Ethical Reasoning Methodology

This section is on methodology of ethical reasoning, providing a detailed definition of the methods employed in psychiatry ethics. The prevailing approach in clinical ethics is the principle-based approach, whereby nearly every ethical problem is approached through this methodology. The principle-based approach is undeniably useful, practical, and widely accepted, particularly in the context of research ethics involving human subjects. However, relying only on the principle-based approach falls short in addressing the complexities and dilemmas arising within the realm of clinical ethics. This limited approach frequently undermines the consideration of inherent moral values of the physician-patient relationship, such as trust, fidelity, veracity, trustworthiness, confidentiality, and privacy, thus steering toward mechanical solutions that are incongruent with the art of medicine. Therefore, it is important to incorporate other ethical analysis methodologies while adressing the complex and interwoven multifaceted ethical issues and dilemmas in clinical ethics. This chapter on methodology explains normative ethical theories and contemporary approaches that have been found to be functional and successful in psychiatric ethics and have rapidly gained prominence such as the hermeneutic approach. In this chapter, these traditional and contemporary methodologies are introduced together with their philosophical frameworks, providing the reader with a comprehensive perspective on how these methods can be applied to solving ethical issues in the clinical settings.