Ethics Consultation: From Theory to Practice / Edition 1

by Mark P. Aulisio

Overview

In the Clinical Setting, physicians encounter a host of perplexing ethical problems, oftert complicated by conflicting perspectives and the need to make immediate decisions. In this volume, bioethicists provide a nuanced, in-depth approach to the difficult issues involved in bioethics consultation. Addressing the needs of researchers, clinicians, and other health professionals on the front lines of bioethics practice, the contributors focus primarily on practical concerns -- whether ethics consultation is best done by individuals, teams, or committees; how an ethics consult service should be structured; the need for institutional support; and techniques and programs for educating and training staff -- without neglecting more theoretical considerations, such as the importance of character or the viability of organizational ethics.

Product Details

ISBN-13:	2900801871657
Publisher:	Johns Hopkins University Press
Publication date:	05/08/2003
Series:	Bioethics
Edition description:	New Edition
Pages:	240
Product dimensions:	6.00(w) x 1.25(h) x 9.00(d)

About the Author

Mark P. Aulisio, Ph.D., is an Assistant Professor of Bioethics and Director of the Clinical Ethics Program at MetroHealth Medical Center at Case Western Reserve University. Robert M. Arnold, M.D., is Professor and Leo H. Criep Chair in Patient Care in the Department of Medicine of the University of Pittsburgh School of Medicine, Associate Director for Education at the Center for Bioethics and Health Law, and Chief of the Section of Palliative Care and Medical Ethics.Stuart J. Youngner, M.D., is Chairman of the Department of Bioethics and Susan B. Watson Professor of Bioethics, and Professor of Psychiatry at Case Western Reserve University School of Medicine

Table of Contents

	List of Contributors	ix
	Preface	xi
I	Foundational and Theoretical Questions	1
1.	Meeting the Need: Ethics Consultation in Health Care Today	3
	Is There a Need?	5
	Values and Medical Decision Making	8
	Convergence in the Clinic: The Need for Ethics Consultation	8
	Finding an Appropriate Approach to Ethics Consultation	9
	Conclusion	19
2.	Can Ethics Consultation Be Saved? Ethics Consultation and Moral Consensus in a Democratic Society	23
	Ethics Consultation and the Pursuit of the Good	24
	Morality and Democracy	27
	Hazards along the Way	29
	Avoiding Moral Relativism and Spiritual Bankruptcy	31
	Conclusion	34
3.	Character and Ethics Consultation: Even the Ethicists Don't Agree	36
	The Importance of Character for Ethics Consultants	37
	Whose Virtue? Which Character?	45
	Conclusion: "But There Is Some Common Ground"	48
II	Practical Questions	51
4.	Innovative Educational Programs: A Necessary First Step toward Improving Quality in Ethics Consultation	53
	Face-to-Face Educational Programs	57
	Distance Learning	62
	Fellowships, Certificates, and Degree Programs	66
	Continuing Support and Mentoring	66
	Evaluation	67
	Conclusion	67
5.	Techniques for Training Ethics Consultants: Why Traditional Classroom Methods Are Not Enough	70
	Conceptions of Bioethics Consultation	71
	Competencies Required to Serve as an Ethics Facilitator	72
	Training for an Ethics Facilitator	73
	Teaching Facilitation: Knowledge and Skills	77
	Praxis	82
	Conclusion	84
6.	Models for Ethics Consultation: Individual, Team, or Committee?	88
	Individual Consultant	88
	Small-Group Consultation Team	90
	Full Ethics Committee	92
	Contextual and Practical Issues	93
	A Mixed Model	94
	Conclusion	94
7.	The Structure and Process of Ethics Consultation Services	96
	Structures for Ethics Consultation	96
	The Process of Ethics Consultation	99
	Institutional Policy on Ethics Consultation	105
	Legal Cases Naming Ethics Committees or Consultants	105
	Conclusion	117
8.	Institutional Support for Bioethics Committees	121
	Legitimizing the Ethics Consultation Service	122
	Infrastructure Support of the Ethics Consultation Service	123
	Administrative Management of Controversies Caused by Ethics Consultation	125
	Conclusion	128
III	Questions on the Horizon	129
9.	Organizational Ethics: Promises and Pitfalls	131
	The Separation of Clinical and Organizational Ethics	133
	The Structure of Ethics Committees and Consultation Services	135
	The Approach to Organizational Ethics Consultation	140
	Competencies for Organizational Ethics Consultation	143
	Conclusion	145
10.	The Licensing and Certification of Ethics Consultants: What Part of "No!" Was So Hard to Understand?	147
	Who Is a Professional?	149
	Some Practical Difficulties with Licensure and Certification	152
	Some Philosophical Questions Raised by Licensure and Certification	156
	A Temporizing Conclusion to Some Intemperate Arguments	159
Appendix	Core Competencies for Health Care Ethics Consultation: The Report of the American Society for Bioethics and Humanities	165
	Index	211

