L’approche dialogique dans les comités d’éthique clinique en Amérique du nord
This research focuses on communication processes used in hospital ethics committees (HECs) in North America in their consultation role. According to the literature, HECs would benefit if they ―pay closer attention to group process [as an] effective communication in a HEC is essential to a committee’s function‖ (Berchelmann and Blechner 2002 359 p.143). However, very little data on group dynamics and modes of communication are available. This thesis explores whether the dialogical approach may be useful to supporting group discussion in HECs. The first part of this thesis presents a literature review and history to situate the current state of HECs. The various methods used to conduct discussions in ethics consultations are then explored and analyzed, with regards to their advantages and limitations. The second part of the thesis examines communication barriers that potentially affect HECs, and then proposes a possible solution to improve the communication process (and reduce the effect of barriers), that is, the dialogic approach as developed by the organizational setting. This approach is then conceptualized and linked with the communication needs of HECs. Although dialogue can provide several beneficial contributions to HECs and their members, some contextual constraints reduce its feasibility for a comprehensive application. However, using it as a means of additional training, dialogue enables the development of the individual and the group and remains an interesting and useful approach for HECs facing difficulties, and who are able to understand the systemic implications of this approach.
Ethics consultation Method Dialogue Dialogue Decision making Facilitation Consensus Consensus Process Communication Communication Clinical Ethics Committee