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This volume brings together researchers from different European countries and disciplines who are involved in Clinical Ethics Consultation (CEC). The work provides an analysis of the theories and methods underlying CEC as well a discussion of practical issues regarding the implementation and evaluation of CEC. The first section deals with different possible approaches in CEC. The authors explore the question of how we should decide complex cases in clinical ethics, that is, which ethical theory, approach or method is most suitable in order to make an informed ethical decision. It also discusses whether clinical ethicists should be ethicists by education or rather well-trained facilitators with some ethical knowledge. The second chapter of this book focuses on practical aspects of the implementation of CEC structures. The analysis of experienced clinical ethicists refers to macro and micro levels in both developed and transitional countries. Research on the evaluation of CEC is at the centre of the final chapter of this volume. In this context conceptual as well as empirical challenges with respect to a sound approach to judgements about the quality of the work of CECs are described and suggestion for further research in this area are made. In summary this volumes brings together theorists and healthcare practitioners with expertise in CEC. In this respect the volume serves as good example for a multi- and interdisciplinary approach to clinical ethics which combines philosophical reasoning and empirical research.
28 detailed cases explore the ethical reasoning, professional issues, and the emotional aspects of difficult consultations.
This book provides a robust analysis of the history of clinical ethics, the philosophical theories that support its practice, and the practical institutional criteria needed to become a practicing clinical ethicist. Featuring cases and a step-by-step approach, this book combines knowledge points associated with moral philosophy and medicine with general skill objectives for ethics consultants. The book aids in developing analytic moral reasoning skills for clinical ethicists, fostering the comprehensive education and professional development of clinical ethics consultants. In addition, it offers key components of how an ethics consultation curriculum manifest in an educational venue for clinical ethicists are illustrated. Adaptable and relevant for educating multiple disciplines in health care, this resource enables ethicists to understand the philosophical foundations and practical application of clinical ethics.
In the clinical setting, questions of medical ethics raise a host of perplexing problems, often complicated by conflicting perspectives and the need to make immediate decisions. In this volume, bioethicists and physicians 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.
To our knowledge, no existing book or article describes how to establish and operate a vibrant and sustainable clinical ethics consultation service (ECS) from the ground up. As a result, ECS directors and ethics consultants may be charged with building or reinvigorating and sustaining a high-quality, successful service without sufficient practical guidance on how to plan, implement, and monitor their efforts. This lack of guidance can give rise to problems, including wasted time and effort, as well as misalignments in expectations and goals between hospital administrators and ethics consultants on what constitutes "success" and "failure" in service activities. Toward the goal of providing this much-needed guidance, we describe key considerations and strategies for developing, implementing, and monitoring a high-quality, successful service. It is important to note that in responding to hospital administrators' expectations and establishing a successful service, it is necessary but not sufficient to demonstrate the competence of individual consultants. Thus, some portions of this guide are addressed to the individual or individuals leading an ECS, but many chapters will be useful to anyone engaging in clinical ethics consultation or playing a role in overseeing or otherwise advocating for an ECS. Our focus is on building and sustaining high-quality, successful services in ways that go well beyond the traditional focus on how to conduct an ethics consultation. Specifically, we have chapters and sections devoted to working through a case, mediation skills, and conducting and facilitating family meetings that should be useful for any ethics consultant, particularly individuals who are new to ethics consultation or seasoned consultants who wish to reflect on their practices, but we also have chapters and sections devoted to "selling points to hospital administrators on the value of ECSs," building an ECS infrastructure, launching a service, etc., that are aimed more towards ECS directors, with the goal of providing essential guidance on ECS development and maintenance. Finally, our goal is to be as practical and clinically-oriented as possible by addressing everyday nuts-and-bolts concerns that apply across demographically- and geographically-diverse hospital settings, subject to some individual variation that we will underscore for our readership. In particular, we arrange this guide according to phases of an ECS. Part 1 will focus on planning for an ECS. Part 2 will discuss how to implement an ECS. Part 3 will then conclude with information about how to monitor an ECS once it is established, and how to address common challenges. We believe that much of the advice we provide can be extended to other consultative or hospital services that are based in hospitals, such as palliative medicine, chaplaincy, or social work services. We hope you find this useful!
This instant gold standard title is a major contribution to the field of clinical medical ethics and will be used widely for reference and teaching purposes for years to come. Throughout his career, Mark Siegler, MD, has written on topics ranging from the teaching of clinical medical ethics to end-of-life decision-making and the ethics of advances in technology. With more than 200 journal publications and 60 book chapters published in this area over the course of his illustrious career, Dr. Siegler has become the pre-eminent scholar and teacher in the field. Indeed his work has had a profound impact on a range of therapeutic areas, especially internal medicine, pediatrics, surgery, oncology, and medical education. Having grown steadily in importance the last 30 years, clinical ethics examines the practical, everyday ethical issues that arise in encounters among patients, doctors, nurses, allied health workers, and health care institutions. The goal of clinical ethics is to improve patient care and patient outcomes, and almost every large hospital now has an ethics committee or ethics consultation service to help resolve clinical ethical problems; and almost every medical organization now has an ethics committee and code of ethics. Most significantly, clinical ethics discussions have become a part of the routine clinical discourse that occurs in outpatient and inpatient clinical settings across the country. This seminal collection of 46 landmark works by Dr. Siegler on the topic is organized around five themes of foundational scholarship: restoring and transforming the ethical basis of modern clinical medicine, the doctor-patient relationship, education and professionalism, end-of-life care, and clinical innovation. With introductory perspectives by a group of renowned scholars in medicine, Clinical Medical Ethics: Landmark Works of Mark Siegler, MD explains the field authoritatively and comprehensively and will be of invaluable assistance to all clinicians and scholars concerned with clinical ethics.
This collection addresses whether ethicists, like authorities in other fields, can speak as experts in their subject matter. Though ethics consultation is a growing practice in medical contexts, there remain difficult questions about the role of ethicists in professional decision-making. Contributors examine the nature and plausibility of moral expertise, the relationship between character and expertise, the nature and limits of moral authority, how one might become a moral expert, and the trustworthiness of moral testimony. This volume engages with the growing literature in these debates and offers new perspectives from both academics and practitioners. The readings will be of particular interest to bioethicists, clinicians, ethics committees, and students of social epistemology. These new essays promise to advance discussions in the professionalization and accreditation of ethics consultation.
Professionals in need of such training and bioethicists will be interested.