After many policy attempts to tackle the persistent rise in the costs of health care, physicians are increasingly seen as potentially effective resource stewards. Frameworks including the quadruple aim, value-based health care and choosing wisely underline the importance of positive engagement of the health care workforce in reinventing the system–paving the way to real affordability by defining the right care. Current programmes focus on educating future doctors to provide ‘high-value, cost-conscious care’ (HVCCC), which proponents believe is the future of sustainable (...) medical practice. Such programmes, which aim to extend population-level allocation concerns to interactions between an individual doctor and patient, have generated lively debates about the ethics of expanding doctors’ professional accountability. To empirically ground this discussion, we conducted a qualitative interview study to examine what happens when resource stewardship responsibilities are extended to the consulting room. Attempts to deliver HVCCC were found to involve inevitable trade-offs between benefits to the individual patient and (social) costs, medical uncertainty and efficiency, and between resource stewardship and trust. Physicians reconcile this by justifying good-value care in terms of what is in the best interest of individual patients–redefining the currency of value from monetary costs to a patient’s quality of life, and cost-conscious care as reflective medical practice. Micro-level resource stewardship thus becomes a matter of working reflexively and reducing wasteful forms of care, rather than of making difficult choices about resource allocation. (shrink)

Multinational corporations (MNCs) have brought attention to the challenges of business ethics in intercultural settings. A lack of understanding regarding cultural pluralism in business ethics education has motivated some scholars to consider a broader lens, one that recognizes the influence of religion (Spalding and Franks 2012). Management awareness of the similarities and differences that stem from deeply held beliefs is essential, as unstated thoughts and feelings caninfluence starting assumptions, even before ethical decision-making processes begin. If deeply entrenched cultural traditions and (...) religious values remain implicit and/or misunderstood, collaborative efforts may be derailed due to an inadvertent lack of respect and understanding. Because many Westerners remain unfamiliar with Muslim-based beliefs, the authors advance business ethics education by offering an overview of business practices in the Middle East. A modeland exercise are presented as tools to promote awareness of cultural perspectives. This platform for understanding will help adult learners see how their personal origins can shape and influence management thought. (shrink)

Phenomenology has been adapted for use in qualitative health research, where it’s often used as a method for conducting interviews and analyzing interview data. But how can phenomenologists study subjects who cannot accurately reflect upon or report their own experiences, for instance, because of a psychiatric or neurological disorder? For conditions like these, qualitative researchers may gain more insight by conducting observational studies in lieu of, or in conjunction with, interviews. In this article, we introduce a phenomenological approach to conducting (...) this kind of observational research. The approach relies on conceptual grounding to focus a study on specific aspects of the participants’ experiences. Moreover, the approach maintains the openness to novel discoveries that qualitative research requires while also providing a structured framework for data collection and analysis. To illustrate its practical application, we use examples of hemispatial neglect—a neurologic disorder in which patients characteristically lack awareness of their own illness and bodily capacities. However, the approach that we describe can be applied more broadly to the study of complex illness experiences and other experiential alterations. (shrink)

Is the Miranda warning, which lets an accused know of the right to remain silent, more about procedural fairness or about the conventions of speech acts and silences? Do U.S. laws about Native Americans violate the preferred or traditional "silence" of the peoples whose religions and languages they aim to "protect" and "preserve"? In Just Silences, Marianne Constable draws on such examples to explore what is at stake in modern law: a potentially new silence as to justice.Grounding her claims (...) about modern law in rhetorical analyses of U.S. law and legal texts and locating those claims within the tradition of Nietzsche, Heidegger, and Foucault, Constable asks what we are to make of silences in modern law and justice. She shows how what she calls "sociolegal positivism" is more important than the natural law/positive law distinction for understanding modern law. Modern law is a social and sociological phenomenon, whose instrumental, power-oriented, sometimes violent nature raises serious doubts about the continued possibility of justice. She shows how particular views of language and speech are implicated in such law.But law--like language--has not always been positivist, empirical, or sociological, nor need it be. Constable examines possibilities of silence and proposes an alternative understanding of law--one that emerges in the calling, however silently, of words to justice. Profoundly insightful and fluently written, Just Silences suggests that justice today lies precariously in the silences of modern positive law. (shrink)

In this book, Marianne Moyaert develops a new interreligious appropriation of Paul Ricoeur’s hermeneutical philosophy. Viewed in context of his philosophical, anthropological, and ethical work, Ricoeur’s fragmentary reflections on the encounters between religions provide insights on global cooperation practices and religious identity concerns.

