Living ethics: a new avenue for health ethics

In the form of a scientific article published at the end of January in the journal Medicine, Health Care and Philosophy, the team led by Éric Racine , from the Université de Montréal, is proposing for the first time a formal definition of living ethics and its founding principles. In a creative, collaborative approach, this publication addresses the theoretical, methodological and practical frameworks that govern living ethics, as well as the factors that can hinder its implementation.

Known as "living ethics", this approach offers a new perspective on ethics, emphasizing the importance of dialogue,empowerment, co-learning and co-creation in order to establish health care and social service orientations aimed at human fulfillment and development.

For example, in terms of medical care, living ethics places the experience of patients and members of the communities concerned at the heart of the care process. This living approach implies a constant and natural effort to consult stakeholders, and to take their experiences into account so as to adapt care to their needs.

"Living ethics in healthcare cannot be conceived of in any other way than through 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 the academic and healthcare worlds 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," explainsDr. Racine.

Changing medical practice to focus on people

Building on seminal work in the field of neuroethics,Dr. Racine’s team, supported by several collaborators, has made a major breakthrough by devising a form of ethics that is accessible, participatory, adaptive and oriented towards human well-being. It brings to the fore aspects that, while essential to restoring health, remain little considered in medical practice. The psychological management of chronic illness is an excellent example.

"Living ethics invites us to humanize medical practice by decompartmentalizing it," confidesDr. Racine.

The team wanted to experiment with this concept by setting up, in 2022, the first living ethics laboratory (É-LABO) which, in collaboration with the IRCM clinic and the Université de Montréal, will address, among other things, the psychological distress of people living with a chronic, rare or complex disease.

"The Living Ethics Lab experience has enabled us to work closely with patients. By offering them a space to talk about the psychological distress they may experience as a result of their health condition, and by seeking to better understand the multiple facets of their distress, we were able to shed light on little-known aspects of these people’s experience," observes Bénédicte D’Anjou, research coordinator at the Pragmatic Health Ethics Research Unit.

Living ethics beyond borders

Far beyond the projects carried out at the IRCM,Dr. Racine and his team have taken the lead in the development of living ethics in healthcare, both in Quebec and abroad.

So, in addition to the project on psychological distress, the Unité de recherche en éthique pragmatique de la santé is working on a number of other living ethics initiatives. Maisonneuve-Rosemont Hospital, a project on ethical deliberation processes in Canadian hospitals and a living ethics laboratory in rehabilitation (LEViER), designed at the Institut universitaire sur la réadaptation en déficience physique de Montréal.

About this study

The article "Living ethics: A stance and its implications in health ethics", by Éric Racine and colleagues, was published on January 24, 2024 in Medicine, Health Care and Philosophy.

The study was funded by a Merit Scholar award from the Fonds de recherche du Québec - Santé and a Connexion grant from the Social Sciences and Humanities Research Council.