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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.

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© Copyright Leonard H. Bucklin 2000 to 01/30/2008 ©  All rights reserved.  No copying or distribution of this material may be made without the express written consent of the copyright holder.  For more information -  see the Legal Notices.