An “ethics of strangers”? On knowing the patient in clinical ethics

Bibliographic Data

ID21702564
AuthorsJoar Björk (0000-0001-7194-4875, Uppsala University, corresponding author), Anna Hirsch (0000-0002-2115-918X, Ludwig-Maximilians-Universität München)
Year2024
Volume27
Issue3
Pages389-397
Publication date2024-09-01
Open AccessYes
TypeARTICLE
VenueMedicine Health Care and Philosophy (JOURNAL)
Journal identifiersISSN: 1386-7423 • E-ISSN: 1572-8633
PublisherSpringer Science and Business Media LLC (PUBLISHER)
DOI10.1007/s11019-024-10213-y
PMID38850498
OpenAlexW4399462849
LanguageEN
Citations received1
References cited52

The shape and function of ethical imperatives may vary if the context is an interaction between strangers, or those who are well acquainted. This idea, taken up from Stephen Toulmin’s distinction between an “ethics of strangers” and an “ethics of intimacy”, can be applied to encounters in healthcare. There are situations where healthcare personnel (HCP) know their patients (corresponding to an “ethics of intimacy”) and situations where HCP do not know their patients (corresponding to “an ethics of strangers”). Does it make a difference for normative imperatives that follow from central concepts and principles in medical ethics whether HCP know their patients or not? In our view, this question has not yet been answered satisfactorily. Once we have clarified what is meant by “knowing the patient”, we will show that the distinction is particularly relevant with regard to some thorny questions of autonomy in healthcare (e.g., regarding advance directives or paternalism in the name of autonomy), whereas the differences with regard to imperatives following from the principles of justice and beneficence seem to be smaller. We provide a detailed argument for why knowing the patient is ethically valuable in encounters in healthcare. Consequently, healthcare systems should provide fertile ground for HCP to get to know their patients, and structures that foster therapeutic continuity. For this to succeed, a number of questions still need to be clarified, which is an important task for medical ethics

Applied ethics · Autonomy · Beneficence · Bioethics · Clinical Ethics · Economic Justice · Engineering ethics · Epistemology · Health care · Medical ethics · Meta-ethics · Normative · Normative ethics · Nursing ethics · Paternalism · Political science · Respect for persons · Ethics and Legal Issues in Pediatric Healthcare · Ethics in medical practice · Law · Medicine · Patient Dignity and Privacy · Philosophy · Psychology · Social Psychology

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