Doing Clinical Ethics

In this Brief, Daniel Sokol interprets ‘doing medical ethics’ broadly to capture the application of ethical knowledge to a concrete situation, rather than just resolving a moral dilemma contained within a case. It instructs clinicians on how to identify and analyse a clinical ethics case, and guides the reader in publishing in general medical, specialist medical, and medical ethics journals, and through presenting on ethical issues at conferences. In addition to this, advice on how to teach medical ethics, and apply for research ethics approval, is included. ​ “...an admirably short and clear guide to doing medical ethics... I welcome this book and urge medical students and doctors of all grades to read it in paper, on-line or on your portable screen reader.” Sir Richard Thompson, President of the Royal College of Physicians, UK “Dr. Sokol has provided the field with a much needed, easy and comprehensive tool on 'doing' clinical ethics that all should have in their back pockets.” Dr. Nneka Mokwunye, Director of Bioethics, Washington Hospital Center, Washington DC, USA “This is a magnificent guide to clinical ethics and reflects the author’s very well known and widely respected academic gravitas and real life experience in clinical ethics. It is a “must read” for anyone involved in the field.” Mr. Vassilios Papalois, Consultant Surgeon and Chairman, Imperial College Healthcare NHS Trust Clinical Ethics Committee, UK

Clinical Ethics introduces the four-topics method of approaching ethical problems (i.e., medical indications, patient preferences, quality of life, and contextual features). Each of the four chapters represents one of the topics. In each chapter, the authors discuss cases and provide comments and recommendations. The four-topics method is an organizational process by which clinicians can begin to understand the complexities involved in ethical cases and can proceed to find a solution for each case.

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.

​The goal of this open access book is to develop an approach to clinical health care ethics that is more accessible to, and usable by, health professionals than the now-dominant approaches that focus, for example, on the application of ethical principles. The book elaborates the view that health professionals have the emotional and intellectual resources to discuss and address ethical issues in clinical health care without needing to rely on the expertise of bioethicists. The early chapters review the history of bioethics and explain how academics from outside health care came to dominate the field of health care ethics, both in professional schools and in clinical health care. The middle chapters elaborate a series of concepts, drawn from philosophy and the social sciences, that set the stage for developing a framework that builds upon the individual moral experience of health professionals, that explains the discontinuities between the demands of bioethics and the experience and perceptions of health professionals, and that enables the articulation of a full theory of clinical ethics with clinicians themselves as the foundation. Against that background, the first of three chapters on professional education presents a general framework for teaching clinical ethics; the second discusses how to integrate ethics into formal health care curricula; and the third addresses the opportunities for teaching available in clinical settings. The final chapter, "Empowering Clinicians", brings together the various dimensions of the argument and anticipates potential questions about the framework developed in earlier chapters.

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.

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.

Doing Right is a concise and practical guide to ethical decision-making in medicine. The text is aimed at second and third year one-semester ethics courses offered in medical schools, health sciences departments and nursing programs.

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.