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  1. Moving It Along: A study of healthcare professionals’ experience with ethics consultations.Nancy Crigger, Maria Fox, Tarris Rosell & Wilaiporn Rojjanasrirat - 2017 - Nursing Ethics 24 (3):279-291.
    Background:Ethics consultation is the traditional way of resolving challenging ethical questions raised about patient care in the United States. Little research has been published on the resolution process used during ethics consultations and on how this experience affects healthcare professionals who participate in them.Objectives:The purpose of this qualitative research was to uncover the basic process that occurs in consultation services through study of the perceptions of healthcare professionals.Design and Method:The researchers in this study used a constructivist grounded theory approach that (...)
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  • Preventive Ethics Through Expanding Education.Anita Ho, Lisa Mei-Hwa MacDonald & David Unger - 2016 - HEC Forum 28 (1):69-74.
    Healthcare institutions have been making increasing efforts to standardize consultation methodology and to accredit both bioethics training programs and the consultants accordingly. The focus has traditionally been on the ethics consultation as the relevant unit of ethics intervention. Outcome measures are studied in relation to consultations, and the hidden assumption is that consultations are the preferred or best way to address day-to-day ethical dilemmas. Reflecting on the data from an internal quality improvement survey and the literature, we argue that having (...)
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  • Response to Open Peer Commentaries on “Neglected Ends: Clinical Ethics Consultation and the Prospects for Closure”.Autumn Fiester - 2015 - American Journal of Bioethics 15 (1):9-10.
    Clinical ethics consultations are sometimes deemed complete at the moment when the consultants make a recommendation. In CECs that involve actual ethical conflict, this view of a consult's endpoint runs the risk of overemphasizing the conflict's resolution at the expense of the consult's process, which can have deleterious effects on the various parties in the conflict. This overly narrow focus on reaching a decision or recommendation in consults that involve profound moral disagreement can result in two types of adverse, lingering (...)
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  • Philosophical Counseling as an Alternative Process to Bioethics Mediation.Nancy J. Matchett - 2015 - American Journal of Bioethics 15 (1):56-58.
    This commentary shows how philosophical counseling offers an alternative way for consultants to facilitate "closure" in bioethical disputes.
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  • Neglected Ends: Clinical Ethics Consultation and the Prospects for Closure.Autumn Fiester - 2015 - American Journal of Bioethics 15 (1):29-36.
    Clinical ethics consultations are sometimes deemed complete at the moment when the consultants make a recommendation. In CECs that involve actual ethical conflict, this view of a consult's endpoint runs the risk of overemphasizing the conflict's resolution at the expense of the consult's process, which can have deleterious effects on the various parties in the conflict. This overly narrow focus on reaching a decision or recommendation in consults that involve profound moral disagreement can result in two types of adverse, lingering (...)
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  • The “Difficult” Patient Reconceived: An Expanded Moral Mandate for Clinical Ethics.Autumn Fiester - 2012 - American Journal of Bioethics 12 (5):2-7.
    Between 15 and 60% of patients are considered ?difficult? by their treating physicians. Patient psychiatric pathology is the conventional explanation for why patients are deemed ?difficult.? But the prevalence of the problem suggests the possibility of a less pathological cause. I argue that the phenomenon can be better explained as a response to problematic interactions related to health care delivery. If there are grounds to reconceive the ?difficult? patient as reacting to the perception of ill treatment, then there is an (...)
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  • Defense Mechanisms in Ethics Consultation.George J. Agich - 2011 - HEC Forum 23 (4):269-279.
    While there is no denying the relevance of ethical knowledge and analytical and cognitive skills in ethics consultation, such knowledge and skills can be overemphasized. They can be effectively put into practice only by an ethics consultant, who has a broad range of other skills, including interpretive and communicative capacities as well as the capacity effectively to address the psychosocial needs of patients, family members, and healthcare professionals in the context of an ethics consultation case. In this paper, I discuss (...)
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  • Response to Open Peer Commentaries on "Ethics Consultation in U.S. Hospitals: A National Survey".Ellen Fox, Sarah Myers & Robert A. Pearlman - 2007 - American Journal of Bioethics 7 (2):1-3.
    Context: Although ethics consultation is commonplace in United States hospitals, descriptive data about this health service are lacking. Objective: To describe the prevalence, practitioners, and processes of ethics consultation in U.S. hospitals. Design: A 56-item phone or questionnaire survey of the “best informant” within each hospital. Participants: Random sample of 600 U.S. general hospitals, stratified by bed size. Results: The response rate was 87.4%. Ethics consultation services were found in 81% of all general hospitals in the U.S., and in 100% (...)
