-06-22 In Favour of Medical Dissensus: Why We Should Agree to Disagree About End‐of‐Life Decisions Wilkinson, Dominic Truog, Robert Savulescu, Julian Bioethics Original Articles End‐of‐life decision‐making is controversial. There are different views about when it is appropriate to limit life‐sustaining treatment, and about what palliative options are permissible. One approach to decisions of this nature sees consensus as crucial. Decisions to limit treatment are made only if all or a majority of caregivers agree. We argue, however, that it is a mistake to require professional consensus in end‐of‐life decisions. In the first part of the article we explore practical, ethical, and legal factors that support agreement. We analyse subjective and objective accounts of moral reasoning: accord is neither necessary nor sufficient for decisions. We propose an alternative norm for decisions – that of ‘professional dissensus’. In the final part of the article we address the role of agreement in end‐of‐life policy. Such guidelines can ethically be based on dissensus rather than consensus. Disagreement is not always a bad thing. John Wiley and Sons Inc. 2015-04-23 2016-02 /pmc/articles/PMC4864446/ /pubmed/25908398 http://dx.doi.org/10.1111/bioe.12162 Text en © 2015 The Authors. Bioethics published by John Wiley & Sons Ltd. This is an open access article under the terms of the Creative Commons Attribution (http://creativecommons.org/licenses/by/4.0/) License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited. |
spellingShingle | Original Articles Wilkinson, Dominic Truog, Robert Savulescu, Julian In Favour of Medical Dissensus: Why We Should Agree to Disagree About End‐of‐Life Decisions |
title | In Favour of Medical Dissensus: Why We Should Agree to Disagree About End‐of‐Life Decisions |
title_full | In Favour of Medical Dissensus: Why We Should Agree to Disagree About End‐of‐Life Decisions |
title_fullStr | In Favour of Medical Dissensus: Why We Should Agree to Disagree About End‐of‐Life Decisions |
title_full_unstemmed | In Favour of Medical Dissensus: Why We Should Agree to Disagree About End‐of‐Life Decisions |
title_short | In Favour of Medical Dissensus: Why We Should Agree to Disagree About End‐of‐Life Decisions |
title_sort | in favour of medical dissensus: why we should agree to disagree about end‐of‐life decisions |
topic | Original Articles |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4864446/ https://www.ncbi.nlm.nih.gov/pubmed/25908398 http://dx.doi.org/10.1111/bioe.12162 |
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