During the last decades several tools have been developed to anticipate the future impact of new and emerging technologies. Many of these focus on ‘hard,’ quantifiable impacts, investigating how novel technologies may affect health, environment and safety. Much less attention is paid to what might be called ‘soft’ impacts: the way technology influences, for example, the distribution of social roles and responsibilities, moral norms and values, or identities. Several types of technology assessment and of scenario studies can be used to (...) anticipate such soft impacts. We argue, however, that these methods do not recognize the dynamic character of morality and its interaction with technology. As a result, they miss an important opportunity to broaden the scope of social and political deliberation on new and emerging technologies.In this paper we outline a framework for building scenarios that enhance the techno-moral imagination by anticipating how technology, morality and their interaction might evolve. To show what kind of product might result from this framework, a scenario is presented as an exemplar. This scenario focuses on developments in biomedical nanotechnology and the moral regime of experimenting with human beings. Finally, the merits and limitations of our framework and the resulting type of scenarios are discussed. (shrink)

L’analyse lexicographique des termes employés par les auteurs latins et grecs pour décrire le processus décisionnel qui aboutit au vote des sénatus-consultes, dans la Rome républicaine, est un moyen de dévoiler les éléments de la culture politique de l’élite chargée des affaires publiques. En mettant en lumière la centralité de la notion de sententia, elle permet une déconstruction des lieux communs de la description institutionnelle habituelle et une approche anthropologique de la fonction de sénateur.

Neuropalliative care developed to address the needs of patients living with life‐limiting neurologic disease. One critical consideration is that disease‐related changes to cognition, communication, and function challenge illness experiences and care practices. We conducted an ethnography to understand neuropalliative care as a phenomenon; how it was experienced, provided, conceptualized. Personhood served as our conceptual framework; with its long philosophical history and important place in nursing theory, we examined the extent to which it captured neuropalliative experiences and concerns. Personhood contextualized complex (...) losses, aligning the impact of functional and relational changes. Cognition, communication, and functional alterations stretched conceptions of personhood, insinuating it can be relational, fluid, adaptive. Although normative conceptions of personhood guided research and decision‐making, ethical considerations suggested personhood could be transformed, remade. We consider the implications of our findings through three themes. First, we examine how literature on illness experience fails to integrate the realities of people living with and dying from neurologic disease; we counter this by interrogating the concept of experience. Second, we turn to Ricoeur's work on recognition to illuminate relational conceptions of personhood to inform care practices. Finally, we reflect on how personhood can bridge the gap left by functional changes, enhance relational engagement, and promote dignity at the end of life. (shrink)

French cultural theorist and urbanist Paul Virilio is best known for his writings on media, technology, and architecture. Gathered here in _A Winter’s Journey _are four remarkable conversations in which Virilio and architectural writer Marianne Brausch look at a twentieth century characterized by enormous technological acceleration and by technocultural accidents of barbarism and horror. The dialogues in _A Winter_’_s Journey—_structured loosely around the dates 1940, 1950, 1960, and 1980—chart Virilio’s intimate intellectual biography, from his childhood lived against the unstable (...) backdrop of a heavily bombed, wartime Nantes to maturity in a crisis space that is neither entirely militarized nor yet fully civilian, but somewhere between the two. In the course of these conversations, Virilio and Brausch ultimately find hope that in understanding the events of the last century and the cultural responses spawned by them, we can create a more humane era that is more adept at handling the transformations of its technology and culture. _A Winter’s Journey _is a revealing and engaging look into the intellectual life and ideas of one of the most influential theorists of contemporary civilization. (shrink)

In the advertising discourse of human genetic database projects, of genetic ancestry tracing companies, and in popular books on anthropological genetics, what I refer to as the anthropological gene and genome appear as documents of human history, by far surpassing the written record and oral history in scope and accuracy as archives of our past. How did macromolecules become "documents of human evolutionary history"? Historically, molecular anthropology, a term introduced by Emile Zuckerkandl in 1962 to characterize the study of primate (...) phylogeny and human evolution on the molecular level, asserted its claim to the privilege of interpretation regarding hominoid, hominid, and human phylogeny and evolution vis-à-vis other historical sciences such as evolutionary biology, physical anthropology, and paleoanthropology. This process will be discussed on the basis of three key conferences on primate classification and evolution that brought together exponents of the respective fields and that were held in approximately ten-years intervals between the early 1960s and the 1980s. I show how the anthropological gene and genome gained their status as the most fundamental, clean, and direct records of historical information, and how the prioritizing of these epistemic objects was part of a complex involving the objectivity of numbers, logic, and mathematics, the objectivity of machines and instruments, and the objectivity seen to reside in the epistemic objects themselves. (shrink)

