After a short description of the nature of philosophical counselling, this paper suggests that what makes philosophical counselling philosophical is that it helps the counsellee in philosophical self‐investigations. These are critical non‐empirical investigations of the fundamental principles underlying the counsellee's ‘lived understanding’(i.e. conceptions which the counsellee lives by, though not necessarily articulates in words), aimed at the development of wisdom. In order to illustrate the nature of philosophical self‐investigation, two case studies are presented. The nature and measurability of success in (...) philosophical counselling is then discussed. A questionnaire filled out by a counsellee is quoted as an illustration of the possible effects and success of philosophical counselling. (shrink)

Clinical ethics consultations are sometimes deemed complete at the moment when the consultants make a recommendation. In CECs that involve actual ethical conflict, this view of a consult's endpoint runs the risk of overemphasizing the conflict's resolution at the expense of the consult's process, which can have deleterious effects on the various parties in the conflict. This overly narrow focus on reaching a decision or recommendation in consults that involve profound moral disagreement can result in two types of adverse, lingering (...) sequelae: moral distress or negative moral emotions. The problem, succinctly named, is that such consults have insufficient “closure” for patients, families, and providers. To promote closure, and avoid the ills of moral distress and the moral emotions, I argue that CECs need to prioritize assisted conversation between the different stakeholders in these conflicts, what is often referred to as “bioethics mediation.”. (shrink)

In this paper I will move away from what has become the "traditional" approach to writing and thinking about philosophical counseling - I will not compare and contrast the virtues of the philosophical and psychological paradigms, nor will I attempt to defend philosophical counseling against its critics. Instead, I will use the methods and practices employed by philosophical counselors as a paradigm to inform and govern another philosophical practice, that is, clinical medical ethics. I will show that clinical ethics and (...) philosophical counseling share many common attributes, and argue that each discipline has much to offer to the other. (shrink)

This article describes, analyzes, and advocates for management of clinical healthcare conflict by a process commonly referred to as bioethics mediation. Section I provides a brief introduction to classical mediation outside the realm of clinical healthcare. Section II highlights certain distinguishing characteristics of bioethics mediation. Section III chronicles the history of bioethics mediation and references a number of seminal writings on the subject. Finally, Section IV analyzes barriers that have, thus far, limited the widespread implementation of bioethics mediation.

Clinical ethicists encounter the most emotionally eviscerating medical cases possible. They struggle to facilitate resolutions founded on good reasoning embedded in compassionate care. This book fills the considerable gap between current texts and the continuing educational needs of those actually facing complex ethics consultations in hospital settings. 28 richly detailed cases explore the ethical reasoning, professional issues, and the emotional aspects of these impossibly difficult consultations. The cases are grouped together by theme to aid teaching, discussion and professional growth. The (...) cases inform any reader who has a keen interest in the choices made in real-life medical dilemmas as well as the emotional cost to those who work to improve the situations. On a more advanced level, this book should be read by ethics committee members who participate in ethics consultations, individual ethics consultants, clinicians who seek education about complex clinical ethics cases, and bioethics students. (shrink)

Why mediation? -- What makes bioethics mediation unique? -- Before you begin a bioethics mediation program -- The stages of bioethics mediation -- Techniques for mediating bioethics disputes -- How to write a bioethics mediation chart note -- Mediation with a competent patient : Mr. Samuels's case -- Mediation with a dysfunctional family : Mrs. Bates's case -- A complex mediation with a large and involved family : Mrs. Leonari's case -- Discharge planning for a dying patient : a role-play (...) -- An at-risk pregnancy : a role-play -- HIV and postsurgical complications in the ICU : a role-play -- Treating the dying adolescent : a role-play -- She didn't mean it : a role-play -- Don't tell mama : a role-play -- An at-risk pregnancy : a role-play transcript -- HIV and postsurgical complications in the ICU : a role-play transcript -- She didn't mean it: a role-play transcript -- Don't tell mama : a role-play transcript. (shrink)

In this book, Raabe argues that philosophy can effectively inform and improve conventional methods of treating mental illness. He presents clinical evidence showing that mild and so-called clinical mental illnesses can be both prevented and alleviated with philosophical talk therapy. Raabe offers concrete case examples that support his findings.

