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Kaldjian wins 'Defining Wisdom' grant
"Defining Wisdom," a project of The University of Chicago across multiple disciplines, awarded Lauris Kaldjian, MD, PhD, in 2008 a grant to develop a framework for medical decision making.
Medical Ethics Advisor talked with Kaldjian last November about what he expects to be a two-year project.
"What I'm trying to do in this large work is to do something that would actually be concrete and practically useful at the end of the day," Kaldjian says.
He expects to develop a "conceptual framework of wisdom" for clinicians that integrates three domains: medical ethical reasoning, the professional's conscientious practice, and the professional's obligation to society."
Kaldjian notes that a great deal of focus is placed in medical ethics today on the patient's autonomy. However, he says, if a physician or a clinician says, "What about me, what about my autonomy? How do you start to fit those two together?"
Kaldjian says he believes there is a struggle with how to balance the needs of the patient to the professional and against the needs of society.
An example scenario would be: duty to serve in time of epidemic.
"You know, the experience with SARS in Toronto and elsewhere in the world led to a lot of head scratching and hand-wringing about when should a physician or other clinician be willing to sacrifice their own or their family's welfare for the sake of the social good and for patients in need, etc.," Kaldjian says.
The goal, he says, would be on one hand to "first bring together what I call contrasting normative values," including a deontological principles approach, a consequentialist, and a utilitarian approach.
"How to understand these different approaches would be to say that deontological principles have to do with: What is the intrinsically right action? Consequentialism has to do with: What is the good state of affairs you are trying to accomplish by way of outcomes? But virtue ethics is about: What is the morally good person, and when you start talking about — not just what do you think, or what will you do but who should you be, you know now you're stepping onto a very different ground," Kaldjian says.
He suggests that much of the ethical debate and dialogue today and in the past has been "not necessarily to do with what are our different options, but trying to figure out how to prioritize those options," he points out.
He says one concise and helpful definition of wisdom is "the attempt to assess the value of different ends and to determine the best means to achieve those ends in particular circumstances."
"The reference to wisdom is not meant to be abstract and sophisticated," Kaldjian says. "It's really meant ultimately to try to create a framework that makes sense to clinicians and helps them understand what it is they're trying to accomplish, and to come up with a justification for it as well."
For more information about the "Defining Wisdom" project and medical decision making, contact: