The ethics man strikes again – ethics checklists

By David Hunter

Daniel Sokal has been busy again Success from surgical checklists breeds idea for ethical checks suggesting that clinicians ought to consider adopting an ethics checklist to use on their rounds.

The idea of the list is to put ethical considerations on the table to be considered as part of medical practice rather than as an optional extra. And if the list succeeds in this, it would seem worthwhile.

It is however a suggestion that might raise the heckles of some ethicists, who see approaches such as the four principles approach as an over-simplification of the complexity of ethical decision making and would see such a list as doubly so.

It might be argued that the list doesn’t aim to simplify ethical decision making, it aims to identify where ethical decision making needs to take place. This is true but misses the point of the objection, the concern is that whether or not it is aimed at being a decision making tool it might well be misapplied as one. A constant request from medical students in regards to medical ethics, is to simply be told the right answers, and one could see such a list being used in just this way.

Nonetheless the use of such a list and its impact seems worth exploring, however I do wonder given the recent controversy of the introduction of an infectious disease control list in the US and whether this constituted research or not, whether the list proposers have considered whether they ought to seek IRB approval before its introduction…

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