In this book, Raabe argues that philosophy can effectively inform and improve conventional methods of treating mental illness. He presents clinical evidence showing that mild and so-called clinical mental illnesses can be both prevented and alleviated with philosophical talk therapy. Raabe offers concrete case examples that support his findings.

Introduction/Background: Moral distress and related concepts surrounding morality and ethical decision-making have been given much attention in nursing. Despite the general consensus that moral distress is an affective response to being unable to act morally, the literature attests to the need for increased clarity regarding theoretical and conceptual constructs used to describe precisely what the experience of moral distress involves. The purpose of this study is to understand how student nurses experience morally distressing situations when caring for patients with different (...) values and beliefs than their own in the clinical environment -/- Methods: This study is based on secondary analysis of participant data. The stories of eight student nurses who completed the original study were reviewed following Yin’s multiple-case study design. -/- Results: Findings suggest there is a subtle form of moral distress that has been under appreciated in the literature and differs from Jameton’s classic definition. While traditional institutional triggers to moral distress are pervasive, personal conflict as a result of differing value systems may be a moral challenge faced by nursing students working with culturally diverse patients. -/- Conclusion: Ethics education is needed in nursing school to reduce moral distress in the clinical environment. Nursing students need opportunities to develop moral reasoning skills in addition to their clinical skills. A philosophical approach to ethics education may be needed to prevent and alleviate moral distress. (shrink)

The case studies we present in this article are from an Institutional Review Board approved research project conducted at the State University of New York College at Cortland, in May through November 2008. Our IRB supported research in philosophical practice is the first of its kind. It was entitled “Philosophical Counseling: Case Studies and Their Implications.” Our research question was“Does talking to a trained philosopher help people resolve life issues?” We concluded that most of our clients benefited from philosophical counseling (...) and that we should continue to offer it as an element in our philosophical outreach.Realizing that it was necessary to preclude or overcome potential resistance from IRB members who had never heard of philosophical practice, we took on the task of educating them. This was not a formidable undertaking because [co-author] Andrew Fitz-Gibbon was the professional ethicist sitting on the IRB itself. Thus he had gained credibility through his association with board members, and he was able to engage in informal conversations with them. Our proposal began with the definition of philosophical practice used by APPA and suggested by Lou Marinoff:Philosophical practice is a relatively new field, though its roots are deep in the philosophical tradition. Philosophical counseling is intended for clients who are rational, functional, and not mentally ill, but who can benefit from philosophical assistance in resolving or managing problems associated with normal life experience. (shrink)

The paper discusses neo-Socratic dialogue as a participatory method to tackle bioethics, focusing on the field of new medical biotechnologies. Recent sociological research has investigated the role of so called ethics committees in the field of the new biotechnologies, approaches of participatory technology assessment and moral communication in bioethical controversies. The paper gives a brief overview about this research and the deficiencies of these approaches. Neo-Socratic dialogue is presented as a method to overcome at least some of these shortcomings. To (...) proof this statement the paper gives details about two international research projects which used Neo-Socratic Dialogues to discuss ethical questions with different groups of stakeholders. One project was about the ethics of xenotransplantation, the second one on ethical problems of genetic counseling. In both projects neo-Socratic Dialogue was used as a form of intervention and to evaluate the NSD as a transdisciplinary tool for dialogue and problem solving, as well as means for participatory policy making involving relevant stakeholders. The paper presents results of the neo-Socratic Dialogues and the accompanying sociological research on the effects of the talks. In the final part the chances and limits of neo-Socratic Dialogues in the field of bioethics will be resumed. (shrink)