This book provides a robust analysis of the history of clinical ethics, the philosophical theories that support its practice, and the practical institutional criteria needed to become a practicing clinical ethicist. Featuring cases and a step-by-step approach, this book combines knowledge points associated with moral philosophy and medicine with general skill objectives for ethics consultants. The book aids in developing analytic moral reasoning skills for clinical ethicists, fostering the comprehensive education and professional development of clinical ethics consultants. In addition, it offers key components of how an ethics consultation curriculum manifest in an educational venue for clinical ethicists are illustrated. Adaptable and relevant for educating multiple disciplines in health care, this resource enables ethicists to understand the philosophical foundations and practical application of clinical ethics.

In the clinical setting, questions of medical ethics raise a host of perplexing problems, often complicated by conflicting perspectives and the need to make immediate decisions. In this volume, bioethicists and physicians provide a nuanced, in-depth approach to the difficult issues involved in bioethics consultation. Addressing the needs of researchers, clinicians, and other health professionals on the front lines of bioethics practice, the contributors focus primarily on practical concerns—whether ethics consultation is best done by individuals, teams, or committees; how an ethics consult service should be structured; the need for institutional support; and techniques and programs for educating and training staff—without neglecting more theoretical considerations, such as the importance of character or the viability of organizational ethics.

This volume brings together researchers from different European countries and disciplines who are involved in Clinical Ethics Consultation (CEC). The work provides an analysis of the theories and methods underlying CEC as well a discussion of practical issues regarding the implementation and evaluation of CEC. The first section deals with different possible approaches in CEC. The authors explore the question of how we should decide complex cases in clinical ethics, that is, which ethical theory, approach or method is most suitable in order to make an informed ethical decision. It also discusses whether clinical ethicists should be ethicists by education or rather well-trained facilitators with some ethical knowledge. The second chapter of this book focuses on practical aspects of the implementation of CEC structures. The analysis of experienced clinical ethicists refers to macro and micro levels in both developed and transitional countries. Research on the evaluation of CEC is at the centre of the final chapter of this volume. In this context conceptual as well as empirical challenges with respect to a sound approach to judgements about the quality of the work of CECs are described and suggestion for further research in this area are made. In summary this volumes brings together theorists and healthcare practitioners with expertise in CEC. In this respect the volume serves as good example for a multi- and interdisciplinary approach to clinical ethics which combines philosophical reasoning and empirical research.

This book addresses new and evolving thorny issues in clinical ethics consultation. It is a book for our time. The contributors provide essential critical reflection on the standards and methods of training clinical ethics consultants as the field seeks to professionalize. This collection incorporates both North American and European experts, offering different perspectives on issues such as marginalized populations, the opioid epidemic, complex discharge, micro-managing families, and continually challenging issues at the end-of-life, such as determinations of brain death, physician-assisted death, and futility. The authors engage the complexities of choosing for others when making decisions for incapacitated adults and pediatric patients. This volume engages with the growing literature in these debates and offers new perspectives from both academics and practitioners. The readings are of particular interest to bioethicists, clinicians, ethics committees, and students in bioethics and beyond. These new essays advance discussions in the professionalization and certification of ethics consultants and offer crucial insights on new and evolving thorny issues in the practice of clinical ethics consultation.

This open access book about the Zadeh Project demonstrates and explores a core question in clinical ethics: how can ethics consultants be accountable in the face of a robust plurality of ethical standpoints, especially those that underwrite practices and methods for doing ethics consultation as well as those viewpoints and values encountered in daily clinical ethics practice? Underscoring this question is the recognition that the field of clinical ethics consultation has arrived at a crucial point in its maturation. Many efforts are underway to more formally “professionalize” the field, with most aimed toward stabilizing a specific set of institutional considerations. Stretched between these institutional and practical initiatives resides a crucial set of of ethical considerations, chief among them the meaning and scope of responsibility for clinical ethics consultants. Developed around a long-form case scenario, the Zadeh Project provides a multi-layered series of “peer-reviews”: critique of the actions of the case scenario’s ethics consultant; reflection on clinical ethics method; examination of the many ways that commitments to method and practice can, and do, intersect, overlap, and alter one another. The design and format of this book thus models a key element for clinical ethics practice: the need and ability to provide careful and thoughtful explanation of core moral considerations that emerge among diverse standpoints. Specifically designed for those studying to become and those who are ethics consultants, this book, with its innovative and multi-layered approach, allows readers to share a peer-review-like experience that shows accountability to be what it is, an ethical, not merely procedural or administrative, undertaking.

This collection addresses whether ethicists, like authorities in other fields, can speak as experts in their subject matter. Though ethics consultation is a growing practice in medical contexts, there remain difficult questions about the role of ethicists in professional decision-making. Contributors examine the nature and plausibility of moral expertise, the relationship between character and expertise, the nature and limits of moral authority, how one might become a moral expert, and the trustworthiness of moral testimony. This volume engages with the growing literature in these debates and offers new perspectives from both academics and practitioners. The readings will be of particular interest to bioethicists, clinicians, ethics committees, and students of social epistemology. These new essays promise to advance discussions in the professionalization and accreditation of ethics consultation.

In the following essays discussing clinical ethics consultation, three sorts of reflective writing are presented. The first is a description of a clinical ethics consultation, more generously detailed than most that have been published, yet obviously limited as a documentation of the experiences at its source. It is followed by three examples of a second kind in the probing commentaries by highly regarded figures in biomedical and clinical ethics - François Baylis, Tom Tomlinson, and Barry Hoffmaster. Finally, these are followed by a third variety of reflection in the form of responses to those three commentaries, by Bilton and Stuart G. Finder, and my Afterword - a further reflection on some of the issues and questions intrinsic to clinical ethics consultation and to these various essays. The consultation itself was conducted by Bliton; but Finder not only assisted at one point (he is the `colleague' mentioned in Bliton's manuscript) but frequently participated in the discussions that are invariably part of our clinical ethics consultative practice in our Center for Clinical and Research Ethics at Vanderbilt University Medical Center. It was thus natural for Finder to participate in the response. Each of these essays is fascinating and important on its own; together, however, they constitute a truly unusual and, we believe, very significant contribution that will hopefully figure prominently in subsequent discussions, and in shaping and deepening an endeavor - clinical ethics - still in much-needed search of its own discipline, method rationale and place in the domain of clinical practice more generally. This group of essays is also quite unique, addressing as it does the coherence of a form of practice - and, it must be emphasized, several forms of writing about as well as theoretical proposals for understanding that practice - whose current and future character remains very much in contention. That a situation such as the one discussed here often provokes strong and passionate responses will be no surprise – whether because of its relative novelty, its risky nature, the high stakes involved, or something else. It is in any event a striking feature of ethics consultations that the people directly or even indirectly involved tend at times to feel rather passionately about what is said (and not said), what is done (and not done), and what is then reported (or, it may be, left out). Even so, such energetic feelings, much less the candor of my colleague's response to such passion, are rarely if ever apparent from published reports. For this reason alone, a considerable debt of gratitude is surely owed to our commentators – reflective and deliberative, yet passionate and forceful as each of them are.