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Communicative action and practical discourse to empower patients in healthcare-related decision making

100%

Napiwodzka K.

nr 38

81-99

The aim of the paper is to reconsider Habermas’ discourse approach in terms of its usefulness in the realm of public healthcare where, on a microscale, intersubjective communicative situations arise between defined participants, i.e., patients and healthcare providers, patients’ family members, and further eligible contributors to patient-related decision making. A need for more “communicative interaction,” and explicative and practical discourse, is illustrated by two empirical examples of medical decision making which reveal both communicative and discursive deficits (Section I). To empower and enable the patient as a rational and autonomous speaker and discourse participant, a Habermasian emancipatory argument and ‘the power of the better argument’ is recalled (Section III). The possibility of equal communicative and discursive rights in the light of real inequalities is discussed in the context of a ‘competence gap’ between participants (Section IV). Further sections focus on the importance of informed consent on the side of the patient and the communicative competences as an important factor of healthcare system.

Ars Moriendi. Ethical Challenges of the Ultimate Realities of Life

51%

Sgarlata S. , Dłużewicz A. , Napiwodzka K.

nr 2

4-10

The aim of this issue of Ethics in Progress is to provide a provisional, open-ended view on the ultimate realities of life and the ethical challenges they pose in medical, sociological, and existential contexts. The issue explores axiologies and meta-ethical narratives related to the art of dying, or in other words the moral domain encompassing the quest for a good life and a good death. Two problematic aspects emerge from the latest body of research: (1) the difficulty involved in tackling ethical challenges in medical and sociological contexts; and (2) the marginal role of the patient’s agency and narrative-ownership of end-of-life decision-making. A direction is pointed out that suggests that interventions across interdisciplinary groups involved in medical aid to dying should focus on promoting ethical behaviour on the side of healthcare personnel. Finally, attention to language, discourse, communication, and the narratives of death and dying call this edition of Ethics in Progress to examine the ontological and epistemological categories that underlie the study of lifeworlds and ‘discourse communities’, which are those associated with moral agents interlacing historical motives, language, communication, normative beliefs, social norms and roles, power relations, hard clinical evidence, and contested values in the context of medical practices and, broadly speaking, practices surrounding death.