Abstract
Clinical ethics consultants occasionally encounter unethical and/or unprofessional behavior as part of their normal job functions. In this article, we explore whether resigning (i.e., threatening resignation or resigning) and whistleblowing are acceptable methods ethics consultants can use to address these situations. Per our analysis, whether one considers ethics consultants private or public employees, loyal to their employer or to patients, families, and the public, resigning and whistleblowing are all acceptable, if not obligatory, actions of ethics consultants in certain circumstances. In this article, we analyze salient characteristics of ethics consultation as a profession as they pertain to resignation and whistleblowing in the context of ethics consultation. We also present tentative criteria for when ethics consultants are justified, if not obligated, to resign or blow the whistle.
This is a preview of subscription content, log in via an institution to check access.
Similar content being viewed by others
References
American Society for Bioethics and Humanities. (2014). Code of ethics and professional responsibilities for healthcare ethics consultants. American Society for Bioethics and Humanities.
Arnold, R. M., et al. (2011). Core competencies for healthcare ethics consultation (2nd ed.). American Society for Bioethics and Humanities.
Beauchamp, T. L., & Childress, J. F. (2019). Principles of biomedical ethics (8th ed.). Oxford University Press.
Brody, B., Dubler, N., Blustein, J., Caplan, A., Kahn, J. P., Kass, N., Lo, B., Moreno, J., Sugarman, J., & Zoloth, L. (2002). Bioethics consultation in the private sector. Hastings Center Report, 32(3), 14–20.
Cal. Health & Safety Code § 1278.5 (West 2020).
Callahan, E. S., & Dworkin, T. M. (2000). The state of state whistleblower protection. American Business Law Journal, 38(1), 99–175.
Colo. Rev. Stat. Ann. § 8–2–123 (West 2019).
Cook, A. F., & Hoas, H. (2008). Ethics and rural healthcare: What really happens? What might help? The American Journal of Bioethics, 8(4), 52–56.
Costain v. Sunbury Primary Care, P.A., 2008 ME 142, ¶ 7, 954 A.2d 1051, 1053 (Me. 2008).
Cummins, D. (2002). The professional status of bioethics consultation. Theoretical Medicine and Bioethics, 23(1), 19–43.
Davis, M. (1996). Some paradoxes of whistleblowing. Business & Professional Ethics, 15(1), 3–19.
Dennison v. Pennsylvania Dept. of Corrections, 268 F. Supp. 2d 387, 398 (M.D. Pa. 2003).
Dobel, J. P. (1999). The ethics of resigning. Journal of Policy Analysis and Management, 18(2), 245–263.
Dubler, N. N., & Liebman, C. B. (2011). Bioethics mediation: A guide to shaping shared solutions. Vanderbilt University Press.
Fiester, A. (2015). Contentious conversations: Using mediation techniques in difficult clinical ethics consultations. Journal of Clinical Ethics, 26(4), 324–330.
Fletcher, J. C., & Boverman, M. (1996). Heroism, martyrs, and other choices. The Journal of Clinical Ethics, 7(4), 301–305.
Fox, E., Bottrell, M. M., Berkowitz, K. A., Chanko, B. L., Foglia, M. B., & Pearlman, R. A. (2010). IntegratedEthics: An innovative program to improve ethics quality in health care. Innovation Journal, 15(2), 1–36.
Fox, E., Berkowitz, K. A. Chanko, B. L., & Powell, T. (n.d.). Ethics consultation: Responding to ethics questions in health care. National Center for Ethics in Health Care: Veterans Health Administration.
Frader, J. E. (1992). Political and interpersonal aspects of ethics consultation. Theoretical Medicine, 13, 31–44.
Furrow, L., Arnold, R. M., & Parker, L. S. (1993). Preventative ethics: Expanding the horizons of clinical ethics. Journal of Clinical Ethics, 4(4), 287–294.
Gasparetto, A., Jox, R. J., & Picozzi, M. (2018). The notion of neutrality in clinical ethics consultation. Philosophy, Ethics, and Humanities in Medicine, 13(1), 1–7.
