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• When guideline aren't enough
  Matthew K Jackson
  Published on: 24 April 2012

• Published on: 24 April 2012

  When guideline aren't enough

  • Matthew K Jackson, Doctor

  Dear Editor,

  Muirhead argues that Beauchamp and Childress' principalist approach to ethics is of little practical relevance to the majority of commonly occurring clinical ethical scenarios. Through analysis of three cases which involve conflict between the principles of autonomy and benefice, he demonstrates that many scenarios are well rehearsed with the "correct" answers enshrined in guideline and statute. His pap...

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  Dear Editor,

  Muirhead argues that Beauchamp and Childress' principalist approach to ethics is of little practical relevance to the majority of commonly occurring clinical ethical scenarios. Through analysis of three cases which involve conflict between the principles of autonomy and benefice, he demonstrates that many scenarios are well rehearsed with the "correct" answers enshrined in guideline and statute. His paper belittles the need of ethical deliberation from healthcare workers, but stops short of suggesting a limited role of merely knowing and applying the appropriate law or guideline.

  Clinical scenarios can rarely be summarised into neat vignettes without overlooking vital details. Each case presented is one-dimensional, with no conflict between existing guidelines and statutes. Ethical guidance provides standardised framework for common dilemma, in much the same way that clinical guidelines, protocols, checklists and pathways assist clinical decision making. However, guidance is open to abuse when applied to unintended situation. For this reason, a clinician must not only know the appropriate guidelines and legislation, but also have an understanding of how such guidance was developed in order to apply it correctly.

  Even if appropriate guidance could fully replace the need for in- depth, case-by-case deliberation, one must question how these guidelines came into being and are subsequently developed? Current guidelines and laws will change over time to incorporate ethical dilemma raised by emergent technologies, shifts in public attitude and failures of previous guidance. The next generation of guidance and legislation will require discourse within society; healthcare workers will bring their experiences from the clinical realm to this discussion.

  Conflict of Interest:

  None declared

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  Conflict of Interest:
  None declared.

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