Article: Kairos. Decision-making in medical ethics

David JOUSSET

Ancien élève de l’Ecole normale supérieure (Ulm), agrégé et docteur en philosophie, maître de conférences de philosophie, Directeur de l’équipe de recherche « Ethique, Professionnalisme et Santé » (EA 4686), Université de Bretagne occidentale, Brest, France. Membre du Comité scientifique de l’Espace éthique de Bretagne occidentale

Abstract

This paper assesses the decision making patterns in medical ethics: the formalized pattern of decision science, the meditative pattern of an art of judgement and lastly the still-to-be-elaborated pattern of kairology or sense of the right time. The ethical decision is to be thought out in the conditions of medical action while resorting to the philosophical concepts that shed light on the issue. And it is precisely where medicine and philosophy of human action meet that the Greek notion of kairos, or “propitious moment”, evokes the critical point where decision has to do with what is vital. Reflection shows that this kairos can be thought out outside the sacrificial pattern (deciding comes down to killing a possibility) by understanding the opportune moment as a sign of ethical action, as the condition for the formation of the subject (making a decision) and finally as a new relationship to time, including in the context of medical urgency. Thus with an approach to clinical ethics centred on the relation to the individual, the focus is less on the probabilistic knowledge of the decidable than on the meaning of the decision, and the undecidable comes to be accepted as an infinite dimension going beyond the limits of our acts, which makes the contingency and the grandeur of human responsibility.