Which opinion should a clinical ethicist give: Personal viewpoint or professional consensus?
- 31 Downloads
When clinical ethicists are called upon to give a recommendation regarding patient care, they may be faced with a dilemma of their own. If their own personal opinion is not widely shared, the ethicist will have three options. These include: (1) giving their own opinion; (2) giving the widely shared opinion; and (3) giving both opinions, leaving the physician to select which opinion to accept. The intentions of this article are to evaluate strengths and weaknesses of these three alternatives and to suggest that ethics consultants recognize and deal with this issue. Two cases are presented to explore the limitations of each option. The author suggests that when the views of ethics consultants differ from the consensus view, the consultant should give the consensus view, their own dissenting view and the arguments in support of each position.
Key wordsclinical ethics ethicist ethics consultation referral
Unable to display preview. Download preview PDF.
- 1.Basson MD. Bioethics in the medical center: an exploration. Hosp Pract 1984; 19:177–84.Google Scholar
- 2.Churchill LR, Cross AW. Moralist, technician, sophist, teacher/learner: reflections on the ethicist in the clinical setting. Theor Med 1986; 7:3–12.Google Scholar
- 3.Fleishman AR. A physician's view. Hastings Cent Rep 1981; (Apr):18–9.Google Scholar
- 4.Fowler MD. The role of the clinical ethicist. Heart Lung 1986; 15:318–9.Google Scholar
- 5.Freedman B. One philosopher's experience on an ethics committee. Hastings Cent Rep 1981; (Apr):20–2.Google Scholar
- 6.LaPuma J, Stocking CB, Silverstein M, DiMartini A, Siegler M. An ethics consultation service in a teaching hospital. JAMA 1988; 260:808–11.Google Scholar
- 7.Lyon-Loftus GT. What is a clinical ethicist? Theor Med 1986; 7:41–5.Google Scholar
- 8.Self DJ, Skeel JD. Potential roles of the medical ethicist in the clinical setting. Theor Med 1986; 7:33–9.Google Scholar
- 9.LaPuma J. Consultations in clinical ethics—issues and questions in 27 cases. West J Med 1987; 146:633–7.Google Scholar
- 10.Purtillo R. Ethics consultations in the hospital. N Engl J Med 1984; 311:983–6.Google Scholar
- 11.Ruddick W. Can doctors and philosophers work together? Hastings Cent Rep 1981; (Apr):12–7.Google Scholar
- 12.Skeel JD, Self DJ. An analysis of ethics consultation in the clinical setting. Theor Med 1989; 10:289–99.Google Scholar
- 13.Webster's Third New International Dictionary of the English Language. Springfield, MA: G & C Meriam Company, 1966.Google Scholar
- 14.President's Commission for the Study of Ethical Problems in Medicine and Biomedical and Behavioral Research. Deciding to Forego Life-Sustaining Treatment: Ethical, Medical and Legal Issues in Treatment Decisions. Washington, DC: US Government Printing Office, 1983.Google Scholar
- 15.The Council on Ethical and Judical Affairs of the American Medical Association. Current Opinions. Chicago: American Medical Association, 1989.Google Scholar
- 16.Ackerman TF. Conceptualizing the role of the ethics consultant: some theoretical issues. In: Fletcher JC, Quist N, Jonsen AR, eds. Ethics Consultation in Health Care. Ann Arbor, MI: Health Administration Press, 1989:47.Google Scholar