What People are Saying About This

Bernard Lo

"A very important topic from the leaders in the field."

Susan B. Rubin

"This book is an important and welcome addition to the scholarship in the field. Addressing the current state and future direction of ethics consultation, it offers a thoughtful overview of some of the most important issues currently debated, from foundational theoretical questions to more practical strategic concerns. It makes a substantial contribution to the literature and will certainly be widely read and referenced."

Reading Group Guide

A very important topic from the leaders in the field.

Editorial Reviews

4 Stars! from Doody

"I recommend this book highly both for its practical value and for its reflective discussion on the nuances of clinical ethics."

Ethics and Medicine - R. Henry Williams

"The writers explore theoretical and practical realities of the ethics consultation process, key participants and their character, and theoretical foundations of ethics and values that contribute to ethical decision making in clinical care."

Choice

Reviewer: Thomas C May, Ph.D.(Medical College of Wisconsin Health Policy Institute)
Description: This book offers a set of in-depth essays that examine issues raised by the ASBH Task Force on Core Competencies for Health Care Ethics Consultation. The original Task Force Report is included as an appendix.
Purpose: The purpose is to explore in detail key issues raised in the ASBH Task Force Report concerning ethics consultation. In this, the book provides a valuable analysis of the report itself. This is essential reading for anyone interested in clinical ethics consultation.
Audience: The book is written for a multidisciplinary audience, and avoids unnecessary use of jargon. The authors and editors are among the most respected names in the field.
Features: Individual chapters in the book cover issues pertaining to the need for and justification of ethics consultation; educational, training and character traits important to ethics consultation; how ethics consultation is conducted (team, individual, or committee; structure and process of consultations themselves); and issues on the horizon for ethics consultation. The sections on education and training are particularly valuable for hospitals wishing to set up ethics consultation services.
Assessment: This book is essential reading for anyone interested in ethics consultation. It provides in-depth analysis of key issues by leading figures in the field, and represents a comprehensive discussion raised by the ASBH Task Force. Because the book includes the Task Force Report as an appendix, and because the book itself is organized around issues raised by the task force, it is a complete, self-contained work that should be extremely valuable both for classroom use, and for ethicists and hospitals conducting ethics consultation.

Doody's Review Service

I recommend this book highly both for its practical value and for its reflective discussion on the nuances of clinical ethics.

— R. Henry Williams, MD

Ethics and Medicine

"Excellent basic and practical introduction to the many issues facing the development of clinical ethics consultation."

Bulletin of Medical Ethics

The observations recorded here deserve close study by anyone who contemplates setting up a referral system for medical staff facing ethical dilemmas.

— Peter D. Toon

Journal of the Royal Society of Medicine

"A nuanced, in depth approach to the difficult issues involved in bioethics consultations."

Human Reproduction and Genetic Ethics

"The observations recorded here deserve close study by anyone who contemplates setting up a referral system for medical staff facing ethical dilemmas."

Journal of the Royal Society of Medicine - Peter D. Toon