Techniques of Ordering and the Dynamism of Being: A Critique of Standardized Clinical Ethics Consultation Methods.

Abstract

Clinical ethics consultation (CEC) has become all about right technique. When we encounter a case of conflict or confusion, clinical ethicists are expected to deploy a standardized, repeatable, and rationally defensible method for working toward a recommendation and/or consensus. While it has been noted previously that our techniques of CEC often foreclose on its internal goods, there remains an assumption that we must just find the right efficient technique and the problem would be solved. In this paper, I question that assumption, arguing that any standardized, identically repeatable model of CEC will pull us counterproductively away from ethical reflection, and toward the values of modern techne: primarily efficiency, efficacy, and repeatability. This is because standardized techniques of CEC pull the dynamism of being into what Catherine Pickstock calls "identical repetition," a technologized ontology, which is fundamentally at odds with what being is. And, since ethics is a search for the good of being, avoiding the ontological heart of being severely restricts ethics.