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How to evaluate the quality of an ethical deliberation? A pragmatist proposal for evaluation criteria and collaborative research

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Abstract

Ethics designates a structured process by which important human values and meanings of life are understood and tackled. Therein, the ability to discuss openly and reflect on (aka deliberation) understandings of moral problems, on solutions to these problems, and to explore what a meaningful resolution could amount to is highly valued. However, the indicators of what constitutes a high-quality ethical deliberation remain vague and unclear. This article proposes and develops a pragmatist approach to evaluate the quality of deliberation. Deliberation features three important moments: (1) broadening and deepening the understanding of the situation, (2) envisioning action scenarios, (3) coming to a judgment based on the comparative evaluation of scenarios. In this paper, we propose seven criteria to evaluate ethical deliberations: (1) collaborative diversity, (2) experiential literacy, (3) organization of experiences, (4) reflective capacity to instrumentalize the experiences of others, (5) interactional creativity, (6) openness of agents, (7) quality of the reformulation of scenarios. These criteria are explained and applied to the three moments of deliberation. Based on these criteria, three kinds of outcomes for deliberations are identified and discussed: good ethical deliberations, partial ethical deliberations, bad ethical deliberations. Our proposal will guide researchers and practitioners interested in the evaluation of the quality of ethical deliberations. It provides a reference tool that allows them to identify the possible limitations of a deliberation and to implement actions aimed at correcting these limitations in order to achieve the desired qualitative objectives.

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Notes

  1. We name these deliberations ethical deliberations to follow usage and simplify our writing but deliberations about moral matters are not necessarily ethical in themselves. The ethical nature of ethics deliberations is something we propose to submit to an evaluation process because it can be of varying quality.

  2. For example, Brown et al. (1992) identify five stages: (1) appreciation of the situation and possible outcomes, (2) review of possible courses of action, (3) selection and application of principles, (4) weighing of practical considerations, (5) decision. Gracia (2003) proposes different steps for deliberations undertaken in a clinical setting : (1) presentation of the case by the person responsible for making the decision, (2) discussion of the clinical aspects of the medical record, (3) identification of the moral problems that arise, (4) the person responsible for the patient chooses the moral problem that concerns him or her and that he or she wishes to analyse, (5) determination of the values in conflict, (6) tree of courses of action, (7) analysis of the best course of action, (8) final decision, (9) decision control consistency.

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Acknowledgements

We wish to thank members of the Pragmatic Health Ethics Research Unit for constructive feedback on a previous version of this manuscript. ER’s research is supported by a career award from the Fonds de recherche du Québec - Santé (FRQ-S).

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This research is conducted with funding from the FRQ-S.

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  1. Pragmatic Health Ethics Research Unit, Institut de recherches cliniques de Montréal, Montréal, QC, Canada

    Abdou Simon Senghor & Eric Racine

  2. Division of Experimental Medicine, McGill University, Montréal, QC, Canada

    Abdou Simon Senghor & Eric Racine

  3. Department of Neurology and Neurosurgery, McGill University, Montréal, QC, Canada

    Eric Racine

  4. Department of Medicine, Department of Social and Preventive Medicine, Université de Montréal, Montréal, QC, Canada

    Eric Racine

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  1. Abdou Simon Senghor
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Senghor, A.S., Racine, E. How to evaluate the quality of an ethical deliberation? A pragmatist proposal for evaluation criteria and collaborative research . Med Health Care and Philos 25, 309–326 (2022). https://doi.org/10.1007/s11019-022-10091-2

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