Autoriai: EDITED BY MARK P. AULISIO, PH.D. ROBERT M. ARNOLD, M.D. STUART J. YOUNGNER, M.D.
Leidykla: The Johns Hopkins University Press
Brūkšninis kodas: 003074958406
Ieškoti VUB kataloge
IN THE CLINICAL SETTING, physicians encounter a host of perplexing ethical problems, often complicated by conflicting perspectives and the need to make immediate decisions. In this volume, bioethicists 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....
"A very important topic from the leaders in the field." - BERNARD LO, University of California, San Francisco, and author of Resolving Ethical Dilemmas.
"This book is an important and welcome addition to the scholarship in the field. Addressing the current state and future direction of ethics consultation, it offers a thoughtful overview of some of the most important issues currently debated, from foundational theoretical questions to more practical strategic concerns. It makes a substantial contribution to the literature and will certainly be widely read and referenced." - SUSAN B. RUBIN, PH.D., co-founder of The Ethics Practice and Chair of the Clinical Ethics Task Force of the American Society for Bioethics and Humanities.
MARK p. AULISIO, PH.D., is an Assistant Professor of Bioethics and Director of the Clinical Ethics Program at MetroHealth Medical Center at Case Western Reserve University.
ROBERT M. ARNOLD, M.D., is Professor and Leo H. Criep Chair in Patient Care in the Department of Medicine of the University of Pittsburgh School of Medicine, Associate Director for Education at the Center for Bioethics and Health Law, and Chief of the Section of Palliative Care and Medical Ethics.
STUART J. YOUNCNER, M.D., is Chairman of the Department of Bioethics and Susan B. Watson Professor of Bioethics, and Professor of Psychiatry at Case Western Reserve University School of Medicine.
ix List of Contributors xi Preface
1 I - FOUNDATIONAL AND THEORETICAL QUESTIONS
3 1. Meeting the Need: Ethics Consultation in Health Care Today
3 MARK P. AULISIO
5 Is There a Need?
8 Values and Medical Decision Making
8 Convergence in the Clinic: The Need for Ethics Consultation
9 Finding an Appropriate Approach to Ethics Consultation
2. Can Ethics Consultation Be Saved? Ethics Consultation and Moral Consensus in a Democratic Society
23 JONATHAN MORENO
24 Ethics Consultation and the Pursuit of the Good
27 Morality and Democracy
29 Hazards along the Way
31 Avoiding Moral Relativism and Spiritual Bankruptcy
3. Character and Ethics Consultation: Even the Ethicists Don't Agree
36 FRANCOISE BAYLIS, HOWARD BRODY, MARK P. AULISIO, DAN
W. BROCK, AND WILLIAM WINSLADE
37 The Importance of Character for Ethics Consultants
45 Whose Virtue? Which Character?
48 Conclusion: "But There Is Some Common Ground"
51 II ï¿½ PRACTICAL QUESTIONS
4. Innovative Educational Programs: A Necessary First Step toward Improving
Quality in Ethics Consultation
53 JACQUELINE J. GLOVER AND WILLIAM NELSON
57 Face-to-Face Educational Programs
62 Distance Learning
66 Fellowships, Certificates, and Degree Programs
66 Continuing Support and Mentoring
5. Techniques for Training Ethics Consultants: Why Traditional Classroom
Methods Are Not Enough
70 ROBERT M. ARNOLD AND MELANIE H. WILSON SILVER
71 Conceptions of Bioethics Consultation
72 Competencies Required to Serve as an Ethics Facilitator
73 Training for an Ethics Facilitator
77 Teaching Facilitation: Knowledge and Skills
6. Models for Ethics Consultation: Individual, Team, or Committee?
88 CYNDA RUSHTON, STUART J. YOUNGNER, AND JOY SKEEL
88 Individual Consultant
90 Small-Group Consultation Team 92 Full Ethics Committee
93 Contextual and Practical Issues
94 A Mixed Model
7. The Structure and Process of Ethics Consultation Services
96 JOHN C. FLETCHER AND KATHRYN L. MOSELEY
96 Structures for Ethics Consultation
99 The Process of Ethics Consultation
105 Institutional Policy on Ethics Consultation
105 Legal Cases Naming Ethics Committees or Consultants
8. Institutional Support for Bioethics Committees
121 STEVEN MILES AND RUTH B. PURTILO
122 Legitimizing the Ethics Consultation Service
123 Infrastructure Support of the Ethics Consultation Service
125 Administrative Management of Controversies Caused by Ethics Consultation
129 III ï¿½ QUESTIONS ON THE HORIZON
9. Organizational Ethics: Promises and Pitfalls
131 PAUL M. SCHYVE, LINDA L. EMANUEL, WILLIAM WINSLADE,
AND STUART J. YOUNGNER
133 The Separation of Clinical and Organizational Ethics
135 The Structure of Ethics Committees and Consultation Services
140 The Approach to Organizational Ethics Consultation
143 Competencies for Organizational Ethics Consultation
10. The Licensing and Certification of Ethics Consultants:
What Part of "No!" Was So Hard to Understand?
147 CHARLES BOSK
149 Who Is a Professional?
152 Some Practical Difficulties with Licensure and Certification
156 Some Philosophical Questions Raised by Licensure and Certification
159 A Temporizing Conclusion to Some Intemperate Arguments
165 Appendix. Core Competencies for Health Care Ethics Consultation:
The Report of the American Society for Bioethics and Humanities