Clinical Ethics Consultation A Practical Guide

This book provides a careful and comprehensive, step-by-step method for providing clinical ethics consultation. This Guide can be applied in almost any healthcare setting and takes the reader from establishing an intake process and developing strategies for interviewing those involved in the situation, to undertaking a consultation meeting and following up on a clinical consult. The book is an invaluable resource to any clinical ethicist, or committee or consult team member who is seeking to provide their service with rigour and quality. Written in simple language, the book explores ideas and concepts that will help the reader to understand, think through, and ultimately offer useful ethical consultation when facing ethically challenging issues.

This is a book about clinical ethics consultation by two practitioners who together have done more than 700 consultations. There is not another authoritative book like it. Practical rather than theoretical in scope, the book addresses strategies for conducting consultations, relating to patients at the bedside, investigating the ethical issues, making recommendations, following up on cases, and keeping records. Chapters include issues such as the need for training, the skills needed, the problem of certification, how to set up a practice, financial compensation and billing, and the relation of the consultant to committees, particularly ethics committees. The authors include reflections about learning clinical ethics and education of committees, hospital staff, and the general public about issues that arise. The purpose is to help ethics consultants improve their conscious assessment of their work, both how they go about it and its legitimacy for patients, health care providers, and hospitals. The orientation is primarily on clinical care of patients, because the goal of such consultations is always aimed to improve patient care. Other ethics consultants might work to develop institutional policies. Although that is touched on in the book, it is not the primary goal of the authors. The book is aimed at the practitioner in bioethics in a clinical setting.

To our knowledge, no existing book or article describes how to establish and operate a vibrant and sustainable clinical ethics consultation service (ECS) from the ground up. As a result, ECS directors and ethics consultants may be charged with building or reinvigorating and sustaining a high-quality, successful service without sufficient practical guidance on how to plan, implement, and monitor their efforts. This lack of guidance can give rise to problems, including wasted time and effort, as well as misalignments in expectations and goals between hospital administrators and ethics consultants on what constitutes "success" and "failure" in service activities. Toward the goal of providing this much-needed guidance, we describe key considerations and strategies for developing, implementing, and monitoring a high-quality, successful service. It is important to note that in responding to hospital administrators' expectations and establishing a successful service, it is necessary but not sufficient to demonstrate the competence of individual consultants. Thus, some portions of this guide are addressed to the individual or individuals leading an ECS, but many chapters will be useful to anyone engaging in clinical ethics consultation or playing a role in overseeing or otherwise advocating for an ECS. Our focus is on building and sustaining high-quality, successful services in ways that go well beyond the traditional focus on how to conduct an ethics consultation. Specifically, we have chapters and sections devoted to working through a case, mediation skills, and conducting and facilitating family meetings that should be useful for any ethics consultant, particularly individuals who are new to ethics consultation or seasoned consultants who wish to reflect on their practices, but we also have chapters and sections devoted to "selling points to hospital administrators on the value of ECSs," building an ECS infrastructure, launching a service, etc., that are aimed more towards ECS directors, with the goal of providing essential guidance on ECS development and maintenance. Finally, our goal is to be as practical and clinically-oriented as possible by addressing everyday nuts-and-bolts concerns that apply across demographically- and geographically-diverse hospital settings, subject to some individual variation that we will underscore for our readership. In particular, we arrange this guide according to phases of an ECS. Part 1 will focus on planning for an ECS. Part 2 will discuss how to implement an ECS. Part 3 will then conclude with information about how to monitor an ECS once it is established, and how to address common challenges. We believe that much of the advice we provide can be extended to other consultative or hospital services that are based in hospitals, such as palliative medicine, chaplaincy, or social work services. We hope you find this useful!

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 workbook is a companion to Clinical Ethics Consultation: A Practical Guide to Changing Culture, Building Capacity and Solving Problems Case by Case. The Toolkit lays out the process for clinical ethics consultation in a series of steps within five phases: Pre-Consult, Interviews, Mid-Consult, Consult meeting(s), and Post-Consult. For each step, the Toolkit provides directions for how to complete it, tips for success, and worksheets for capturing data and analysis. The Clinical Ethics Consultation Toolkit is the playbook from which clinical ethics consultants can draw methods and strategies for effectively delivering ethics consultation.

A Doody's Core Title for 2023! The go-to textbook on the increasingly important and rapidly evolving topic of medical ethics Ethical issues are embedded in every clinical encounter between patients and clinicians. In order to practice excellent clinical care, clinicians must understand ethical issues such as informed consent, decisional capacity, surrogate decision making, truth telling, confidentiality, privacy, the distinction between research and clinical care, and end-of-life care. This popular, clinically-oriented guide provides crystal-clear case-based coverage of the ethical situations encountered in everyday medical practice. Clinical Ethics introduces the proven Four Box Method—a much-needed pattern for collecting, sorting, and ordering the facts of a clinical ethical problem. This easy-to-apply system is based on simple questions about medical indications, patient preferences, quality of life, and contextual features that explain clinical ethics and help clinicians formulate a sound diagnosis and treatment strategy. In each chapter, the authors discuss case examples and provide analysis, comments, and specific recommendations. The book is divided into the four topics that constitute the essential ethical structure of every clinical encounter: Medical Indications, Preferences of Patients Quality of Life Contextual Features

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.