Hot Topics: Clinical Ethics

Blog Posts (47)

February 3, 2016

A Letter to Dick Wolf & Chicago Med

by Craig Klugman, Ph.D.

When I was a graduate student in my clinical bioethics masters program I was rotating through a pediatric subspecialty, following a physician.…

January 26, 2016

The Sky is Falling: How Much Do We Owe A Patient?

by Craig Klugman, Ph.D.

Imagine if a patient went sky diving without a parachute and survived. You fixed up her body and explained to her the dangers of her activities.…

January 18, 2016

Can Health Care Providers Love Their Patients?

by J.S. Blumenthal-Barby

Ms. Clara [name changed] is one of our patient partners on a PCORI funded project. PCORI is unique in that they aim to include patients and other stakeholders in all stages of research—from conceptualization of projects and their aims to the dissemination of results.…

January 13, 2016

Professional Judgment and Justice: Equal Respect for the Professional Judgment of Critical-Care Physicians

by David Magnus, PhD and Norm Rizk, MD

This issue’s target article by Kirby (2016) raises an incredibly important and challenging set of issues: Whether, when, and how should limits be placed on patient access to intensive medical care?…

November 19, 2015

Is There An Ethics Consultant In The House? Striving For Verisimilitude In Chicago Med

by Kayhan Parsi, JD, PhD and Nanette Elster, JD, MPH

The new NBC medical drama Chicago Med premiered this week. A spin off of other established NBC dramas (Chicago Fire and Chicago PD), Chicago Med focuses on the working lives of health care professionals in a busy emergency department in the city of Chicago.…

October 28, 2015

Can a 5-year-old refuse treatment: The Case of Julianna Snow

by Craig Klugman, Ph.D.

Julianna Snow is a 5-year-old who suffers from Charcot-Marie-Tooth disease, a neurodegenerative illness. This is the most common of all inherited neurological disorders (about 1 in 2,500 people have it).…

October 9, 2015

Deeply Superficial

<p style="padding-left: 60px;"><span><span><span class="UFICommentBody"><span>“People need to be made more aware of the need to work at learning how to live because life is so quick and sometimes it goes away too quickly.” – Andy Warhol</span></span></span></span></p> <p><span><span><span class="UFICommentBody"><span>This past weekend was the last one for The Late Drawings of Andy Warhol: 1973-1987 exhibit at <a href="http://www.hydecollection.org/">The Hyde Collection Museum in Glen Falls</a>, and I almost didn’t go to it. I told myself there were far too many other things to do: the stack of recent journal articles I’ve been meaning to get to; student assignments that are in need of grading; the upcoming presentations for which I haven’t even begun putting together powerpoints; the apartment that, despite ongoing efforts, never seems to be completely clean; the piles of unwashed or unfolded laundry; and so on. In terms of triaging my limited time, a two-hour round trip trek to see a handful of sketches hardly seemed sufficiently important.</span></span></span></span></p> <p><span style="color: #34405b; font-family: Arial, Helvetica, sans-serif; font-size: 12px; line-height: 19.04px;"><strong>The Alden March Bioethics Institute offers a Master of Science in Bioethics, a</strong> </span><strong style="color: #34405b; font-family: Arial, Helvetica, sans-serif; font-size: 12px; line-height: 19.04px;">Doctorate of Professional Studies in Bioethics, and Graduate Certificates in Clinical Ethics and Clinical Ethics Consultation. For more information on AMBI's online graduate programs, please visit our <a style="color: #000099; text-decoration: underline;" href="http://www.amc.edu/Academic/bioethics/index.cfm">website</a>.</strong></p>
August 24, 2015

"One Shoe Can Change Your Life"*

by Jeanie Sauerland, BS, BSN, RN

I hate shopping for shoes – always have. Footwear was not the reason I chose nursing – but it sure made it nice, to be able to wear comfortable walking shoes without looking like you wore orthopedic shoes made for someone 90 years old.…