This literature review of professionalism was prepared by San Jose State University graduate student Marianne Allison as a research committee project of the Mass Communication and Society Division, Association for Education in Journalism and Mass Communication. The project was prepared under the guidance of Professor Diana Stover Tillinghast. It reviews the literature on two approaches to professionalism in general and of the professionalism of journalists in particular: the ?structural?functionalist approach?; and the ?power approach.?; Traditional and recent discussions of the (...) nature of professionalism in occupational sociology are presented. Studies of the professionalism of journalists both in the United States and cross?culturally are critiqued. The paper suggests several areas of fruitful research, and contains an extensive bibliography. (shrink)

With disagreement, doubts, or ambiguous grounds in end–of-life decisions, doctors are advised to involve a clinical ethics committee. However, little has been published on doctors’ experiences with discussing an end-of-life decision in a CEC. As part of the quality assurance of this work, we wanted to find out if clinicians have benefited from discussing end-of-life decisions in CECs and why. We will disseminate some Norwegian doctors’ experiences when discussing end-of-life decisions in CECs, based on semi-structured interviews with fifteen Norwegian physicians (...) who had brought an end-of-life decision case to a CEC. Almost half of the cases involved conflicts with the patients’ relatives. In a majority of the cases, there was uncertainty about what would be the ethically preferable solution. Reasons for referring the case to the CEC were to get broader illumination of the case, to get perspective from people outside the team, to get advice, or to get moral backing on a decision already made. A great majority of the clinicians reported an overall positive experience with the CECs’ discussions. In cases where there was conflict, the clinicians reported less satisfaction with the CECs’ discussions. The study shows that most doctors who have used a CEC in an end-of-life decision find it useful to have ethical and/or legal aspects illuminated, and to have the dilemma scrutinized from a new perspective. A systematic discussion seems to be significant to the clinicians. (shrink)

In this paper, we are interested in the effects of institutional context on public attitudes towards climate policies, where institutions are defined as the conventions, norms and formally sanctioned rules of any given society. Building on a 2014 survey experiment, we conducted thirty qualitative interviews with car-owners in Oslo, Norway, to investigate the ways in which institutional context and political-value orientation affect public attitudes towards emissions policies. One context (presented as a text treatment) highlighted individual rationality, emphasising the ways in (...) which local pollution impacts the individual citizen; the other highlighted social rationality, emphasising the wider significance of carbon emissions and global responsibility for climate change. We analysed the effects of these contexts on attitudes, finding that institutional context influenced individuals' perspectives as well as their attitudes towards climate policies. Groups with different value orientations differed in terms of their evaluations but not their interpretations of these contexts. (shrink)

Analysis of a European Union funded biotechnology project on plant genomics and marker assisted selection in Solanaceous crops shows that the organization of a dialogue between science and society to accompany technological innovations in plant breeding faces practical challenges. Semi-structured interviews with project participants and a survey among representatives of consumer and other non-governmental organizations show that the professed commitment to dialogue on science and biotechnology is rather shallow and has had limited application for all involved. Ultimately, other priorities tend (...) to prevail because of high workload. The paper recommends including results from previous debates and input from societal groups in the research design phase (prior to communication), to use appropriate media to disseminate information and to make explicit how societal feedback is used in research, in order to facilitate true dialogue between science and society on biotechnology. (shrink)

This paper discusses the definition of argumentation as a means for persuading an audience on the acceptability of a thesis. It is argued that persuasion is a goal that relates more to the communicative situation, the type of interaction or the type of discourse, rather than to the argumentative nature of it. Departing from the analysis of a short conversational sequence between people who agree on an issue and nevertheless argue, I suggest that a definition of argumentation in terms of (...) persuasion fails to account for what people are actually doing in these situations. I propose instead that several functions may be assigned to argumentation when considering the context in which it is produced: a cognitive function (which helps participants to elaborate a position on the discussed issue), and an identifying function (which enables them to portray themselves through the expression and the justification of their opinion). In the case analyzed here, a third function to which the argumentative activity contributes can also be identified, namely the enhancing of the emotional tonality of the relationship between the participants. While it becomes clear from the discussion of this argumentative sequence that the participants do not seek to persuade each other or some third party, it is not suggested that argumentation never aims at persuading an audience, but rather that persuasion cannot be considered as a defining feature of argumentation. (shrink)

