Performative bioethics. Committees for clinical ethics between experiences, crises and perspectives

Abstract

Despite their partial diffusion in the Italian context, the clinical ethics Committees represent a fundamental ethical subject within the healthcare organization. Through an analysis of the experiences and the main critical issues, the contribution seeks to recover the performative and proactive elements for a greater integration of these Committees within the health institutions, through the rediscovery of a specific ethical competence. The experiences highlight the main functions of the Committees, case analysis, drafting of guidelines, training of health personnel and social information, advice on allocation of resources in the health system. However, some of these functions remain frequently unexplored or partially used by institutions. It is precisely this aspect that allows to advance into the critical issues of these Committees, connected above all to partial recognition by the institutional structures, as well as to a geographic diffusion that is not widespread and cross-sectional but sporadic. The analysis leads to the recognition of a dual performativity, on the one side the performativity of the bioethicist in the Committee, on the other side the performativity of the Committee in the institution. Furthermore, there is an intersection between ethical competence in the era of complexity and original elements of the philosophy of medicine with attention to care.