An Ethics of Unknowing: Discerning Ethical Patient-Provider Interactions in Clinical Decision-Making

• Published in: Narrative inquiry in bioethics 2020, Vol.10 (6), p.159
• Main Author: Kasman, Deborah
• Format: Article
• Language: English
• ISSN: 2157-1732; 2157-1740; 2157-1740
• DOI: 10.1353/nib.0.0012

There is an irreducible amount of uncertainty in clinical decision-making. Both health care providers and patients experience anxiety elicited by clinical uncertainty, and this can lead to missed opportunities for healthy shared decision-making. In order to improve the patient-provider relationship and the ethical qualities of decision-making, the provider first needs to recognize where his/her "unknowing" exists. This article presents a model for a unique ethics of unknowing by identifying three levels at which the provider's knowledge or lack thereof impacts clinical decision-making. The model illuminates ethical choices that providers can make to promote healthy patient-provider relationships. The means by which an ethics of unknowing informs shared decision-making in patient care will be exemplified through a case study of one patient's encounters with several physicians while making difficult decisions throughout her breast cancer journey.