Regretting Doing the Right Thing: A Defense of Regret in Clinical Ethics Consultation

Abstract: In this paper, I present a case that I encountered in my work as a clinical ethics consultant wherein I was asked to assist in decision-making regarding bilateral above knee amputation in the setting of lower limb ischemia and sepsis for an incapacitated patient whose family was unavailable to consent or refuse on her behalf. I argue that the case sheds light on an important aspect of clinical ethics consultation – regret. Moral theorists have commonly held that regret for one’s past actions involves the constituent thought that “it would have been better if I had acted otherwise.” As a result, many have concluded that it is inappropriate, or in some way irrational, to feel regret when one believes one did the right thing. I argue that the case presented here casts doubt on this view. This patient underwent the amputation, partially due to my recommendation, but she died less than 24 hours after the procedure nonetheless. Reflecting on the case, I believe that the right decision was made. However, I argue that it is also appropriate to feel regret for that decision, and that regret is a necessary, deeply human, response to highly consequential decisions made under conditions of uncertainty. Moreover, I argue that despite being distressing, it is actually desirable that clinical ethicists experience regret in such situations. The paper then explores difficulties disambiguating regret from other phenomena, such as moral distress, and aims to articulate what fitting regret looks like in the context of ethics consultation.