From the 1960s, mathematical and computational tools have been developed to arrive at human population trees from various kinds of serological and molecular data. Focusing on the work of the Italian-born population geneticist Luigi Luca Cavalli-Sforza, I follow the practices of tree-building and mapping from the early blood-group studies to the current genetic admixture research. I argue that the visual language of the tree is paralleled in the narrative of the human diasporas, and I show how the tree was actually (...) mapped onto the surface of the earth. This visual and textual structure is mirrored in the liberal discourse of unity in diversity that has been criticized as running counter to the socio-political effects of human population genetics. From this perspective, one may ask how far the phylogenetic diagram in its various forms is a manifestation of the physics of power that according to Michel Foucault consists in mechanisms that analyse distributions, movements, series, combinations, and that uses instruments to render visible, to register, to differentiate and to compare. It is one among other disciplinary technologies that ensure the ordering of human diversity. In the case of intra-human phylogenetic trees, population samples and labels are one issue. Another is that the separated branches seem to show groups of people, who have in reality been interacting and converging, as isolated. Often based on so-called isolated peoples, molecular tree diagrams freeze a hierarchical kinship system that is meant to represent a state before the great historical population movements. (shrink)

Do you want to make sure you · Don’t invest your money in the next Enron? · Don’t go to work for the next WorldCom right before the crash? · Identify and solve problems in your organization before they send it crashing to the ground? Marianne Jennings has spent a lifetime studying business ethics---and ethical failures. In demand nationwide as a speaker and analyst on business ethics, she takes her decades of findings and shows us in The Seven Signs (...) of Ethical Collapse the reasons that companies and nonprofits undergo ethical collapse, including: · Pressure to maintain numbers · Fear and silence · Young ’uns and a larger-than-life CEO · A weak board · Conflicts · Innovation like no other · Belief that goodness in some areas atones for wrongdoing in others Don’t watch the next accounting disaster take your hard-earned savings, or accept the perfect job only to find out your boss is cooking the books. If you’re just interested in understanding the (not-so) ethical underpinnings of business today, The Seven Signs of Ethical Collapse is both a must-have tool and a fascinating window into today’s business world. (shrink)

In the context of synthetic biology, scientists and bioengineers talk of living beings as being 'living machines'. This categorisation of the envisaged new life forms has given rise to the ethical concern that their moral status may be seen as different from that of natural or only partially artificial living beings. The paper discusses the notion of a living being and the notion of a machine in order to arrive at a conclusion to the question of whether this categorisation is (...) warranted or not. For this reason, it also looks back to the history of the comparison of living beings to machines and tries to show what motivated the analogy. In the end, though, it is argued that one should stop short of categorising living beings as machines, even if there are areas of analogy between living beings and machines. Finally, the idea that the envisaged artificial synthetic living beings could be regarded as some kind of machines is rejected. (shrink)

Background Since the enactment of the euthanasia law in the Netherlands, there has been a lively public debate on assisted dying that may influence the way patients talk about euthanasia and physician-assisted suicide with their physicians and the way physicians experience the practice of EAS. Aim To show what developments physicians see in practice and how they perceive the influence of the public debate on the practice of EAS. Methods We conducted a secondary analysis of in-depth interviews with 28 Dutch (...) physicians who had experience with a complex case of EAS. Respondents were recruited both by the network of physicians working for SCEN as well as via a national questionnaire, wherein participating physicians could indicate their willingness to be interviewed. Results Three themes came up in analysing the interviews. First, the interviewed physicians experienced a change in what patients would expect from them: from a role as an involved caregiver to being the mere performer of EAS. Second, interviewees said that requests for EAS based on non-medical reasons came up more frequently and wondered if EAS was the right solution for these requests. Last, respondents had the impression that the standards of EAS are shifting and that the boundaries of the EAS regulation were stretched. Conclusions The perceived developments could make physicians less willing to consider a request for EAS. Our results also raise questions about the role of physicians and of EAS in society. (shrink)

