Using empirical research to formulate normative ethical principles in biomedicine

Scientific Contribution
First Online:
Received:
Accepted:

Abstract

Bioethical research has tended to focus on theoretical discussion of the principles on which the analysis of ethical issues in biomedicine should be based. But this discussion often seems remote from biomedical practice where researchers and physicians confront ethical problems. On the other hand, published empirical research on the ethical reasoning of health care professionals offer only descriptions of how physicians and nurses actually reason ethically. The question remains whether these descriptions have any normative implications for nurses and physicians? In this article, we illustrate an approach that integrates empirical research into the formulation of normative ethical principles using the moral-philosophical method of Wide Reflective Equilibrium (WRE). The research method discussed in this article was developed in connection with the project ‘Bioethics in Theory and Practice’. The purpose of this project is to investigate ethical reasoning in biomedical practice in Denmark empirically. In this article, we take the research method as our point of departure, but we exclusively discuss the theoretical framework of the method, not its empirical results. We argue that the descriptive phenomenological hermeneutical method developed by Lindseth and Norberg (2004) and Pedersen (1999) can be combined with the theory of WRE to arrive at a decision procedure and thus a foundation for the formulation of normative ethical principles. This could provide health care professionals and biomedical researchers with normative principles about how to analyse, reason and act in ethically difficult situations in their practice. We also show how to use existing bioethical principles as inspiration for interpreting the empirical findings of qualitative studies. This may help researchers design their own empirical studies in the field of ethics.

Keywords

biomedicine empirical ethics normative bioethical principles phenomenological hermeneutical method theory of Wide Reflective Equilibrium 
This is a preview of subscription content, log in to check access.

