Of Goals and Goods and Floundering About: A Dissensus Report on Clinical Ethics Consultation

Bishop, Jeffrey P.; Fanning, Joseph B.; Bliton, Mark J.

doi:10.1007/s10730-009-9109-6

Cited by 6 publications

(11 citation statements)

References 12 publications

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“…The values required of a committee are described as "aspirations" to be acquired over time similar to professional development. While there is limited evidence on the extent to which the Core Competencies are applied by individual services, and whilst there is some concern that emphasis on competencies reflects the malign influence of managerialism and may divert CES from the primary goal of moral inquiry towards more institutional or bureaucratic goals (King, 1999;Bishop, Fanning, and Bliton, 2009), there is little doubt that debate about the competencies of CES has had a significant impact on the establishment of standards for CES services (Adams, 2009;Bishop, Fanning, and Bliton, 2009).…”

Section: Optimizing the Quality Of Ces Servicesmentioning

confidence: 99%

“…Others are concerned that standardization forces ethics consultation towards procedural efficiency and metrics and away from the substantive goods of the case at hand. A focus on standardized, measurable process can limit the capacity of a CES service to reveal, clarify and perhaps challenge the various understandings, of all parties, of what is a medical good, an institutional good and what a patient holds as good (Bishop, Fanning, and Bliton, 2009). …”

Section: Optimizing the Quality Of Ces Servicesmentioning

confidence: 99%

“…There has also been resistance to the notion of an ethics "expert" from the inception of CES services (Bishop, Fanning, and Bliton, 2009) and this has been a significant obstacle for establishing CES and gaining patronage (Rasmussen, 2011a). The notion of expertise in ethics is a complicated matter that involves both metaphysical and epistemological questions of whether expertise in ethics is actually possible and moral and normative questions of whether such expertise and the authority it brings is desirable (Noble, 1982;Yoder, 1998;Rasmussen, 2011a).…”

Section: Optimizing the Quality Of Ces Servicesmentioning

confidence: 99%

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Clinical Ethics Support in Contemporary Health Care

Doran¹,

Kerridge²,

Jordens³

et al. 2016

Oxford Handbooks Online

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This chapter discusses clinical ethics support services (CES Services), the development of which has arisen to help respond to ethical issues arising in health care settings. CES services are comprised of an individual or group, usually in an organization, who can provide a suite of services to support all stakeholders in identifying and managing ethical issues they face. While there is a degree of consensus about the potential value of such services, they are also the focus of ongoing theoretical, methodological and political debates. The aim of this chapter is to provide health care managers with an account of how and why CES services are becoming a part of the contemporary organizational landscape of health care, and describe the concerns that bioethicists and others have raised regarding their role, function and dissemination.

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Section: Optimizing the Quality Of Ces Servicesmentioning

confidence: 99%

Section: Optimizing the Quality Of Ces Servicesmentioning

confidence: 99%

Section: Optimizing the Quality Of Ces Servicesmentioning

confidence: 99%

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Clinical Ethics Support in Contemporary Health Care

Doran¹,

Kerridge²,

Jordens³

et al. 2016

Oxford Handbooks Online

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“…Ours is an approach to decision-making in which defensible solutions emerge in the course of dialogue, dissensus and negotiation. 29…”

Section: Resultsmentioning

confidence: 99%

A decision-making tool for building clinical ethics capacity among Irish health professionals

Campbell

McCarthy

2017

Clinical Ethics

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Although clinical ethics support services are becoming increasingly prevalent in Europe and North America, they remain an uncommon feature of the Irish healthcare system and Irish health professionals lack formal support when faced with ethically challenging cases. We have developed a variant on existing clinical ethics decision-making tools which is designed to build capacity and confidence amongst Irish practitioners and enable them to confront challenging situations in the absence of any dedicated support structure. The tool provided below follows a transparent stepwise procedure which avoids an overcomplicated analysis while remaining sensitive to the complexity of the issues addressed. The novelty of the tool lies in the explicit association it makes between each step in the process and one or more responsibilities based on established norms of ethical decision-making in the public domain.

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“…2,3 CEC can help to identify solutions to ethical problems in clinical practice in ways consistent with patient values in order to improve patient care. 4,5 CEC has two models. The top-down model resolves cases by applying prescribed norms and values which come from the institutional management or the legal framework.…”

Section: Introductionmentioning

confidence: 99%

Application of METAP methodology for clinical ethics consultation in end-of-life care in Bulgaria

Aleksandrova-Yankulovska

2020

Clinical Ethics

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Although clinical ethics consultation has existed for more than 40 years in the USA and Europe, it was not available in Bulgaria until recently. In introducing clinical ethics consultation into our country, the Modular, Ethical, Treatment, Allocation of resources, Process (METAP) methodology has been preferred because of its potential to be used in resource-poor settings and its strong educational function. This paper presents the results of a METAP evaluation in a hospital palliative care ward in the town of Vratsa. The evaluation was based on Beauchamp and Childress’ four principles of biomedical ethics and involves implementation of specific instruments for clinical ethics decision-making. Research tasks emphasised analyses of ethics meetings in the ward. Data were processed by SPSS v.24 using descriptive statistical analysis. Altogether, 32 ethics meetings of an average duration 20.63 min were conducted on cases involving critically ill patients. Most of the participants (86.0%) expressed satisfaction with the ethics process. The principlist approach supported resolution of conflicts between autonomous patients and their relatives, clarified definitions of “medical benefit” and “social good,” and enabled assessments of the risk of unequal treatment. Even as the specific research tasks were achieved, further participant follow-up is necessary to identify any improvement in healthcare personnel’s ethical competence. METAP worked well in end-of-life care settings. Participants experienced several benefits, including improved team communication, better understanding of patient preferences, and confidence in the correctness of decisions. Despite the significant educational potential of METAP, the need for additional and ongoing ethics training of health professionals should not be underestimated.

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Of Goals and Goods and Floundering About: A Dissensus Report on Clinical Ethics Consultation

Cited by 6 publications

References 12 publications

Clinical Ethics Support in Contemporary Health Care

Clinical Ethics Support in Contemporary Health Care

A decision-making tool for building clinical ethics capacity among Irish health professionals

Application of METAP methodology for clinical ethics consultation in end-of-life care in Bulgaria

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