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Courtenay R. Bruce [21]Courtenay Rose Bruce [1]
  1.  8
    Developing, Administering, and Scoring the Healthcare Ethics Consultant Certification Examination.Courtenay R. Bruce, Chris Feudtner, Daniel Davis & Mary Beth Benner - 2019 - Hastings Center Report 49 (5):15-22.
    In November 2018, the practice of health care ethics consultation crossed a major threshold when 138 candidates took the inaugural Healthcare Ethics Consultant Certification Examination. This accomplishment, long in the making, has had and continues to have both advocates and critics. The Healthcare Ethics Consultant Certification Commission, a functionally autonomous body created and funded by the American Society for Bioethics and Humanities, was charged with overseeing creation of the certification process, developing the exam, and formulating certification standards and policies to (...)
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  2.  41
    A Systematic Review of Activities at a High-Volume Ethics Consultation Service.Courtenay R. Bruce, Martin L. Smith, Sabahat Hizlan & Richard R. Sharp - 2011 - Journal of Clinical Ethics 22 (2):151-164.
    We describe the ethics consultation service (ECS) at the Cleveland Clinic and report on its activities over a 24-month period in which 478 consultations were performed. To our knowledge, this is the largest case series of ethics consultations reported to date. Established more than 25 years ago, the ECS at the Cleveland Clinic is staffed by multiple consultants with advanced training in bioethics. Several of these ethicists work closely with specialized clinical units and research departments, where they participate in multidisciplinary (...)
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  3.  66
    An Embedded Model for Ethics Consultation: Characteristics, Outcomes, and Challenges.Courtenay R. Bruce, Adam Peña, Betsy B. Kusin, Nathan G. Allen, Martin L. Smith & Mary A. Majumder - 2014 - AJOB Empirical Bioethics 5 (3):8-18.
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  4.  57
    Practical Guidance for Charting Ethics Consultations.Courtenay R. Bruce, Martin L. Smith, Olubukunola Mary Tawose & Richard R. Sharp - 2014 - HEC Forum 26 (1):79-93.
    It is generally accepted that appropriate documentation of activities and recommendations of ethics consultants in patients’ medical records is critical. Despite this acceptance, the bioethics literature is largely devoid of guidance on key elements of an ethics chart note, the degree of specificity that it should contain, and its stylistic tenor. We aim to provide guidance for a variety of persons engaged in clinical ethics consultation: new and seasoned ethics committee members who are new to ethics consultation, students and trainees (...)
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  5.  6
    The Work of ASBH’s Clinical Ethics Consultation Affairs Committee: Development Processes Behind Our Educational Materials.George E. Hardart, Katherine Wasson, Ellen M. Robinson, Aviva Katz, Deborah L. Kasman, Liza-Marie Johnson, Barrie J. Huberman, Anne Cordes, Barbara L. Chanko, Jane Jankowski & Courtenay R. Bruce - 2018 - Journal of Clinical Ethics 29 (2):150-157.
    The authors of this article are previous or current members of the Clinical Ethics Consultation Affairs (CECA) Committee, a standing committee of the American Society for Bioethics and Humanities (ASBH). The committee is composed of seasoned healthcare ethics consultants (HCECs), and it is charged with developing and disseminating education materials for HCECs and ethics committees. The purpose of this article is to describe the educational research and development processes behind our teaching materials, which culminated in a case studies book called (...)
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  6.  14
    Building a Vibrant Clinical Ethics Consultation Service.Courtenay R. Bruce, Jocelyn Lapointe, Peter Koch, Katarina Lee & Savitri Fedson - 2018 - The National Catholic Bioethics Quarterly 18 (1):29-38.
    The authors work in a variety of clinical ethics consultation services (CECSs) that employ a range of methods and approaches. This article discusses the approach to ethics consultation at the Center for Medical Ethics and Health Policy at Baylor College of Medicine and describes the development and transformation of the authors’ CECSs. It discusses how one CECS shifted from a nascent program with only fifty consultations a year to a vibrant, heavily staffed service with five hundred ethics consultations a year.
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  7.  16
    Why Families Get Angry: Practical Strategies for Clinical Ethics Consultants to Rebuild Trust Between Angry Families and Clinicians in the Critical Care Environment.Ashley L. Stephens, Courtenay R. Bruce, Andrew Childress & Janet Malek - 2019 - HEC Forum 31 (3):201-217.
    Developing a care plan in a critical care context can be challenging when the therapeutic alliance between clinicians and families is compromised by anger. When these cases occur, clinicians often turn to clinical ethics consultants to assist them with repairing this alliance before further damage can occur. This paper describes five different reasons family members may feel and express anger and offers concrete strategies for clinical ethics consultants to use when working with angry families acting as surrogate decision makers for (...)
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  8.  10
    Not There Yet: Evaluating Clinical Ethics Consultation in an Accountability Culture.Courtenay R. Bruce & Trevor M. Bibler - 2016 - American Journal of Bioethics 16 (3):46-48.
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  9.  9
    Moral Distress: Professional Integrity as the Basis for Taxonomies.Tessy Ann Thomas & Courtenay Rose Bruce - 2016 - American Journal of Bioethics 16 (12):11-13.
    There has been an ongoing appeal in the bioethics literature for a broader understanding and conceptual clarity of the phenomenon of moral distress. Several authors argue that greater conceptual cl...
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  10.  44
    “Systematizing” Ethics Consultation Services.Courtenay R. Bruce, Margot M. Eves, Nathan G. Allen, Martin L. Smith, Adam M. Peña, John R. Cheney & Mary A. Majumder - 2015 - HEC Forum 27 (1):35-45.
