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Toward a Theory of Process

Published online by Cambridge University Press:  29 April 2021

Susan M. Wolf
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Extract

Bioethics has no theory of process. We have labored to develop a widely shared set of substantive values, but have been slow to spell out exactly what processes our values command. Nor have we examined process itself, to gauge the impact of different procedures and debate what we should value in process itself.

The little work that has been done on process focuses almost exclusively on what action should be taken in one-to-one encounters. Thus, much has been said on the obligation of the physician to speak with the patient, share information, and seek consent. Indeed, it would have been difficult to advocate respect for patient autonomy at all, without at least requiring this minimal and individualistic sort of procedure. But the requirement of certain behaviors in individual encounters has not been set in any broader vision of institutional process.

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Article
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Law, Medicine and Healthcare , Volume 20 , Issue 4 , Winter 1992 , pp. 278 - 290
Copyright
Copyright © American Society of Law, Medicine and Ethics 1992

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References

Dennis Thompson has made a closely related point, noting recently that “It is surprising that hospital ethics—and institutional ethics more generally—has been so neglected.” Thompson, Dennis F., “Hospital Ethics,” 3 Cambridge Quarterly of Healthcare Ethics 203, 203 (1992). He goes on to examine ethics committees, favoring an advisory role in case consultation coupled with “expanded authority” to formulate standards and make policy. Id. at 208–09.CrossRefGoogle Scholar
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By suggesting that some others might share the patient's standpoint, I do not mean to suggest that all members of certain gender, racial, and ethnic groups share the same standpoint. I merely mean to suggest that committee members and caregivers who do not share the same groups as the patient may find they have to deal with additional barriers to understanding her viewpoint. Clearly, members of the same groups may also find substantial differences and barriers to understanding each others' views. Note that I use “groups” in the plural to recognize that a person may be part of more than one, and that the identification and delimitation of different groups is almost always problematic. See, e.g., Crenshaw, Kimberle, “Whose Story Is It Anyway? Feminist and Antiracist Appropriations of Anita Hill,” in Raceing Justice, En-gendering Power: Essays on Anita Hill, Clarence Thomas, and the Construction of Social Reality 402 (Morrison, Toni, ed., New York: Pantheon Books, 1992).Google Scholar
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