July 7, 2015

Clinical Ethics Consultant Professionalization: A Response to Dr. Shelton

<p><span style="font-size: 11.1999998092651px; line-height: 22.3999996185303px;">In his <a href="/BioethicsBlog/post.cfm/does-the-work-clinical-ethics-consultation-lend-itself-to-professionalization">last AMBI blog</a> </span><span style="font-size: 11.1999998092651px; line-height: 22.3999996185303px;">posted on June 18, 2015, Wayne N. Shelton, PhD, MSW, discussed recent movement toward the professionalization of clinical ethics consultants. He noted the adoption of a Code of Ethics for Health Care Ethics Consultants by the American Society for Bioethics and Humanities (ASBH), which has been praised as important milestone toward the professionalization of clinical ethics consultants. Moreover, Dr. Shelton listed several challenges that “professionals” who call themselves “clinical ethics consultants” currently face, including: “[1] </span><span style="font-size: 11.1999998092651px; line-height: 22.3999996185303px; color: #273049;">how to make sense of the diverse educational backgrounds and training of those who perform clinical ethics consultations and how far to push such requirements; [2] the lack of a national body to set requirements that leaves local hospital leaders with little incentive to pay for highly qualified CECs and view this as a sound investment; and finally [3], most seriously, the way in which many problems in patient care are misidentified as clinical ethical problems while other serious clinical ethical problems may be entirely overlooked or if recognized, not viewed as requiring the expertise of a CEC.” He concluded his post with: “These challenges are indications that clinical ethics consultation will not likely achieve professional status in the healthcare system in the near future.” Of course, Dr. Shelton is correct in his analysis, but some might see the challenges he listed as surmountable if those who practiced clinical ethics consultation were to: (1) establish minimum uniform educational standards for new clinical ethics consultants; (2) create national certification and accreditation standards so employers would more fully understand the nature and value of their work; and (3) provide consultants themselves and other stakeholders unmistakable guidance on what clearly constitutes the work of clinical ethics consultants. (This third point sounds very much like a “scope of practice” definition found in state professional licensing statutes.) However, it may take something much more for clinical ethics consultants to be a separate professional category.</span></p> <p><strong style="color: #34405b; font-family: Arial, Helvetica, sans-serif; font-size: 12px; line-height: 19.0400009155273px;">The Alden March Bioethics Institute offers a Master of Science in Bioethics, a Doctorate of Professional Studies in Bioethics, and Graduate Certificates in Clinical Ethics and Clinical Ethics Consultation. For more information on AMBI's online graduate programs, please visit our <a style="color: #000099; text-decoration: underline;" href="http://www.amc.edu/Academic/bioethics/index.cfm">website</a>.</strong></p>
June 17, 2015

Does Clinical Ethics Consultation Lend Itself to Professionalization?

<p style="font-size: 11.1999998092651px; line-height: 19.0400009155273px;"><span style="font-size: 11.1999998092651px; line-height: 19.0400009155273px;">Let me say emphatically at the outset of this blog, as someone who has been a clinical ethics consultant for over 20 years, I am quite sure that clinical ethics consultations overall improve the quality of patient care and currently are an important, even essential, part of the providing excellent patient care in hospitals. Contemporary medicine is filled with value laden questions and issues that often can be effectively addressed by someone with expertise and training in clinical ethics. Having said this, I am still somewhat skeptical about clinical ethics consultation becoming a professional area of healthcare that parallels other professional areas like medicine, nursing, and social work. I think there are some special considerations about the field of clinical ethics consultation that makes its future status as a professional activity uncertain.</span></p> <p style="font-size: 11.1999998092651px; line-height: 19.0400009155273px;">First of all it is well-known that CEC’s come from a variety of backgrounds and training—from philosophers to physicians to social workers to nurses and lawyers and on and on. People enter the field of clinical ethics consultations from very different disciplinary backgrounds and seemingly learn a common vocabulary and methodology of clinical ethics and a basic familiarity with and ability to function in the clinical setting. They learn this vocabulary in very different ways—some informally, some through short 1-2 week long intensives, some with certificate programs, some with master’s degrees, and some with 1-2 year long fellowships. No other area of healthcare work admits of such diversity. Though this is a positive feature in some ways by providing diverse perspectives in understanding value dilemmas, it creates a challenge of considerable controversy when we try to define the kind of educational training a future CEC should have. At the moment there seem to be many pathways into the field and no clear answer has emerged.</p> <p><strong style="color: #34405b; font-family: Arial, Helvetica, sans-serif; line-height: 19.0400009155273px; font-size: 12px;">The Alden March Bioethics Institute offers a Master of Science in Bioethics, a Doctorate of Professional Studies in Bioethics, and Graduate Certificates in Clinical Ethics and Clinical Ethics Consultation. For more information on AMBI's online graduate programs, please visit our <a style="color: #000099; text-decoration: underline;" href="/Academic/bioethics/index.cfm">website</a>.</strong></p>

View More Blog Entries

Published Articles (47)

American Journal of Bioethics: Volume 16 Issue 1 - Jan 2016

Balancing Legitimate Critical-Care Interests: Setting Defensible Care Limits Through Policy Development Jeffrey Kirby

American Journal of Bioethics: Volume 16 Issue 1 - Jan 2016

Professional Judgment and Justice: Equal Respect for the Professional Judgment of Critical-Care Physicians David Magnus & Norm Rizk

