Bucklin's adaptation of the Clinical
Pragmatism Method (CP) follows.
A five step method of solving
a corporate business or medical
ethics / bioethics problem in the real world.
By Leonard H. Bucklin

STEP # 1 - INQUIRY
Assess the facts. (A
Facts@ includes not only what
has happened, but also the operative entity policies, and the state and federal law, that
is known to apply or is being asserted.)
Determine the parties involved.
Diagnose the moral problems. Determine what the parties
believe to be the difficulties that create the problems they see
Articulate what ethical problems exist. The problem should
be stated in terms of a question, to wit: a specific ethics or action question, or series of
questions, to be answered.
Ascertain the law that is involved. Law is not an ethical
principle. Law may have ethical principles in it, because laws are an expression
of community morality. But law should be treated as a fact in Clinical
Pragmatism. The fact of the applicable law needs to be clearly stated, and added
to the list of the assessed facts of the case. The law does not
answer automatically answer the ethics question, and indeed the law may be hazy
or unhelpful. The participants in the discussion must not get bogged down
in a legal debate. The discussion must leave the fact of applicable law on the
table while the bioethical or medical ethics principles are identified and
discussed.
List -- just list at this point - what principles of ethics exist that relate to those
problems. (CP treats moral principles as guides that identify a range of
reasonable moral choices for deliberation by all concerned.) Usually, in the United States, the relevant ethical
principles will be: Justice,
Utility, and Autonomy.
STEP # 2 - DISCUSSION
List - just list at this point - the options of action of the participants
(action options).
Consider and discuss fully the ethical principles for each action option. Articulate the principles of ethics that exist as they
relate to each possible plan of action
Set the goal for resolution of the ethical problem. What
will an acceptable plan of action accomplish in resolving the ethics questions?
STEP # 3 - DECISION
Negotiate a decision for an consensus acceptable plan of action
for the participants. State it as an action or series of actions to be
taken.
STEP # 4 - JUSTIFICATION
| The aim of moral problem solving in a medical clinical setting is to reach a consensus
resolution that can withstand moral scrutiny with respect to both the decision
made and also the process of reaching and implementing the decision. |
Articulate the reasons for the decision. That is: prepare the
explanation of the decision to be given to the persons outside of the
participants. ("Justify", "rationalize": the decision.)
STEP # 5 - EVALUATION
After the plan of action has been completed, evaluate the
results.