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Clinical Ethics and the Road Less Taken: Mapping the Future by Tracking the Past

Published online by Cambridge University Press:  01 January 2021

Extract

Clinical ethics, like the broader field of bioethics from which it emerged, is at a critical crossroads in its development, with conflicting paths ahead. It can either claim its distinctive place in the clinical arena, insisting unapologetically on certain minimal standards of professional training, practice and competence, addressing head on debates about various models of and methodological approaches to consultation, and establishing a shared vision of the purpose and meaning of the enterprise of clinical ethics itself. Or, it can devolve into a hobby that untrained, albeit interested, and generally well intentioned individuals can dabble in for fun or even profit, as they see fit, and without regard to the deep history and rich disciplinary roots of the field, the serious debates in the academic literature of bioethics, the foundational case histories and legal theories, or even any sense of professional accountability.

Type
Article
Copyright
Copyright © American Society of Law, Medicine and Ethics 2004

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References

Fox, E., “Ethics Consultation in U.S. Hospitals: A National Study and Its Implications,” presented at the Annual Meeting of the American Society for Bioethics and Humanities, October 2002.Google Scholar
Teel, K., “The Physician's Dilemma: A Doctor’s View: What the Law Should Be,” Baylor Law Review 27 (1975): 668–69.Google Scholar
While the literature documents discussion of this point, see for example, Swenson, M. D. Miller, R. B., “Ethics Case Review in Health Care Institutions: Committees, Consultants, or Teams?” Archives of Internal Medicine 152 (1992): 694–97, there is no consensus on which model might be preferred. In fact, the Core Competencies for Health Care Ethics Consultation, a report of the American Society for Bioethics and Humanities, arguably the most recent consensus document bearing on this point explicitly chose to not take a position on whether ethics consultation is best done by individuals, teams, or committees. See American Society for Bioethics and Humanities, Core Competencies for Health Care Ethics Consultation (Glenview, Illinois: American Society for Bioethics and Humanities, 1998).CrossRefGoogle Scholar
Schneiderman, L. J. et al. , “Effect of Ethics Consultations on Nonbeneficial Life-Sustaining Treatments in the Intensive Care Setting,” Journal of the American Medical Association 290 (2003): 1166–72.CrossRefGoogle Scholar
Churchill, L. R., “The Ethicist in Professional Education,” The Hastings Center Report (1978): 1315 and Barnard, D., “Reflections of a Reluctant Clinical Ethicist: Ethics Consultation and the Collapse of Critical Distance,” Theoretical Medicine 13 (1992): 1522.CrossRefGoogle Scholar
Zoloth-Dorfman, L. Rubin, S. B., “Navigators and Captains: Expertise in Clinical Ethics Consultation,” Theoretical Medicine 18 (1997): 421–32.CrossRefGoogle Scholar
Urban Walker, M., “Keeping Moral Space Open: New Images of Ethics Consulting,” Hastings Center Report 23 (1993): 3340.CrossRefGoogle Scholar
Freedman, B., “Where Are The Heroes of Bioethics?” Journal of Clinical Ethics 7 (Winter 1996): 297–99.Google Scholar
Loftus, E., “Creating False Memories,” Scientific American 277 (1977): 7075.CrossRefGoogle Scholar
We have called for the discipline’s attention to this issue in Rubin, S. B. Zoloth, L., Margin of Error The Ethics of Mistakes in the Practice of Medicine (Hagerstown, Maryland: University Publishing Group, 2000).Google Scholar
See most recently the American Society for Bioethics and Humanities, Core Competencies for Health Care Ethics Consultation (Glenview, Illinois: American Society for Bioethics and Humanities, 1998).Google Scholar