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How is clinical ethics reasoning done in practice? A review of the empirical literature

Bibliographic Data

ID21515448
AuthorsSharon L Feldman (0000-0002-9762-3700, The University of Melbourne, corresponding author), Lynn Gillam (0000-0001-6481-5004, The University of Melbourne), Rosalind Mcdougall (0000-0002-3809-2575, The University of Melbourne), Clare Delany (0000-0001-6156-2347, The University of Melbourne)
Year2026
Volume52
Issue1
Pages32-38
Publication date2026-01-01
Peer ReviewedYes
Open AccessNo
TypeARTICLE
VenueJournal of Medical Ethics (JOURNAL)
Journal identifiersISSN: 0306-6800 • E-ISSN: 1473-4257
PublisherBMJ (PUBLISHER • GB)
DOI10.1136/jme-2024-110569
PMID40118525
OpenAlexW4408741680
LanguageEN
Citations received1
References cited39

BACKGROUND: Clinical ethics reasoning is one of the unique contributions of clinical ethicists to healthcare, and is common to all models of clinical ethics support and methods of case analysis. Despite being a fundamental aspect of clinical ethics practice, the phenomenon of clinical ethics reasoning is not well understood. There are no formal definitions or models of clinical ethics reasoning, and it is unclear whether there is a shared understanding of this phenomenon among those who perform and encounter it. METHODS: A scoping review of empirical literature was conducted across four databases in July 2024 to capture papers that shed light on how clinical ethicists undertake or facilitate clinical ethics reasoning in practice in individual patient cases. The review process was guided by the Arksey and O'Malley framework for scoping reviews. RESULTS: 16 publications were included in this review. These publications reveal four thinking strategies used to advance ethical thinking, and three strategies for resolving clinical ethics challenges in individual patient cases. The literature also highlights a number of other influences on clinical ethics reasoning in practice. CONCLUSION: While this review has allowed us to start sketching the outlines of an account of clinical ethics reasoning in practice, the body of relevant literature is limited in quantity and in specificity. Further work is needed to better understand and evaluate the complex phenomenon of clinical ethics reasoning as it is done in clinical ethics practice

Clinical Ethics · Clinical Practice · Engineering ethics · Epistemology · Management science · Phenomenon · Ethics and Legal Issues in Pediatric Healthcare · Ethics in medical practice · Innovations in Medical Education · Medicine · Nursing · Psychology

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    Open Access•Zachary Munn, Micah D J Peters et al.•BMC Medical Research Methodology•2018

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  • Ethical case deliberation on the ward. A comparison of four methods

    Open Access•Norbert Steinkamp, Bert Gordijn•Medicine Health Care and Philosophy•2003

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    Hilary Arksey, Lisa O’malley•International Journal of Social…•2005

  • Evaluating the use of casuistry during moral case deliberation in the ICU

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Unique citing works1
Citations per year1
Citation span2026 - 2026 (1)
Citation velocitycurrent
Highly citedNo
Citation typesNeutral: 1

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