Social scientists and scholars in the humanities all rely on first-person descriptions of experience to understand how subjects construct their worlds. The problem they always face is how to integrate first-person accounts with an impersonal stance. Over the course of the twentieth century, this problem was compounded as the concept of experience itself came under scrutiny. First hailed as a wellspring of knowledge and the weapon that would vanquish metaphysics and Cartesianism by pragmatists like Dewey and James, by the century's (...) end experience had become a mere vestige of both, a holdover from seventeenth-century empiricist metaphysics. This devaluation of experience has left us bereft, unable to account for first-person perspectives and for any kind of agency or intentionality. This book takes on the critique of empiricism and the skepticism with regard to experience that has issued from two seemingly disparate intellectual strains of thought: anti-foundationalist and holistic philosophy of science and epistemology and feminist critiques of identity politics. Both strains end up marginalizing experience as a viable corrective for theory, and both share notions of human beings and cognition that cause the problem of the relation between experience and our theories to present itself in a particular way. Indeed, they render experience an intractable problem by opening up a gap between a naturalistic understanding of human beings and an understanding of humans as cultural entities, as non-natural makers of meaning. Marianne Janack aims to close this gap, to allow us to be naturalistic and hermeneutic at once. Drawing on cognitive neuroscience, the pragmatist tradition, and ecological psychology, her book rescues experience as natural contact with the world. (shrink)

A central aim of Construction Grammar is to model links within the construct-i-con. This paper investigates three constructions that share one property: an atypical element in the object slot. The constructions are therefore not prototypically transitive. Structural priming (implemented with an automatic maze variant of self-paced reading) is used to test hypotheses on the relation among the Reaction Objoid (She smiled her thanks), the Cognate Objoid (She smiled a sweet smile or He told a sly tale), and the Superlative Objoid (...) (She smiled her sweetest) Construction, and between two variants of the latter (They worked (at) their hardest). Results support transitivity as gradient: intransitive COCs prime the ROC and the SOC, whereas COCs with transitives only prime the ROC. For variants of the SOC, we find evidence of asymmetric priming with the bare SOC priming the at-SOC. Within-construction priming effects in the SOC are of greater magnitude than those with the at-SOC and the latter are weaker than those of the COC and of a rather different nature than those from the ROC. This suggests that speakers, rather than creating a constructeme between the bare and the at-SOC, store distinct but closely related constructions on a cline of transitivity. (shrink)

First Published in 1991. Routledge is an imprint of Taylor & Francis, an informa company.

Mehr Markt und Wettbewerb im Gesundheitswesen, so der Tenor aktueller gesundheitspolitischer Debatten, soll Transparenz schaffen, Kosten senken, Missbräuche verhindern und die Qualität der Leistungen steigern. Marianne Rychner zeigt anhand objektiv-hermeneutischer Materialanalysen, in welcher Weise professionalisierte ärztliche Praxis und die Logik des Marktes in einem Widerspruch zueinander stehen. Dies wird deutlich anhand einer detailgetreuen Rekonstruktion zweier ärztlicher Konsultationen. In der Interaktion zwischen Ärztin und Patient entfaltet sich eine komplexe Handlungslogik. Diese konfrontiert die Autorin mit aktuellen Versuchen, der ärztlichen Praxis den (...) Charakter eines marktkonformen Produkts zu geben. (shrink)

Pig farmers and scientists appear to have different perspectives and underlying framing on animal welfare issues as tail biting and natural behaviour of pigs. Literature proposes a joint learning process in which a shared vision is developed. Using two different settings, a symposium and one-to-one dialogues, we aimed to investigate what elements affected joint learning between scientists and pig farmers. Although both groups agreed that more interaction was important, the process of joint learning appeared to be rather potentially dangerous for (...) the farmer–scientist relationship. During the symposium, farmers were only moderately open for scientific knowledge and the issue of tail biting had the tendency to run into a deadlock. The setting was an influencing element for the degree of success, because the dialogues did lead to improved mutual trust and understanding of each other’s framing and context. Another element was the degree of usability and absoluteness of scientific facts. They were frequently not concrete enough, too uncertain or not relating to the context of the farmers. In addition, some scientific facts were not recognized by the farmers. Both groups appeared to react and argue from their praxis, including their local environment, way of living, handling and understanding their environment. These praxises appeared to function as a filter, influencing the way of observing the environment, inducing ‘blind spots’ and misunderstandings. Stepping in each other’s praxis might provide concrete and fusing insights, required to realize joint learning processes. (shrink)

