Berger and Miller argue that cultural competency as an educational tool for physicians-in-training fails to address structural inequality and systemic oppression. Instead, it focuses on “cul...

We reject the concept of a default option of withdrawal as proposed by Syltern and colleagues, and will outline here potential consequences on parental trust, particularly in historically marginali...

We argue for the addition of trauma informed awareness, training, and skill in clinical ethics consultation by proposing a novel framework for Trauma Informed Ethics Consultation (TIEC). This approach expands on the American Society for Bioethics and Humanities (ASBH) framework for, and key insights from feminist approaches to, ethics consultation, and the literature on trauma informed care (TIC). TIEC keeps ethics consultation in line with the provision of TIC in other clinical settings. Most crucially, TIEC (like TIC) is systematically sensitive (...) to culture, history, difference, power, social exclusion, oppression, and marginalization. By engaging a neonatal intensive care ethics consult example, we define our TIEC approach and illustrate its application. Through TIEC we argue it is the role of ethics consultants to not only hold open moral spaces, but to furnish them in morally habitable ways for all stakeholders involved in the ethics consultation process, including patients, surrogates, and practitioners. (shrink)

This case raises questions of what “trauma-informed care” (TIC) means to the medical team caring for Maurice and how they embrace a TIC approach. There are established principles of trauma-informed...

This paper responds to a proposal for an intersectional approach to the clinical encounter between patient and medical provider. We agree that an intersectional framework offers new insights and information in the clinical encounter. Intersectionality involves awareness of the physician-patient dynamic, and understanding the various privileges and disadvantages of all parties involved, at a micro and macroscopic level. Yet, this analysis alone is insufficient to aid in the clinical encounter and risks harm. We worry about a clinician making assumptions about (...) her patient’s race, gender, economic status, and how these influence the patient’s own views of her life and health. We argue that a narrative supplement is a necessary element of intersectional clinical encounters. Prioritizing patient narrative curtails assumptions, builds trust, and improves care. (shrink)

We are grateful for the excellent and incisive commentaries on our paper “Trauma Informed Ethics Consultation” (Lanphier and Anani 2022). It is heartening to see most commentators agree with why cl...

En la antigüedad, en la era axial, tiene lugar la madurez del espíritu y del intelecto y la generalización de la escritura. Entonces la religión, que tenía la forma del rito, de la ley y de la doctrina, adopta la forma del culto interior.

We read with interest Lanphier and Anani’s manuscript on trauma-informed ethics consultation. Their model rightly integrates trauma-informed principles within the ethics c...

Elizabeth Lanphier and Uchenna E. Anani provide a powerful argument for the value of a trauma-informed approach to the ethics consultation, which acknowledges the perspectives of all stakeho...

Not only is deception commonplace in medical encounters, according to Christopher Meyers (2021), but the clinical ethicist might have moral obligations to support and even enact deception. Descriptively Meyers is right that there are “opportunistic, self-interested and benevolent reasons” for deception through omission and commission in clinical medicine. But it is possible to retain this premise while rejecting the normative conclusion that the clinical ethicist “should sometimes be an active participant in the deception of patients and families.” One reason to (...) reject the normative conclusion is its incompatibility with providing trauma informed ethics consultation (TIEC). In the TIEC framework I developed with Uchenna Anani, we defend the integration of trauma informed care (TIC) into ethics consultation (Lanphier and Anani 2021). While ethicists narrowly attend to the question and scope of the ethics consults made to them, doing so in alignment with trauma informed principles is tantamount to providing good ethics consultation. According to Meyers, the clinical ethicist is an “advocate for the best ethical choices.” The best ethical choices are also trauma informed ones. (shrink)