Inclusive consultation: a hermeneutical approach to ethical deliberation in the clinical setting.

The problem of ethical consultations in the clinical setting should be reasonable, but it cannot be reduced to reason and philosophical theory alone. I will argue that emotions are constitutively and discursively relevant features of the evaluative experience of persons. Ethical consultations should include emotions. Emotions like shame and guilt are complex and learned reactions of persons, which form one basis of ethical reflection. I argue that ethical consultation can rely neither on a strict theory or method nor on a philosophical theory that is external to the situational triggers of consultations in the clinical setting. Emotions are one essential trigger of the need for ethical consultations. I will show that methodologically consultation depends on understanding the evaluative experiences of persons who cooperate in the clinical setting. Moreover, such evaluative experiences includes emotive reactions as well as reason. My conclusion is that ethical consultation in the clinical setting needs a conceptual understanding of epistemic, justificatory and methodological inclusiveness. This circumstance can be summarized: ethical consultations need the ongoing development of a moral hermeneutics of clinical consultation.