American Journal of Bioethics: Volume 16 Issue 1 - Jan 2016

Professional Judgment and Justice: Equal Respect for the Professional Judgment of Critical-Care Physicians David Magnus & Norm Rizk

American Journal of Bioethics: Volume 15 Issue 10 - Oct 2015

Doctors, Patients, and Nudging in the Clinical Context—Four Views on Nudging and Informed Consent Thomas Ploug & Søren Holm

American Journal of Bioethics: Volume 15 Issue 10 - Oct 2015

Do Patients Want to Participate in Decisions About Their Own Medical Care? John D. Lantos

American Journal of Bioethics: Volume 15 Issue 9 - Sep 2015

Patient Perspectives on the Learning Health System: The Importance of Trust and Shared Decision Making Maureen Kelley, Cyan James, Stephanie Alessi Kraft, Diane Korngiebel, Isabelle Wijangco, Emily Rosenthal, Steven Joffe, Mildred K. Cho, Benjamin Wilfond & Sandra Soo-Jin Lee

American Journal of Bioethics: Volume 15 Issue 6 - Jun 2015

U.S. Complicity and Japan's Wartime Medical Atrocities: Time for a Response Katrien Devolder

American Journal of Bioethics: Volume 15 Issue 5 - May 2015

A Code of Ethics for Health Care Ethics Consultants: Journey to the Present and Implications for the Field Anita J. Tarzian, Lucia D. Wocial & The ASBH Clinical Ethics Consultation Affairs Committee

American Journal of Bioethics: Volume 15 Issue 5 - May 2015

Ethics Consultation in Pediatrics: Long-Term Experience From a Pediatric Oncology Center Liza-Marie Johnson, Christopher L. Church, Monika Metzger & Justin N. Baker

American Journal of Bioethics: Volume 15 Issue 5 - May 2015

The Proper Locus of Professionalization: The Individual or the Institutions? David Magnus & Bela Fishbeyn

View More Articles

News (118)

December 8, 2015 2:54 pm

More than half of U.S. doctors experience burnout

Burnout among U.S. doctors is becoming more common and now affects more than half of practicing physicians, according to a new study.  About 54 percent of U.S. doctors experienced at least one symptom of burnout in 2014, compared to about 46 percent of doctors in 2011, researchers report in Mayo Clinic Proceedings.

December 2, 2015 6:31 pm

When medical knowledge is at a crossroads, how research can take patient preferences into account

Neither drug is experimental; both are within the standard of care. Your doctor doesn’t have any medical reason to recommend one or the other.
November 10, 2015 4:48 pm

The Theranos mess: A timeline

How the blood-testing company went from hot to troubled in just a couple of weeks.

November 3, 2015 12:12 pm

A group of middle-aged whites in the U.S. is dying at a startling rate

A large segment of white middle-aged Americans has suffered a startling rise in its death rate since 1999, according to a review of statistics published Monday that shows a sharp reversal in decades of progress toward longer lives.

October 27, 2015 6:11 pm

Heaven over hospital: Dying girl, age 5, makes a choice

Julianna Snow is dying of an incurable disease. She’s stable at the moment, but any germ that comes her way, even just the common cold virus, could kill her. She’s told her parents that the next time this happens, she wants to die at home instead of going to the hospital for treatment.

October 26, 2015 7:24 pm

Clash in the name of Care

It was a battle pitting a star surgeon against a great hospital, MGH. The question: Is it right or safe for surgeons to run two operations at once? Is it right that their patients may have no idea? The conflict went on for years. And it isn’t over yet.

September 24, 2015 1:02 pm

Black patients fare better than whites when both get same healthcare, study finds

A nine-year study of more than 3 million veterans found that when black patients and white patients received the same level of healthcare, blacks fared better than whites.

September 16, 2015 4:01 pm

Poverty may increase odds of repeat hospitalizations

When patients are hospitalized more than once in the same month, it may have more to do with their income or education levels than the quality of care they received, a U.S. study suggests.

September 15, 2015 3:54 pm

Rise in crowdfunding lets patients seek help for medical treatment

When Esperanza Hannon was denied entrance to a clinical trial in June, it was another dashed hope in many attempts to find treatment for her fast-spreading breast cancer.

September 2, 2015 2:50 pm

Stethoscope meets smartphone and the heart knows it's right

The Food and Drug Administration has cleared for the U.S. market a digital stethoscope, the Eko Core, that aims to bring auscultation — the ancient medical practice of listening to a patient’s heartbeat — squarely into the 21st century.

View More News Items