The Ethical Dimension of Burn Care

Optimal care of the patient with severe burns is infused with technological innovation, clinical sophistication, and the application of evidence-based knowledge. It is also a moral activity requiring rigorous attention to the ethical principles and values that constitute the practice of medicine. In providing optimal care, healthcare providers make difficult decisions that fundamentally affect the rights and well-being of these exquisitely vulnerable patients. At times, clinical decision-making reveals conflicts and disagreements about a patient's best interests or quality of life. We argue that these disagreements are best resolved through ethical dialogue. Ethical dialogue is the means by which clinicians examine the full range of our ethical responsibilities to others, drawing on principles of trust, autonomy, dignity, beneficence, and care. Ethical dialogue fosters a sense of moral agency and humanistic inquiry among the members of the team. A seven-step framework depicting a dialogical approach to ethical decision-making is provided.