The moral malaises of modern pediatric medicine

Authors: Carnevale, Franco
Advisor: Duhamel, André; Maclure, Jocelyn
Abstract: The dominant ethical framework in pediatric medicine is inherently problematic because important moral considerations are concealed. This problem is congruent with the displacement of moral malaises in modernity articulated by Charles Taylor. Drawing on Taylor’s work, I argue that contemporary pediatric medicine and bioethics are reflective of modern moral theory, which is centered on decisional procedures without explicit regard for the substantive moral grounds that such procedures should relate to. The goal of this thesis is to examine moral concerns in contemporary pediatric medicine through Taylor’s philosophical work. Taylor’s ideas oriented this examination (a) methodologically, as his conception of hermeneutics served as the analytical framework, and (b) substantively, by drawing on his analysis of modernity and moral theory. Taylor’s hermeneutical philosophy as well as his examination of modernity are reviewed to provide a philosophical framework for tracing the horizons of significance and social imaginaries within which pediatric medicine emerged and became aligned with particular moral orientations. An operational explicitation of Taylor’s hermeneutical approach was developed to examine (a) the early history of pediatric medicine as children’s health became valued in light of state and societal economic and military interests and (b) the emergence and ongoing development of the best interests standard, a more child-centered ethical orientation. Three moral malaises in modern pediatric medicine were identified: (a) the convergence of law and ethics; (b) the construal of children as incapable and dependent; and (c) the ambiguous nature of best interests. These malaises were examined to the retrieve the background horizons of significance and social imaginaries against which they were shaped. Moreover, a Taylorian framework for the practice of pediatric bioethics is proposed - hermeneutical retrieval and rapprochement - to enrich pediatric practice through interpretive attunement and reconciliation of concealed moral considerations. The implications for future research as well as pediatric practice and education are outlined.
Document Type: Thèse de doctorat
Issue Date: 2013
Open Access Date: 19 April 2018
Grantor: Université Laval
Collection:Thèses et mémoires

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