With Hope and Imagination: Imaginative Moral Decision-Making in Neonatal Intensive Care Units |
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Authors: | Mark Coeckelbergh Jessica Mesman |
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Institution: | (1) Philosophy, Maastricht University, P.O. Box 616, Maastricht, 6200 MD, The Netherlands;(2) Technology & Society Studies, Maastricht University, P.O. Box 616, Maastricht, 6200 MD, The Netherlands |
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Abstract: | Although the role of imagination in moral reasoning is often neglected, recent literature, mostly of pragmatist signature,
points to imagination as one of its central elements. In this article we develop some of their arguments by looking at the
moral role of imagination in practice, in particular the practice of neonatal intensive care. Drawing on empirical research,
we analyze a decision-making process in various stages: delivery, staff meeting, and reflection afterwards. We show how imagination
aids medical practitioners demarcating moral categories, tuning their actions, and exploring long-range consequences of decisions.
We argue that imagination helps to bring about at least four kinds of integration in the moral decision-making process: personal
integration by creating a moral self-image in moments of reflection; social integration by aiding the conciliation of the
diverging perspectives of the people involved; temporal integration by facilitating the parties to transcend the present moment
and connect past, present, and future; and epistemological integration by helping to combine the various forms of knowledge
and experience needed to make moral decisions. Furthermore, we argue that the role of imagination in these moral decision-processes
is limited in several significant ways. Rather than being a solution itself, it is merely an aid and cannot replace the decision
itself. Finally, there are also limits to the practical relevance of this theoretical reflection. In the end, it is up to
care professionals as reflective practitioners to re-imagine the practice of intensive care and make the right decisions with
hope and imagination.
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Keywords: | imagination moral theory moral decision-making pragmatism neonatal intensive care medical ethics |
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