MEDI7231 Study Guide - Final Guide: Artificial Insemination, Private Placement, Terri Schiavo Case
CASUISTRY
Introduction
Definitions
oCase-based method of ethical-reasoning
oCasuistry is a method of ethical reasoning, not a theory; it is often grouped with theories
because it is used in clinical ethics to assist decision making (much like ethical theories)
oA traditional method of interpreting and resolving moral problems, involving thinking and
talking about how the circumstances of this or that case of moral perplexity fit the general
norms, rules, standards and principles of morality
oIt uses procedures of reasoning based on paradigms and analogies, leading to the formation of
expect opinion; they hold good with certainty only in the typical conditions of the agent &
circumstances of action
oIt can clarify out thoughts, be an adjunct to other theories, provide us with paradigmatic
(precedent) cases to refer back too & guide our decisions and actions
oExample: casuistry can be used in conjunction with utilitarianism, principlism etc
Cicero, Aristotle and Augustine taught rhetoric (an ancient form of reasoning using casuistry) – the art
of making a persuasive argument in favour of the just, the good and the right
3 step process of traditional casuistry (do not learn)
oSituate a case within a topic area
In medicine, these topic areas may be medical indicators, patient preferences, QoL or
contextual features
oDescribe/ evaluate the circumstances of the case
Time, place, person, actions, affairs (happenings)
All features are important as moral knowledge is particular
Circumstances surround a central core known as a maxim; maxim is shareable
oComparison with other cases
Compare cases within a topic area
Similarities vs differences
Central maximum are the same
Moral decisions are made
oThis can be established as a paradigm case & be referred to for guidance for similar cases within
the topic area
Casuistry in clinical practice
oIt is not practices in its pure form, however is often utilised in an adapted/ applied form due to
its helpfulness in guiding decision-making in difficult and/or unusual cases
oProcess/ model for practice in medicine today
Challenging case arises
Ask questions, no straight forward answers
Colleagues consult each others (ethics committee or consultant)
Seek literature for similar cases worldwide
Literature is found, reviewed, critically evaluated for sim vs diff to current case &
discussed
Findings from literature are used to guide & applied to current case where
circumstances are similar
Example of casuistry application – Tony Bland
oUK, 96 people died in crowd crush at Hillsborough football ground in Sheffield 15.04.89
oTony Bland survived with multiple injuries complicated by events in hospital & suffered
irreversible brain damage causing persistent vegetative state
oIn 1993, his family believed his life had little quality and wanted to cease tube feeding
find more resources at oneclass.com
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Document Summary
Cicero, aristotle and augustine taught rhetoric (an ancient form of reasoning using casuistry) the art of making a persuasive argument in favour of the just, the good and the right. 3 step process of traditional casuistry (do not learn: situate a case within a topic area. In medicine, these topic areas may be medical indicators, patient preferences, qol or contextual features: describe/ evaluate the circumstances of the case. All features are important as moral knowledge is particular. Circumstances surround a central core known as a maxim; maxim is shareable: comparison with other cases. Moral decisions are made: this can be established as a paradigm case & be referred to for guidance for similar cases within the topic area. Colleagues consult each others (ethics committee or consultant) Literature is found, reviewed, critically evaluated for sim vs diff to current case & discussed. Findings from literature are used to guide & applied to current case where circumstances are similar.
