부산대학교 도서관

In ethics consultations, it is difficult to formulate an ethical reasoning process. Being able to widely share the reasoning process of individual cases is an essential activity for its progress ; as such, this paper seeks to participate in this activity. This paper describes and analyzes the written requests and responses of 15 consultations (July 2017 to June 2019) conducted by the ethics consultation team of Tohoku University Hospital. The reasoning process was mainly based on the “principle” approach, with most cases involving difficulties in applying, comparing, and contrasting principles due to the patient’s limited decisional capacity, a lack of relatives, and disagreements between the patient, their family members, and medical professionals. There were even cases in which the assessment of the decisional capacity and the consideration of the appropriateness of medical care led to proposals that differed from the patient’s preference. Although the reasoning process in this consultation was generally consistent with the views of previous studies, it is important to have an opportunity to examine each case to see if appropriate reasoning is being performed.