References

  1. Beauchamp T.L. (2003). A Defense of the Common Morality. Kennedy Institute of Ethics Journal 13(3):259–274CrossRefPubMedGoogle Scholar
  2. Beauchamp T.L., Childress J.F. (1989). Principles of Biomedical Ethics. 3rd ed. Oxford, Oxford University PressGoogle Scholar
  3. Beauchamp T.L., Childress J.F. (2001). Principles of Biomedical Ethics. 5th ed. Oxford, Oxford University PressGoogle Scholar
  4. Christiansen K. (2003). The Condition of Understanding in H.-G. Gadamer’s Philosophical Hermeneutics. Australia, The University of MelbourneGoogle Scholar
  5. Daniels N. (1979). Wide Reflective Equilibrium and Theory Acceptance in Ethics. Journal of Philosophy 76:257–282CrossRefGoogle Scholar
  6. Delden J.J.M. van (2002). Moral Intuitions as a Source for Empirical Ethics. Politeia XVIII(67):20–24Google Scholar
  7. Delden J.J.M., van Thiel G.J.M.W. Van (1998). Reflective Equilibrium as a Normative Empirical Model in Bioethics. In: van der Burg W., van Willigenburg T. (eds). Reflective Equilibrium. The Nederlands, Kluwer Academic Publishers, pp. 251–259Google Scholar
  8. Gadamer, H.-G.: 1960, Truth and Method. 2. rev. ed. translation revised by J. Weinsheimer and D. G. Marshall. New York: Continuum, 2003Google Scholar
  9. Kappel, K.: 2006, ‘The Metajustification of Reflective Equilibrium’, Journal of Ethical Theory and Moral Practice. ForthcomingGoogle Scholar
  10. Kvale S. (1983). The Qualitative Research Interview — A Phenomenological and a Hermeneutical Mode of Understanding. Journal of Phenomenological Psychology 14:171–196CrossRefGoogle Scholar
  11. Kvale S. (1997). Interview. Denmark, Hans Reitzels ForlagGoogle Scholar
  12. Lindseth A., Norberg A. (2004). A Phenomenological Hermeneutical Method for Researching Lived Experience. Scandinavian Journal of Caring Sciences 18:145–153CrossRefPubMedGoogle Scholar
  13. Lindseth A., Marhaug V., Norberg A., Udén G. (1994). ‘Registered Nurses’ and Physicians’ Reflections on their Narratives about Ethically Difficult Care Episodes. Journal of Advanced Nursing 20:245–250CrossRefPubMedGoogle Scholar
  14. Loegstrup K.E. (1993). Norm and Spontaneity. Denmark: Gyldendal (first published in 1972)Google Scholar
  15. Loegstrup K.E. (1997). Concepts and Problems in Ethics. Denmark: Gyldendal (first published in 1971)Google Scholar
  16. Molewijk B., Stiggelbout A.M., Otten W., Dupuis H.M., Kievit J. (2004). Empirical Data and Moral Theory. A Plea for Integrated Empirical Ethics. Medicine, Health Care and Philosophy 7:55–69CrossRefGoogle Scholar
  17. Pedersen, B.D.: 1999, Nursing Practice, Language and Cognition. Ph.D.-Thesis, University of Aarhus, DenmarkGoogle Scholar
  18. Pedersen, B.D. and C. Delmar: 2003, ‘Research Method and Network Collaboration — A Qualitative Method inspired by Ricoeur’, in Research in Nursing Practice 2. Methods and Development of Knowledge. Copenhagen: Akademisk ForlagGoogle Scholar
  19. Petersson B. (1998). Wide Reflective Equilibrium and the Justification of Moral Theory. In: van der Burg W., van Willigenburg T. (eds). Reflective Equilibrium. The Netherlands, Kluwer Academic Publishers, pp. 127–134Google Scholar
  20. Rawls J. (1951). Outline of a Decision Procedure for Ethics. In: Freeman S. (eds). John Rawls Collected Papers. Cambridge, MA, Harvard University Press, pp. 1–19Google Scholar
  21. Rawls J. (1971). A Theory of Justice. Fourth Printing, 2001. Cambridge, MA. London: BelknapGoogle Scholar
  22. Rawls J. (1975). The Independence of Moral Theory. In: Freeman S. (eds). John Rawls Collected Papers. Cambridge, MA, Harvard University Press, pp. 286–303Google Scholar
  23. Rawls J. (2001). Justice as Fairness. A Restatement. Cambridge MA. London, BelknapGoogle Scholar
  24. Rendtorff, J. and P. Kemp: 2000, Basic Ethical Principles in European Bioethics and Biolaw. Vol. 1: Autonomy, Dignity, Integrity and Vulnerability. Denmark: Centre for Ethics and LawGoogle Scholar
  25. Rossel P. (1986). Empirical Ethics — Its Necessity and Method’, Philosophia 14(3—4),90–103Google Scholar
  26. Scanlon T.M. (2003). Rawls on Justification. In: S. Freeman. (eds). The Cambridge Companion to Rawls. Cambridge, Cambridge University PressGoogle Scholar
  27. Svenaeus F. (2003). Hermeneutics of Medicine in the Wake of Gadamer: The Issue of Phronesis. Theoretical Medicine and Bioethics 24:407–431CrossRefPubMedGoogle Scholar
  28. Udén G., Norberg A., Lindseth A., Marhaug V. (1992). ‘Ethical Reasoning in Nurses’ and Physicians’ Stories about Care Episodes’, Journal of Advanced Nursing 17(9):1028–1034CrossRefPubMedGoogle Scholar
  29. Walters L., Palmer J. (1997). Ethics of Human Gene Therapy. New York, Oxford University PressGoogle Scholar

Copyright information

© Springer Science+Business Media B.V. 2006

Authors and Affiliations

  1. 1.Centre for BioethicsUniversity of AarhusAarhus CDenmark
  2. 2.Visiting Researcher at the Kennedy Institute of EthicsGeorgetown UniversityWashington DCUSA
  3. 3.Department of Nursing ScienceUniversity of AarhusAarhus CDenmark
  4. 4.Faculty of Health SciencesUniversity of AarhusAarhus CDenmark

Personalised recommendations