Thorny Issues in Clinical Ethics Consultation

1. Front Matter

   Pages i-xiv

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2. Part I

   1. Front Matter

      Pages 1-2

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   2. A Brief Introduction to the History of Clinical Ethics

      • Robert Baker

      Pages 3-12

   3. Clinical Ethics Consultation: Current Standards in the Field

      • Anita Tarzian

      Pages 13-20

   4. What Does Competency Have to Do with It? Ethics Fellowship Training and the Experience of a Hospital-Based Program in Canada

      • Dave Langlois, Juhee Makkar, Michael J. Szego

      Pages 21-28

   5. Models of Training for Clinical Ethics Consultants and Approaches to Quality Assessment and Improvement

      • Katherine Wasson

      Pages 29-37

   6. New Approaches for Advancing Ethics Quality: Assessment of the Ethics Consultation Record

      • David Alfandre, Robert A. Pearlman

      Pages 39-46

   7. Historical Development of Clinical Ethics Consultation in Europe

      • Ralf Jox, Stella Reiter-Theil

      Pages 47-54

   8. Clinical Ethics Consultation in Germany: History, Current Status and Models of Training

      • Gerald Neitzke, Alfred Simon

      Pages 55-63

   9. Innovation or Stagnation? The State of Art of Clinical Ethics Support in Switzerland

      • Rouven Porz, Hubert Kössler, Urs Mosimann

      Pages 65-72

3. Part II

   1. Front Matter

      Pages 73-73

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   2. Ethics Consultation and Marginalized Populations

      • Marion Danis

      Pages 75-83

   3. Vulnerable Populations, the Inverse Care Law, and the Role of Clinical Ethicists: Experiences from Switzerland

      • Tanja Krones, Settimio Monteverde

      Pages 85-92

   4. Clinical Ethics Consultations Regarding Patients with Opioid Use Disorders

      • Mark G. Kuczewski

      Pages 93-100

   5. The Opioid Crisis: A European Perspective

      • Ralf J. Jox

      Pages 101-108

   6. Ethical Issues in Complex Discharge Cases

      • Kayhan Parsi

      Pages 109-115

   7. How Clinical Ethics Consultants Navigate Complex Acute Care Discharge Cases in Ontario

      • Sally Bean, Julija Kelecevic

      Pages 117-124

   8. Thorny Issues in Clinical Ethics Consultation: When Surrogates Refuse Basic Care

      • Sarah Vittone

      Pages 125-133

   9. Families Who Micromanage: “Please Come Help Us with This Family – They Are Micromanaging Everything!”

      • Patricia A. Mayer

      Pages 135-143

4. Part III

   1. Front Matter

      Pages 145-146

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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.

• Clinical Ethics Consultation
• Ethical Issues in Clinical Healthcare
• End-of-life-futility
• Pediatric Ethics
• The Business of Healthcare
• Organizational Issues in Healthcare
• Development of Clinical Ethics
• Clinical Ethics Consultants

• Neiswanger Institute for Bioethics and Health Policy, Maywood, USA

  Katherine Wasson, Mark Kuczewski

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.

Policies and ethics