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Asian Journal of Ethics in Health and Medicine

2022 Volume 2

Bioethical Decision-Making For Extremely Premature Births Guided by Dialogue and Pragmatic Principles


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  1. Providence St. Vincent Medical Center, Women and Children’s Services, 9205 SW Barnes Road, Portland, OR, 97225, USA.

  2. Department of Obstetrics, Gynecology, and Newborn Care, The Ottawa Hospital – General Campus, 501 Smyth Road, Box 806, Ottawa, ON, K1H 8L6, Canada.

Abstract

Moral values in healthcare are diverse and inherently subjective, often differing across stakeholders. Such disagreements can hinder meaningful dialogue and marginalize alternative perspectives. Extremely premature births illustrate how conflicts can become counterproductive when competing interests, cultural misinterpretations, limited evidence assessment, and hierarchical pressures operate without the guidance of objective reasoning. Embracing uncertainty, equitably distributing risk, and recognizing the boundaries of treatment are virtues, not mere relativism, and are particularly vital in settings with scarce resources. We propose that dialogics fosters mutual understanding by: i) helping beliefs evolve beyond personal bias, ii) directing disputes toward pragmatic resolution (where the validity of any stance is tested through experience), and iii) acknowledging value pluralism (the irreducible, conflicting, and ultimately incommensurable nature of human values). This article presents a structured Point-Counterpoint on controversies surrounding extreme prematurity, an objective table of neurodevelopmental outcomes, and a dialogics model designed to enhance shared empathy rather than create opposing camps. Our aim is to narrow the comprehension gap between physicians and bioethicists. Dialogics recognizes the inevitability of conflicting human interests, understanding that universally satisfactory solutions are impossible, as every choice entails trade-offs. Cultivating collective awareness through dialogics and pragmatism harmonizes objective evidence appraisal with moral and cultural values, embodying a rare ethical construct that functions simultaneously as process and goal.


How to cite this article
Vancouver
Landry M, Farkas GJ. Bioethical Decision-Making For Extremely Premature Births Guided by Dialogue and Pragmatic Principles. Asian J Ethics Health Med. 2022;2:61-71. https://doi.org/10.51847/WV7d4GSLYK
APA
Landry, M., & Farkas, G. J. (2022). Bioethical Decision-Making For Extremely Premature Births Guided by Dialogue and Pragmatic Principles. Asian Journal of Ethics in Health and Medicine, 2, 61-71. https://doi.org/10.51847/WV7d4GSLYK

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