Journal of Bioethical Inquiry

, Volume 13, Issue 4, pp 571–580 | Cite as

Dialogic Consensus In Clinical Decision-Making

  • Paul WalkerEmail author
  • Terry Lovat
Original Research


This paper is predicated on the understanding that clinical encounters between clinicians and patients should be seen primarily as inter-relations among persons and, as such, are necessarily moral encounters. It aims to relocate the discussion to be had in challenging medical decision-making situations, including, for example, as the end of life comes into view, onto a more robust moral philosophical footing than is currently commonplace. In our contemporary era, those making moral decisions must be cognizant of the existence of perspectives other than their own, and be attuned to the demands of inter-subjectivity. Applicable to clinical practice, we propose and justify a Habermasian approach as one useful means of achieving what can be described as dialogic consensus. The Habermasian approach builds around, first, his discourse theory of morality as universalizable to all and, second, communicative action as a cooperative search for truth. It is a concrete way to ground the discourse which must be held in complex medical decision-making situations, in its actual reality. Considerations about the theoretical underpinnings of the application of dialogic consensus to clinical practice, and potential difficulties, are explored.


Consensus Dialogue Discourse Ethics Habermas Moral Decision-Making 



We thank the anonymous reviewers for their comments, which helped us to focus our argument.


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Copyright information

© Journal of Bioethical Inquiry Pty Ltd. 2016

Authors and Affiliations

  1. 1.Clinical Unit in Ethics and Health Law, Faculty of Medicine and HealthUniversity of NewcastleCallaghanAustralia
  2. 2.Philosophy, Religion & TheologyUniversity of NewcastleCallaghanAustralia
  3. 3.University of OxfordOxfordUK

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