The Montreal Clinical research Institute (IRCM) is pleased to announce the recent publication of an important scientific article by Dr. Eric Racine's team, laying the foundations for an innovative vision of ethics in healthcare.
Named Living Ethics, this new approach offers a fresh perspective on ethics, emphasizing the importance of dialogue, empowerment, co-learning and co-creation in generating healthcare and social service orientations aimed at human flourishing and development. For example, in medical care, Living Ethics places the experience of concerned patients and community members at the heart of the care process. This living approach implies a constant and natural effort to consult stakeholders and take their experiences into account, so as to better adjust care to their needs. Thus, the practice of Living Ethics in healthcare requires the active involvement of individuals and communities, as well as the integration of their perspectives and other contextual elements that influence their health.
An Important Step for Living Ethics in Healthcare
Based on a major creative collaboration process, this publication is the very first to present the concept of Living Ethics and to formalize its foundations. In fact, it is the fruit of the collective work of over twenty collaborators and co-authors, who willingly lent themselves to numerous consultation exercises, discussions and literature reviews, as well as numerous collaborative reflection and collective writing workshops.
The result of this colossal effort, carried out under the direction of Dr. Racine's team, is a formal definition of Living Ethics and its founding principles. In addition, the publication addresses the theoretical, methodological and practical frameworks governing Living Ethics, as well as the factors that can hinder its implementation.
“We have been developing the notion of Living Ethics for some time now, as an avenue for advancing medical practice. This work is the fruit of an essential collective exercise whose objective for us was to articulate a shared vision of Living Ethics that could form the basis of future projects and interventions. We've taken a major step forward,” explains Dr. Eric Racine, Director of the IRCM's Pragmatic Health Ethics Research Unit, Associate Professor at Université de Montréal and Adjunct Professor at McGill University.
Living Ethics in healthcare: the way to the future, a major step forward
With a solid reputation, rooted on major seminal work in the field of neuroethics, IRCM's Pragmatic Health Ethics Unit and Dr. Racine's team have now taken a major step forward by devising a form of ethics that is accessible, participatory, adaptive and oriented towards human well-being. This brings to the fore aspects that, while essential to restoring health, remain little taken into account in medical practice. The psychological management of chronic illness is an excellent example.
“It very quickly became clear to us that the best way to achieve this was to bring the most directly concerned people to the table: patients and community members. Living ethics invites us to humanize medical practice by decompartmentalizing it,” confides Dr. Racine.
The team wanted to put this concept to the test, with the development in 2022, of a first living ethics laboratory (É-LABO) which, in collaboration with the IRCM Clinic and the Université de Montréal, addresses, among other issues, the psychological distress of people living with a chronic, rare or complex disease.
“The Living Ethics Laboratory's experience with the IRCM Clinic has enabled us to work closely with both male and female patients. By offering them a space to talk about the psychological distress they may experience as a result of their medical condition, and by seeking to better understand the multiple facets of their distress, we have been able to shed light on little-known aspects of these people's experience. We also worked collaboratively to find concrete solutions and develop tools that improve the quality of care while promoting a more holistic approach to health,” explains Bénédicte D'Anjou, research coordinator at the Pragmatic Health Ethics Research Unit and PhD candidate at McGill University.
Living Ethics in Healthcare, Reaching Beyond Borders
Beyond the initiatives led by his research unit at the IRCM, Dr. Eric Racine and his team have taken on a central leadership role in the development of Living Ethics in healthcare, both in Quebec and internationally. They do not hesitate to open up avenues of collaboration so that several reflection avenues and initiatives on this issue can see the light and coexist. A real movement is thus taking shape under the impetus of Dr. Racine and his team.
So, in addition to the project on psychological distress, the Pragmatic Health Ethics Research Unit is pursuing the development of various other Living Ethics initiatives, including 1) a living laboratory experiment in the intensive care unit at Hôpital Maisonneuve-Rosemont, 2) a project on ethical deliberation processes in Canadian hospitals, supported by the Social Sciences and Humanities Research Council of Canada, and 3) thanks to a major Lindsay Prize, a Living Ethics laboratory in rehabilitation (LEViER), developed at the Institut universitaire sur la réadaptation en déficience physique de Montréal. Dr. Eric Racine and his team have also organized an International Living Ethics Co-Development Workshop, and are playing a key role in the development of an International Living Ethics Network.
“Living ethics in healthcare can only be designed with the participation of as many people as possible. At the heart of this notion is a fundamental desire to break down the traditional silos and ivory towers in academic and healthcare circles, through a culture of listening and social innovation. Ultimately, this is what will enable us to develop a health ethic that is sustainable and rooted in a global vision of human health," concludes Dr. Racine.
Read the recent publication on Living Ethics
About Eric Racine
Dr. Racine is an internationally recognized researcher in bioethics, with several major contributions to make to the development of neuroethics and pragmatic ethics. He is the author of several books, including a seminal work on neuroethics, Pragmatic Neuroethics: Improving Treatment and Understanding of the Mind-Brain, published by MIT Press, and The Theory of Deliberative Wisdom, a new theory of ethics to be published by the same publisher in 2024. Inspired by philosophical pragmatism, his research brings to the fore the lived experience of ethically problematic situations by patients and key stakeholders, and seeks to resolve them collaboratively through deliberative processes grounded in lived experiences.
