‘Decisions,’ ‘Options,’ ‘Values,’ ‘Preferences’: Examining the Language of Bioethics

In bioethics and the adjacent fields of health services research and health policy, enhancing the involvement of patients in their care is commonly framed as better aligning medical ‘decisions’ with patients’ ‘values’ and/or ‘preferences.’ Synthesizing findings from several ethnographic studies, this talk will explore how this kind of language winds up operationalized in the surgical clinic and intensive care unit, where it often has effects very different from those posited in bioethical accounts. It will examine why these effects have been difficult for researchers in bioethics and adjacent fields to detect and understand.  And it will suggest revised approaches to clinician-patient/family communication in these settings.

Justin Clapp, PhD, MPH, is an Assistant Professor of Anesthesiology and Critical Care and Medical Ethics and Health Policy at the Perelman School of Medicine. He is also an Associated Faculty in Anthropology at the University of Pennsylvania. Dr. Clapp is a linguistic and medical anthropologist who uses qualitative methods and anthropological theory to examine issues in empirical bioethics, health care communication, and medical decision-making. His primary work examines patient care trajectories in the perioperative and critical care spaces, seeking to understand how diffuse chains of health care interactions lead to the pursuit of particular treatments.The goal of this work is to develop ethical and interventional models of medical decision-making better tailored to the empirical complexities of illness and care. Dr. Clapp also maintains lines of research in medical education and medical research ethics. He teaches courses in Penn’s Anthropology department and Master of Public Health program, and he collaborates widely with other investigators on qualitative projects.

Dr. Clapp received his PhD in Anthropology and Master of Public Health from the University of Pennsylvania.