Harper v. Univ. of Louisville, 559 S.W.3d 796, 811 (Ky. 2018).
Health Insurance Portability and Accountability Act of 1996 (HIPAA) (Health Insurance Portability and Accountability Act, PL.104–191, August 21, 1996, 110 Stat. 1936).
Kuperberg, E. (2019). Clinical ethics needs assessment. Adapting clinical ethics to a population health program. HEC Forum, 32(1), 21–32.
Lujan v Defenders of Wildlife, 504 US 555, 559–62 (1992).
MacDougall, D. R. (2014). Whistleblowing and the bioethicist’s public obligations. Cambridge Quarterly of Healthcare Ethics, 23, 431–442.
Me. Rev. Stat. tit. 26, § 833 (West 2021).
N.Y. Lab. Law § 741 (McKinney’s 2003).
N.Y. Lab. Law § 740 (McKinney’s 2003).
Nelson, C. (2012). The familiar foundation and the fuller sense: Ethics consultation and narrative. The Permanente Journal, 16(2), 60–63.
Orlowski, J. P., Hein, S., Christensen, J. A., Meinke, R., & Sincich, T. (2006). Why doctors use or do not use ethics consultation. Journal of Medical Ethics, 32(9), 499–503.
Pa. Stat. Ann. § 1422(West 2014).
Pa. Stat. Ann. §1423 (West 2014).
Pennsylvania Whistleblower Act, 43 Pa. Stat. Ann. § 1422 (West 2014).
Pope, T. M. (2011). Legal briefing: Healthcare ethics committees. The Journal of Clinical Ethics, 22(1), 74–93.
Sarbanes-Oxley Act of 2010, 18 U.S.C. § 1514A (2010).
Schumann, J. H., & Alfandre, D. (2008). Clinical ethics decision making: The four topics approach. Seminars in Medical Practice, 11, 36–42.
Scofield, G. R. (2008). What is medical ethics consultation? Journal of Law, Medicine, & Ethics, 36(1), 95–118.
Sherwin, S., & Baylis, F. (2003). The feminist health care ethics consultant as architect and advocate. Public Affairs Quarterly, 17(2), 141–158.
Smith, M. L., & Weise, K. L. (2007). The goals of ethics consultation: Rejecting the role of “ethics police.” The American Journal of Bioethics, 7(2), 42–44.
Tarzian, A. J., Wocial, L. D., & ASBH Clinical Ethics Consultation Affairs Committee. (2015). A code of ethics for health care ethics consultants: Journey to the present and implications for the field. The American Journal of Bioethics, 15(5), 38–51.
Tides v. The Boeing Co., 644 F.3d 809, 815 (9th Cir. 2011).
Walker, M. U. (1993). Keeping moral space open: New images of ethics consulting. Hastings Center Report, 23(2), 33–40.
Whistleblower Protection Act of 1989, 5 U.S.C. § 2302(b)(8) (1989).
Whistleblower Act, Ky. Rev. Stat. Ann. § 61.102 (West 2012).
Workforce Dev. Cabinet v. Gaines, 276 S.W.3d 789, 793 (Ky. 2008).
Acknowledgements
The authors would like to thank the following for their invaluable help, comments, and criticisms: Marion Danis, Yosef Kuperman, and Anita Tarzian. The authors would like to especially thank Melissa Bottrell for her exceptional feedback, resources, and help in general on this article.
Author information
Authors and Affiliations
Ethics declarations
Conflict of interest
The authors have no conflict of interest to disclose.
Additional information
Publisher's Note
Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.
Rights and permissions
About this article
Cite this article
Kuperberg, E., Dauber, M.S. Addressing Clinical Misconduct: Resigning and Whistleblowing in Clinical Ethics Consultation. HEC Forum 35, 161–183 (2023). https://doi.org/10.1007/s10730-021-09459-3
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s10730-021-09459-3