Strategies to Improve Health Care Ethics Consultation: Bridging the Knowledge Gap

Fox, Ellen

doi:10.1001/journalofethics.2016.18.5.pfor1-1605

Cited by 12 publications

(3 citation statements)

References 23 publications

(15 reference statements)

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“…The above thumbnail sketches represent six different but common kinds of expectations we have frequently encountered within our work as ethics consultants. It has also been our experience that these expectations often are presumed or embedded in the discussions among those in the field of clinical ethics as displayed via the wide variation regarding the nature and goals of the actual practice of ethics consultation (Fox, 2016 ; Fox et al, 2021 ; Klugman, 2018 ). As a result, we believe there is little reason to doubt similar variation regarding the nature of and appropriate responses to such expectations within the field and by those currently engaging in clinical ethics practices (either as sole ethics consultants or members of ethics consultation teams or services).…”

Section: The Six “Kinds” Of Expectations (Summary Overview)mentioning

confidence: 99%

Clinical Ethics Consultations and the Necessity of NOT Meeting Expectations: I Never Promised You a Rose Garden

Finder

Bartlett

2022

HEC Forum

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Clinical ethics consultants (CECs) work in complex environments ripe with multiple types of expectations. Significantly, some are due to the perspectives of professional colleagues and the patients and families with whom CECs consult and concern how CECs can, do, or should function, thus adding to the moral complexity faced by CECs in those particular circumstances. We outline six such common expectations: Ethics Police, Ethics Equalizer, Ethics Superhero, Ethics Expediter, Ethics Healer or Ameliorator, and, finally, Ethics Expert. Framed by examples of requests for ethics consultation that illustrate each kind, along with brief descriptions, we argue that while these expectations ought to be resisted for clear and practical reasons, they also create opportunities for CECs to articulate, educate, and ultimately be responsible to the professional demands of clinical ethics work. Recognizing, acknowledging, and at times resisting those expectations thus become key activities and responsibilities in the performance of ethics consultation.

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Section: The Six “Kinds” Of Expectations (Summary Overview)mentioning

confidence: 99%

Clinical Ethics Consultations and the Necessity of NOT Meeting Expectations: I Never Promised You a Rose Garden

Finder

Bartlett

2022

HEC Forum

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“…Although the prevalence of CES is increasing, it does meet challenges and pressing questions regarding implementation and organization [12,39,46]. Research shows, that CES providers encounter difficulties in setting up the collaboration with clinicians, in receiving cases, and in following the uptake of their advice [29,31,40].…”

Section: Introductionmentioning

confidence: 99%

Theory and practice of integrative clinical ethics support: a joint experience within gender affirmative care

et al. 2020

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Background: Clinical ethics support (CES) aims to support health care professionals in dealing with ethical issues in clinical practice. Although the prevalence of CES is increasing, it does meet challenges and pressing questions regarding implementation and organization. In this paper we present a specific way of organizing CES, which we have called integrative CES, and argue that this approach meets some of the challenges regarding implementation and organization. Methods: This integrative approach was developed in an iterative process, combining actual experiences in a case study in which we offered CES to a team that provides transgender health care and reflecting on the theoretical underpinnings of our work stemming from pragmatism, hermeneutics and organizational and educational sciences. Results: In this paper we describe five key characteristics of an integrative approach to CES; 1. Positioning CES more within care practices, 2. Involving new perspectives, 3. Creating co-ownership of CES, 4. Paying attention to follow up, and 5. Developing innovative CES activities through an emerging design. Conclusions: In the discussion we compare this approach to the integrated approach to CES developed in the US and the hub and spokes strategy developed in Canada. Furthermore, we reflect on how an integrative approach to CES can help to handle some of the challenges of current CES.

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“…HECs must be evaluated to establish whether their work has an impact, and which of the envisioned functions (e.g., individual case consultations, education of HCPs, and policy formation) do HECs actually perform in everyday clinical work [ 17 , 33 – 36 ].…”

Section: Introductionmentioning

confidence: 99%

The first nationwide study on facing and solving ethical dilemmas among healthcare professionals in Slovenia

et al. 2020

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Background Healthcare professionals (HCPs), patients and families are often faced with ethical dilemmas. The role of healthcare ethics committees (HECs) is to offer support in these situations. Aim The primary objective was to study how often HCPs encounter ethical dilemmas. The secondary objective was to identify the main types of ethical dilemmas encountered and how HCPs solve them. Subjects and methods We conducted a cross-sectional, survey-based study among HCPs in 14 Slovenian hospitals. A questionnaire was designed and validated by HCPs who were selected by proportional stratified sampling. Data collection took place between April 2015 and April 2016. Results The final sample size was n = 485 (385 or 79.4%, female). The response rates for HCPs working in secondary and tertiary level institutions were 45% and 51%, respectively. Three hundred and forty (70.4%) of 485 HCPs (very) frequently encountered ethical dilemmas. Frequent ethical dilemmas were waiting periods for diagnostics or treatment, suboptimal working conditions due to poor interpersonal relations on the ward, preserving patients' dignity, and relations between HCPs and patients. Physicians and nurses working in secondary level institutions, compared to their colleagues working in tertiary level institutions, more

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Strategies to Improve Health Care Ethics Consultation: Bridging the Knowledge Gap

Cited by 12 publications

References 23 publications

Clinical Ethics Consultations and the Necessity of NOT Meeting Expectations: I Never Promised You a Rose Garden

Clinical Ethics Consultations and the Necessity of NOT Meeting Expectations: I Never Promised You a Rose Garden

Theory and practice of integrative clinical ethics support: a joint experience within gender affirmative care

The first nationwide study on facing and solving ethical dilemmas among healthcare professionals in Slovenia

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