Living Ethics: a stance and its implications in health ethics

Background Moral questions are vital questions because they concern what is esteemed to be the best action, the best choice and, ultimately, the best life to live. Health ethics which aims to address these moral questions has contributed to moving ethics toward more experience-based and user-oriented ethics theory and methodology. Despite this, current approaches remain an incomplete lever for human development and flourishing. This context led us to imagine and develop the stance of a “living ethics”, a radically participatory and situated form of ethics which we describe in this inaugural collective and programmatic paper. Methods We followed a participatory discussion and writing process known as instrumentalist concept analysis. Initial informal local consultations were undertaken about pragmatic ethics, and from these conversations emerged the current project. An exploratory literature review was undertaken, and a diverse working group of 21 co-authors was assembled. The working group held a total of 8 workshop-like meetings supported by prior reading and iterative revision of a shared draft document accessible through an online platform. Meetings were video-recorded and transcribed to support this process. Four subgroups were created to further the working group’s reflections in specific domains of health ethics. Results In its first sense, a living ethics designates a form of ethics attentive to human experience and the role played by morality in human existence. In its second sense, a living ethics represents an ongoing effort to interrogate and scrutinize our moral experiences to promote the engagement of both individuals and communities in envisioning and enacting scenarios which correspond to their flourishing as authentic ethical agents. Living ethics bears specific theoretical, methodological, and practical implications in various areas of health ethics activity such as clinical and organizational ethics, health policy and public health, health ethics research, and learning and teaching health ethics. Conclusions Living ethics encourages meaningful participation of stakeholders and reflects a commitment to the existential nature of moral affairs. Looking forward, there is a need for ongoing dialogue about the nature of living ethics and the methodological practices coherent with this orientation. We hope to build on this idea to initiate collaborative projects locally and internationally.