    While valuable work has been done addressing clinical ethics within established healthcare systems, we anticipate that the projected growth in acquisitions of community hospitals and facilities by large tertiary hospitals will impact the field of clinical ethics and the day-to-day responsibilities of clinical ethicists in ways that have yet to be explored. Toward the goal of providing clinical ethicists guidance on a range of issues that they may encounter in the systematization process, we discuss key considerations and potential challenges in (...)
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  11.  15
    A Risky Recommendation.Trevor Bibler & Courtenay R. Bruce - 2015 - American Journal of Bioethics 15 (1):70-72.
  12.  31
    The “Permanent” Patient Problem.Courtenay R. Bruce & Mary A. Majumder - 2014 - Journal of Law, Medicine and Ethics 42 (1):88-92.
    Patients who enter the health care system for acute care may become “permanent” patients of the hospital when a lack of resources precludes discharge to the next level of post-acute care. Legal, professional, and ethical norms prohibit physician and acute care hospital “dumping” of these patients. However, limitless use of hospital resources for indefinite stays is untenable. In the absence of hospital policy addressing this specific issue, the availability of financial support will be determined by health care professionals' willingness to (...)
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  13.  20
    The “Permanent” Patient Problem.Courtenay R. Bruce & Mary A. Majumder - 2014 - Journal of Law, Medicine and Ethics 42 (1):88-92.
    Patients who enter the health care system for acute care may become “permanent” patients of the hospital when a lack of resources precludes discharge to the next level of post-acute care. The care of these patients contributes to the rising costs of health care and will remain largely unaffected by the Affordable Care Act. For example, some resources may be available for treatment of undocumented persons, but Medicaid enrollment is unavailable for this population. Even where patients have access to Medicaid, (...)
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  14.  7
    Consultations across Languages.Trevor Bibler, Adam Peña & Courtenay R. Bruce - 2015 - Hastings Center Report 45 (3):13-14.
    Lei, a twenty‐seven‐year‐old Mandarin speaker, visits the United States seeking curative treatments for his acute myeloid leukemia. His mother, Hua, has traveled with him. Neither she nor Lei speak English, and the hospital does not have an onsite professional Mandarin‐speaking interpreter. Using a professional interpreter over the phone, Lei's oncologist, Dr. Branson, attempts to initiate a face‐to‐face goals‐of‐care conversation with Hua as the surrogate decision‐maker. Dr. Branson explains that Lei has “only weeks to months to live” and recommends initiating comfort‐care‐only (...)
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  15.  25
    A Qualitative Exploration of a Clinical Ethicist’s Role and Contributions During Family Meetings.Courtenay R. Bruce, Trevor M. Bibler, Adam M. Pena & Betsy Kusin - 2016 - HEC Forum 28 (4):283-299.
    Despite the interpersonal nature of family meetings and the frequency in which they occur, the clinical ethics literature is devoid of any rich descriptions of what clinical ethicists should actually be doing during family meetings. Here, we propose a framework for describing and understanding “transitioning” facilitation skills based on a retrospective review of our internal documentation of 100 consecutive cases wherein a clinical ethicist facilitated at least one family meeting. The internal documents were analyzed using qualitative methodologies, i.e., “codes”, to (...)
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  16.  30
    Bad Words.Courtenay R. Bruce, Martin L. Smith, Adam M. Peña & Mary A. Majumder - 2014 - Hastings Center Report 44 (2):13-14.
    The clinical ethicist met with Ms. H to clarify what information she wants and does not want to know. First, she wants to receive any treatment that could prolong her life, regardless of how the treatment affects her ability to engage in activities of daily living. Second, she wants to be included in the decision‐making process as much as possible, as long as clinicians use only “positive” language. Ms. H considers the words “dying,” “chemotherapy,” “radiation,” and “cancer” to be “bad (...)
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  17.  12
    Emergent Ethics Consultation Requested From the Operating Room.Courtenay R. Bruce - 2015 - American Journal of Bioethics 15 (1):69-69.
  18.  11
    Lethal Injections: Legal Extensions and Implications of “Do No Harm”.Courtenay R. Bruce - 2008 - American Journal of Bioethics 8 (10):58-59.
  19.  2
    Cultivating Administrative Support for a Clinical Ethics Consultation Service.Amy McGuire, Janet Malek, Ashley Stephens, Mary A. Majumder & Courtenay R. Bruce - 2016 - Journal of Clinical Ethics 27 (4):341-351.
    Hospital administrators may lack familiarity with what clinical ethicists do (and do not do), and many clinical ethicists report receiving inadequate financial support for their clinical ethics consultation services (CECSs). Ethics consultation is distinct in that it is not reimbursable by third parties, and its financial benefit to the hospital may not be quantifiable. These peculiarities make it difficult for clinical ethicists to resort to tried-and-true outcome-centered evaluative strategies, like cost reduction or shortened length of stay for patients, to show (...)
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  20.  8
    Same Goal, Different Path.Adam Peña, Courtenay R. Bruce & Mary A. Majumder - 2014 - American Journal of Bioethics 14 (1):23-24.
    In their article “Structuring a Written Examination to Assess ASBH Health Care Ethics Consultation Core Competencies” (2014), White, Jankowski, and Shelton argue that a written examination to evalu...
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  21.  22
    “In Love With Easeful Death:” Review of the Film How to Die in Oregon 1. [REVIEW]Courtenay R. Bruce - 2012 - American Journal of Bioethics 12 (12):66-67.