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  • The development of a descriptive evaluation tool for clinical ethics case consultations.R. Pedersen, S. A. Hurst, J. Schildmann, S. Schuster & B. Molewijk - 2010 - Clinical Ethics 5 (3):136-141.
    There is growing interest in clinical ethics. However, we still have sparse knowledge about what is actually going on in the everyday practice of clinical ethics consultations. This paper introduces a descriptive evaluation tool to present, discuss and compare how clinical ethics case consultations are actually carried out. The tool does not aim to define ‘best practice’. Rather, it facilitates concrete comparisons and evaluative discussions of the role, function, procedures and ideals inherent in clinical ethics case consultation practices. The tool (...)
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  • Clinical ethics consultations: a scoping review of reported outcomes.Ann M. Heesters, Ruby R. Shanker, Kevin Rodrigues, Daniel Z. Buchman, Andria Bianchi, Claudia Barned, Erica Nekolaichuk, Eryn Tong, Marina Salis & Jennifer A. H. Bell - 2022 - BMC Medical Ethics 23 (1):1-65.
    BackgroundClinical ethics consultations can be complex interventions, involving multiple methods, stakeholders, and competing ethical values. Despite longstanding calls for rigorous evaluation in the field, progress has been limited. The Medical Research Council proposed guidelines for evaluating the effectiveness of complex interventions. The evaluation of CEC may benefit from application of the MRC framework to advance the transparency and methodological rigor of this field. A first step is to understand the outcomes measured in evaluations of CEC in healthcare settings. ObjectiveThe primary (...)
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  • understandings and uses of ‘culture’ in bioethics deliberations over parental refusal of treatment: Children with cancer.Ben Gray & Fern Brunger - 2017 - Clinical Ethics 13 (2):55-66.
    We developed this study to examine the issue of parental refusal of treatment, looking at the issue through a cultural competence lens. Recent cases in Canada where courts have declined applications by clinicians for court orders to overrule parental refusal of treatment highlight the dispute in this area. This study analyses the 16 cases of a larger group of 24 cases that were selected by a literature review where cultural or religious beliefs or ethnic identity was described as important reasons (...)
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  • Culturally competent clinical ethics: Case study response: Response to case study: A family requests that their grandmother, who does not speak English, is not informed of her terminal diagnosis.Ben Gray - 2016 - Clinical Ethics 11 (4):214-216.
    The case study: a family requests that their grandmother, who does not speak English, is not informed of her terminal diagnosis focusses mostly on the issues of autonomy of patient and truth telling but fails to highlight the most ethically salient feature of the case; the clinician did not talk to the patient. The case study notes that the patient spoke a dialect of Cantonese and felt that translation services might not have been readily available. This is unacceptable practice given (...)
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  • The Notion of Neutrality in Clinical Ethics Consultation.Alessandra Gasparetto, Ralf J. Jox & Mario Picozzi - 2018 - Philosophy, Ethics, and Humanities in Medicine 13:3.
    Clinical ethics consultation, as an activity that may be provided by clinical ethics committees and consultants, is nowadays a well-established practice in North America. Although it has been increasingly implemented in Europe and elsewhere, no agreement can be found among scholars and practitioners on the appropriate role or approach the consultant should play when ethically problematic cases involving conflicts and uncertainties come up. In particular, there is no consensus on the acceptability of consultants making recommendations, offering moral advice upon request, (...)
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  • Ethics Consultation in U.S. Hospitals: Opinions of Ethics Practitioners.Ellen Fox, Anita J. Tarzian, Marion Danis & Christopher C. Duke - 2022 - American Journal of Bioethics 22 (4):19-30.
    To design effective strategies to improve ethics consultation (EC) practices, it is important to understand the views of ethics practitioners. Previous U.S. studies of ethics practitioners have overrepresented the views of academic bioethicists. To help inform EC improvement efforts, we surveyed a random stratified sample of U.S. hospitals, examining ethics practitioners’ opinions on EC in general, on their own EC service, on strategies to improve EC, and on ASBH practice standards. Respondents across all categories of hospitals had very positive perceptions (...)
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  • Ethics Consultation in U.S. Hospitals: A National Follow-Up Study.Ellen Fox, Marion Danis, Anita J. Tarzian & Christopher C. Duke - 2022 - American Journal of Bioethics 22 (4):5-18.
    A 1999–2000 national study of U.S. hospitals raised concerns about ethics consultation (EC) practices and catalyzed improvement efforts. To assess how practices have changed since 2000, we administered a 105-item survey to “best informants” in a stratified random sample of 600 U.S. general hospitals. This primary article details the methods for the entire study, then focuses on the 16 items from the prior study. Compared with 2000, the estimated number of case consultations performed annually rose by 94% to 68,000. The (...)
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