Thomasma, "Moral Reasoning Methodology"
Notable for conceding that decision-making will be highly conflicted
SOURCE FOR THE PROCEDURE
Thomasma, David C. and Patricia A. Marshall, eds. Clinical Medical Ethics Cases and Readings. Lantham: University Press of America, 1995.
See also http://www.meddean.luc.edu/lumen/MedEd/IPM/medp2a.htm for information about a related training workshop.
THE PROCEDURE ITSELF
- What are the facts in the case?
- What are the values at risk in the case?
- Determine the principal conflicts between values, professional norms, and between ethical axioms, rules, and principles.
- Determine possible courses of action.
- Determine which values and ethical principles each course of action would protect or infringe.
- Make a decision in the case.
- Defend this course of action. Why is "X" better than "Y"?
WALT'S CHECKLIST
The same checklist was applied to all procedures.
- This method is most useful when the DECISION-MAKER ...
- can tolerate ambiguity, complexity or conflict [step 3]
- has plenty of time for investigation and analysis
- is skilled in conflict- or dilemma-resolution methods [step 3]
- is skilled in the application of general ethical principles to specific cases [step 5]
- This method is most useful in a SITUATION ...
- that will change little over time
- This method is most useful when STAKEHOLDERS ...
- share ethical codes or policies [step 3]
- share ethical principles [step 5]
- share laws and legal precedents [step 2]
- share values
