© 2018

Rethinking Health Care Ethics

  • Offers a radical departure from the dominant paradigm of “principled decision making” and other theory-driven approaches to clinical ethics

  • Presents an alternative approach by exploring ethical issues in a clinically comprehensible and useful manner

  • Explains to practitioners why they typically perceive bioethics as disengaged from clinical practice and their own experience

  • Offers broad appeal for current clinicians; medical students and other professional trainees; patients and their families; experts in bioethics, philosophy, and law

Open Access

Table of contents

  1. Front Matter
    Pages i-xv
  2. Stephen Scher, Kasia Kozlowska
    Pages 1-11 Open Access
  3. Stephen Scher, Kasia Kozlowska
    Pages 13-30 Open Access
  4. Stephen Scher, Kasia Kozlowska
    Pages 31-44 Open Access
  5. Stephen Scher, Kasia Kozlowska
    Pages 45-56 Open Access
  6. Stephen Scher, Kasia Kozlowska
    Pages 57-70 Open Access
  7. Stephen Scher, Kasia Kozlowska
    Pages 71-81 Open Access
  8. Stephen Scher, Kasia Kozlowska
    Pages 83-94 Open Access
  9. Stephen Scher, Kasia Kozlowska
    Pages 95-112 Open Access
  10. Stephen Scher, Kasia Kozlowska
    Pages 113-137 Open Access
  11. Stephen Scher, Kasia Kozlowska
    Pages 139-155 Open Access
  12. Stephen Scher, Kasia Kozlowska
    Pages 157-164 Open Access
  13. Back Matter
    Pages 165-169

About this book


​The goal of this open access book is to develop an approach to clinical health care ethics that is more accessible to, and usable by, health professionals than the now-dominant approaches that focus, for example, on the application of ethical principles. The book elaborates the view that health professionals have the emotional and intellectual resources to discuss and address ethical issues in clinical health care without needing to rely on the expertise of bioethicists. The early chapters review the history of bioethics and explain how academics from outside health care came to dominate the field of health care ethics, both in professional schools and in clinical health care. The middle chapters elaborate a series of concepts, drawn from philosophy and the social sciences, that set the stage for developing a framework that builds upon the individual moral experience of health professionals, that explains the discontinuities between the demands of bioethics and the experience and perceptions of health professionals, and that enables the articulation of a full theory of clinical ethics with clinicians themselves as the foundation. Against that background, the first of three chapters on professional education presents a general framework for teaching clinical ethics; the second discusses how to integrate ethics into formal health care curricula; and the third addresses the opportunities for teaching available in clinical settings. The final chapter, "Empowering Clinicians", brings together the various dimensions of the argument and anticipates potential questions about the framework developed in earlier chapters.


Medicine Nursing Clinical ethics Professional ethics Social work Open Access Clinical psychology Health care Thinking Bioethics Values Professional education Moral philosophy Postmodernism Socialization Arts-based learning Decision making Mental health Organizational health Organizational culture

Authors and affiliations

  1. 1.McLean HospitalDepartment of Psychiatry, Harvard Medical SchoolBostonUSA
  2. 2.The Children’s Hospital at Westmead, Disciplines of Child & Adolescent Health, and of PsychiatryUniversity of Sydney Medical SchoolSydneyAustralia

About the authors

Stephen Scher is Senior Editor, Harvard Review of Psychiatry, and Lecturer in Psychiatry, McLean Hospital/Harvard Medical School, USA, and University of Sydney Medical School, Australia. He recently stepped down as Senior Editor of the American Journal of International Law.

Kasia Kozlowska is a child and adolescent psychiatrist at The Children’s Hospital at Westmead and Clinical Associate Professor at the University of Sydney Medical School, Australia.

Bibliographic information


“There is much to admire about Scher and Kozlowska’s approach, and much to aspire to in their vision of the future of health care ethics. The book is smoothly written and easy to read; it is provocative without being abrasive. It is a valuable counterweight to overly formal, technical approaches to medical ethics.” (Samuel Reis‑Dennis, Monash Bioethics Review, April 18, 2020)

“There are many reasons to recommend Scher and Kozlowska’s text. It presents an excellent case for rethinking the way that health care ethics is taught to health practitioners. It is well written, thoughtful, brief, and freely available via open access online, which should give it wide appeal and make it eminently suitable as a teaching text. … the authors are making a potentially significant contribution to an ecological turn away from merely instrumental and toward truly humane health care practice.” (Patrick Daly, Theoretical Medicine and Bioethics, Vol. 40, August 07, 2019)

“These authors provide a comprehensive review of social science literature and an exploration of how the rise of bioethics in the US and the European response to bioethics culminated in the Universal Declaration on Bioethics and Human Rights. … Scher and Kozlowska's goal is the empowerment of clinicians to respect their moral thinking when addressing health care dilemmas. Summing Up: Recommended. Advanced undergraduates through faculty and professionals.” (B. A. D'Anna, Choice, Vol. 56 (11), July, 2019)

“The book is a lucid critique of healthcare ethics as a [distinct] subject; a critique that naturally leads into constructive suggestions for an alternative pedagogy. The book should be of high interest to teachers in healthcare ethics, to ethicists, and to anyone who finds that ethics often is presented in ways that make us estranged from ourselves. What most impresses me in this book is its trust in the human. The foundation of ethics is in the human self, not in moral theory.” (Pär Segerdahl, The Ethics Blog,, October, 03, 2018)

“Individual moral experience as fundamental … . highly persuasive in its logic and practical orientation … .” (Amir Muzur, European Journal of Bioethics, Vol. 9 (2), 2018)