Toward a theory of process.

This article starts by finding a lack of procedural ethics in the usual debates over the functioning of ethics committees and the proper relationship of ethics committees and the courts, and traces this lack to the absence of a theory of process and process values. I then show why ethics commmittees are an excellent place to start in working on process. I therefore turn to the task of developing process values, and specifically a notion of patient-centered process. Here I recommend both process values commanded by our underlying substantive values, and further independent process values. I specifically suggest that surfacing problems of gender, racial, and economic bias make certain processes ethically mandatory. Having thus indicated what the needed process values might look like, I sketch their considerable theoretical potential. I return to the particular problem of ethics committees and the courts, and use my notion of patient-centered process to derive an answer to the question of how the two entities should interrelate. Finally, I step back to suggest where we might go from here in developing a theory of process.