References to publications written by women constitute a significantly larger proportion of citations in articles written by women than in articles written by men in the same subfields. Further, the difference between citation patterns of men and women authors increases as the proportion of women in the discipline decreases, showing that these women are doubly disadvantaged in accumulating citations. These results suggest that the problems of members of an out-group tend to be most serious when their numbers are small and (...) that they will find it increasingly easier to gain acceptance and recognition as their numbers increase. (shrink)

Homeotic genes are subject to transcriptional silencing, which prevents their expression in inappropriate body regions. Here, we shall focus on Drosophila, as little is known about this process in other organisms. Evidence is accumulating that silencing of Drosophila homeotic genes is conferred by two types of cis‐regulatory sequences: initiation (SIL‐I) and maintenance (SIL‐M) elements. The former contain target sites for transient repressors with a highly localised distribution in the early embryo and the latter for constitutive repressors that are likely to (...) be present in all cells. We discuss how SIL‐I elements may cooperate with SIL‐M elements to promote formation of a silencing complex. We propose that this complex consists of specific non‐histone proteins, the so‐called Polycomb group proteins, and that it is anchored at SIL‐M elements and at the promoter. (shrink)

The legalization of cannabis in Canada instantiates principles of harm-reduction and safe supply. However, in-depth understanding of values at stake and attitudes toward legalization were not part of extensive democratic deliberation. Through a qualitative exploratory study, we undertook 48 semi-structured interviews with three Canadian stakeholder groups to explore opinions and values with respect to the legalization of cannabis: (1) members of the general public, (2) people with lived experience of addiction and (3) clinicians with experience treating patients with addiction. Across (...) all groups, participants tended to be in favor of legalization, but particular opinions rested on their viewpoint as stakeholders. Clinicians considered the way legalization would affect an individual’s health and its potential for increasing rates of addiction on a larger scale. People with lived experience of addiction cited personal autonomy more than other groups and stressed the need to have access to quality information to make truly informed decisions. Alternatively, members of the public considered legalization positive or negative in light of whether one’s addiction affected others. We elaborate on and discuss how scientific evidence about drug use impact values relates and how can different arguments play in democratic debates about legalization. (shrink)

An understanding of the ethical implications of their work is now essential for all scientists. This accessible textbook clearly explains bioethical theories and their philosophical foundations to science students, enabling them to confidently take part in the key ethical debates of biotechnology. Over 200 activities introduce topics for personal reflection and discussion points encourage students to think for themselves and build their own arguments. Highlighting the potential pitfalls for those new to bioethics, each chapter features boxes providing factual information and (...) outlining the philosophical background. Accompanying online podcasts by the author (two of whose podcasts on iTunesU have attracted over 3 million downloads) explain points that might be difficult for beginners. Detailed case studies provide an insight into real-life examples of bioethical problems. Within-chapter essay questions and quizzes, along with end-of-chapter review questions, allow students to check their understanding and encourage broader thinking about the topics discussed. (shrink)

The movement advocating the formal certification of clinical ethics consultants may result in major changes to the field of clinical ethics consultation by creating a new standard of care. The actual certification process is still in the development phase, but unanswered questions include: What will certification cost, and, Who will pay? Currently there is little salary support for ethics consultants and no regulation requiring healthcare institutions to offer clinical ethics consultation. Without the support of healthcare administrators and accreditation bodies, this (...) may remain unchanged.Healthcare administrators may be unwilling to pay for certification or professional services if accreditation bodies do not require healthcare institutions to provide certified ethics consultants’ services. If consultants will not be reimbursed or paid, they may not seek certification. If certified consultants are required, healthcare administrators may look for ways to cover the costs for providing this service, including insurance or third-party reimbursement and direct billing of patients for consultations, which may affect who performs and who participates in ethics consultation. However, this is less than ideal, as bioethicists believe ethics consultation should be available to all as part of providing safe, quality ethical care and support and guidance for patients, families, and healthcare staff.Going forward, bioethicists should study quality improvement, patient safety, and cost-savings resulting from certification-eligible clinical ethics consultants’ activities. Administrators and financial personnel can be surveyed regarding their support for the certification process. Bioethicists should enlist the help of patient rights and safety advocacy groups, professional medical associations, and healthcare administrators. Bioethicists should invite accreditation bodies, healthcare administrators, and financial personnel to collaborate in the development of the certification process. Without their support, certification may be of value only to the bioethics community, and may have little standing in actual clinical healthcare institution settings. (shrink)