Family Focused Grief Therapy: A Model of Family-Centered Care during Palliative Care and Bereavement

By David W. Kissane; Sidney Bloch | Go to book overview

8 The ethical dimension

When we began to treat families in palliative care, we were aware of an ethical dimension to this pursuit. One of us (SB) had written a chapter on family therapy and ethics, and the other (DK) had conducted research on euthanasia. But little did we appreciate how pervasive ethical aspects would turn out to be. In this chapter, which should not be construed in any way as a tag for the nitty gritty of treatment itself, we highlight the principal ethical themes that have emerged and weave in clinical illustrations derived from our experience.


Is there an ethical framework that guides FFGT?

Before we examine these ethical issues, we pose the fundamental question as to whether an overarching moral theory can serve as a framework for FFGT. The reader familiar with moral philosophy will know that many classical models compete for our attention and could be applied to the conduct of our family therapy. Let us consider some of these briefly in order to discern their scope.

The deontological (or Kantian) position is one of these contenders given its key tenet that certain acts are intrinsically wrong, and cannot be put right, and that certain moral judgements are universally applicable. Additionally, the motive for acting in a specific way is to carry out a genuine duty. An obvious example in the context of FFGT would be that we have a duty not to cause any family member psychological or other form of harm. A contrasting theory based on the consequences of one's acts, utilitarianism, de-emphasizes motivation and focuses on the probable benefits and harms that may result from a particular decision or act. The corollary is that we should always act in order to maximize benefits.

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