Taxonomizing Views of Clinical Ethics Expertise

Our aim in this article is to bring some clarity to the clinical ethics expertise debate by critiquing and replacing the taxonomy offered by the Core Competencies report. The orienting question for our taxonomy is: Can clinical ethicists offer justified, normative recommendations for active patient cases? Views that answer “no” are characterized as a “negative” view of clinical ethics expertise and are further differentiated based on why they think ethicists cannot give justified normative recommendations and what they think ethicists can offer, if they cannot offer recommendations. Views that answer “yes” to the orienting question are characterized as a “positive” view of clinical ethics expertise. Positive views are distinguished according to four additional questions. First, how are those recommendations generated? Second, what is the nature of the recommendations? Third, we ask, how are the recommendations justified? And finally, how are the recommendations communicated?