Thorny Issues in Clinical Ethics Consultation

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.

Auteur

Mark G. Kuczewski, PhD, HEC-C, is the Fr. Michael I. English, S.J., Professor of Medical Ethics. He is also the director of the Neiswanger Institute for Bioethics and Healthcare Leadership at the Loyola University Chicago Stritch School of Medicine. Mark is a past president of the American Society for Bioethics and Humanities (ASBH). He has been engaged in bedside clinical ethics issues for more than 25 years and much of that experience forms the basis for the popular text, An Ethics Casebook for Hospitals: Practical Approaches to Everyday Ethics Consultations (2nd edition, Georgetown University Press). For the last decade, he has been an articulate spokesperson for the just and equitable treatment of immigrant patients.

Katherine Wasson, PhD, MPH, HEC-C, is an Associate Professor in The Neiswanger Institute for Bioethics and Healthcare Leadership at the Stritch School of Medicine, Loyola University Chicago where she is the Director of the Bioethics and Professionalism Honors Program. For over 20 years Dr. Wasson has been a clinical ethics consultant and educator, including in both the United States and United Kingdom, teaching a wide range of students and healthcare professionals. She was one of the first Fellows in The Ethics of Prevention and Public Health at The National Cancer Institute and served on the American Society for Bioethics and Humanities Clinical Ethics Consultation Affairs Committee and the Board of Directors. She is the project lead for the Assessing Clinical Ethics Skills (ACES) Tool for training and evaluating clinical ethics consultants and the corresponding research studies.

Contenu

Part 1: History and Development of the Formation and Training of Clinical Ethics Consultants.- Chapter 1. A Brief Introduction to the History of Clinical Ethics in the United States (Robert Baker).- Chapter 2. Clinical Ethics Consultation in the United States: Current Standards in the Field (Anita Tarzian).- Chapter 3. What Does Competency Have to Do with It? Ethics fellowship training and the experience of a hospital-based program in Canada (Dave Langlois).- Chapter 4. Models of Training Clinical Ethics Consultants and Approaches to Quality Assessment and Improvement (Katherine Wasson).- Chapter 5. New Approaches for Advancing Ethics Quality: Assessment of the Ethics Consultation Record (David Alfandre).- Chapter 6. Historical Development of Clinical Ethics Consultation in Europe (Ralf Jox).- Chapter 7. Clinical Ethics Consultation in Germany: History, Current Status and Models of Training Europe (Gerald Neitzke).- Chapter 8. Innovation or Stagnation: The State of Art of Clinical Ethics Support in Switzerland (Rouven Porz).- Part 2: Emerging and Thorny Clinical Ethical Issues.- Chapter 9. Clinical Ethics Consultation and Marginalized Populations (Marion Danis).- Chapter 10. Vulnerable populations, the Law of the Dynamics of Inverse Care, and the role of the Clinical Ethics Consultant: Experiences from Switzerland (Tonja Krones).- Chapter 11. Clinical Ethics Consultations regarding Patients with Opioid Use Disorders (Mark Kuczewski).- Chapter 12. The Opioid Crisis: An European Perspective (Ralf Jox).- Chapter 13. Ethical Issues in Complex Discharge Cases (Kayhan Parsi).- Chapter 14. How Clinical Ethics Consultants Navigate Complex Acute Care Discharge Cases in Ontario (Sally Bean).- Chapter 15. Thorny Issues in Clinical Ethics Consultation: When Surrogates Refuse Basic Care (Sarah Vittone).- Chapter 16. Families Who Micromanage (Patricia Mayer).- Part 3: Persistent and Thorny Ethical Issues.- Chapter 17. Neuroethics in the Clinic: Amplifying patient perspectives through enhanced decision-making frameworks (Sharon L. Feldman).- Chapter 18. Brain Death/Death by Neurological Criteria in the United States: What Every Clinical Ethics Consultant Should Know (Sok Lee).- Chapter 19. When patients still hope, but doctors see no more therapeutic options: Ethical debates on futility and potentially inappropriate treatment (Christoph Mandry).- Chapter 20. Physician Aid in Dying in the United States: A Prescription for Death or Control? (Felicia Cohn).- Chapter 21. Medical Aid in Dying in Canada: Undertaking Clinical Ethics Consultations in a Rapidly Evolving Regulatory Landscape (Benjamin Zolf).- Chapter 22. Physician Assisted Suicide and Euthanasia in the European Context (Charlotte Wetterauer).- Chapter 23. Pediatric Ethical Issues and Clinical Ethics Consultation in the United States (Micah Hester).- Chapter 24. Ethical Issues and Decision Making for Children: An European Perspective (Helen Turnham).- Chapter 25. The Adolescent Transplant Candidate: Thorny Issues in Assessment and Allocation from a Canadian Perspective (Aviva Goldberg).- Chapter 26. Classifying the Contradiction: A Practical Approach When Surrogates Appear to Contradict a Patient's Wishes (Hilary Mabel).- Chapter 27. Thorny Issues in Clinical Ethics Consultation: A Canadian Perspective on Surrogate Decision Making Concerning Potentially Non-Beneficial Care (Katarina Lee-Ameduri).- Part 4: Organizational Issues in United States Ethics Consultation.- Chapter 28. Moving Ethics Upstream: Shifting Clinical Ethics Consultation from Volume to Value (Mark Repenshek).- Chapter 29. The Tension between "Margin and Mission" as an Ethical Issue in Health Care (Patrick McCruden).