Reviewer: David Thomasma, PhD (Loyola University Medical Center)
Description: This is a book about clinical ethics consultation by two practitioners who together have done more than 700 consultations. There is not another authoritative book like it. Practical rather than theoretical in scope, the book addresses strategies for conducting consultations, relating to patients at the bedside, investigating the ethical issues, making recommendations, following up on cases, and keeping records. Chapters include issues such as the need for training, the skills needed, the problem of certification, how to set up a practice, financial compensation and billing, and the relation of the consultant to committees, particularly ethics committees. The authors include reflections about learning clinical ethics and education of committees, hospital staff, and the general public about issues that arise.
Purpose: The purpose is to help ethics consultants improve their conscious assessment of their work, both how they go about it and its legitimacy for patients, health care providers, and hospitals. The orientation is primarily on clinical care of patients, because the goal of such consultations is always aimed to improve patient care. Other ethics consultants might work to develop institutional policies. Although that is touched on in the book, it is not the primary goal of the authors.
Audience: The book is aimed at the practitioner in bioethics in a clinical setting.
Features: Special features include the use of cases to illustrate the work of an ethics consultant, drawing the reader along as the case unfolds. The last part of the book includes an appendix containing a set of cases to illustrate clinical ethics problems such as treatment refusals, do-not-resuscitate orders, advance directives, uncertain patient proxies, decisional capacity, and doing more for the patient. An annotated bibliography about ethics consultation is also very helpful. There is a brief index.
Assessment: This is an outstanding book, reflecting the experience and commitment of the authors to honest and critical examination of their roles as ethics consultants. It will be useful to ethics consultants and ethics committees in hospitals, nursing homes, and other health care institutions.
This is a book about clinical ethics consultation by two practitioners who together have done more than 700 consultations. There is not another authoritative book like it. Practical rather than theoretical in scope, the book addresses strategies for conducting consultations, relating to patients at the bedside, investigating the ethical issues, making recommendations, following up on cases, and keeping records. Chapters include issues such as the need for training, the skills needed, the problem of certification, how to set up a practice, financial compensation and billing, and the relation of the consultant to committees, particularly ethics committees. The authors include reflections about learning clinical ethics and education of committees, hospital staff, and the general public about issues that arise. The purpose is to help ethics consultants improve their conscious assessment of their work, both how they go about it and its legitimacy for patients, health care providers, and hospitals. The orientation is primarily on clinical care of patients, because the goal of such consultations is always aimed to improve patient care. Other ethics consultants might work to develop institutional policies. Although that is touched on in the book, it is not the primary goal of the authors. The book is aimed at the practitioner in bioethics in a clinical setting. Special features include the use of cases to illustrate the work of an ethics consultant, drawing the reader along as the case unfolds. The last part of the book includes an appendix containing a set of cases to illustrate clinical ethics problems such as treatment refusals, do-not-resuscitate orders, advance directives, uncertain patientproxies, decisional capacity, and doing more for the patient. An annotated bibliography about ethics consultation is also very helpful. There is a brief index. This is an outstanding book, reflecting the experience and commitment of the authors to honest and critical examination of their roles as ethics consultants. It will be useful to ethics consultants and ethics committees in hospitals, nursing homes, and other health care institutions.
