HEC Forum

, Volume 28, Issue 1, pp 69–74 | Cite as

Preventive Ethics Through Expanding Education

Article

Abstract

Healthcare institutions have been making increasing efforts to standardize consultation methodology and to accredit both bioethics training programs and the consultants accordingly. The focus has traditionally been on the ethics consultation as the relevant unit of ethics intervention. Outcome measures are studied in relation to consultations, and the hidden assumption is that consultations are the preferred or best way to address day-to-day ethical dilemmas. Reflecting on the data from an internal quality improvement survey and the literature, we argue that having general ethics education as a key function of ethics services may be more important in meeting the contemporaneous needs of acute care settings. An expanded and varied ethics education, with attention to the time constraints of healthcare workers’ schedules, was a key recommendation brought forward by survey respondents. Promoting ethical reflection and creating a culture of ethics may serve to prevent ethical dilemmas or mitigate their effects.

Keywords

Ethics consultation Ethics education Communication Preventive ethics Capacity building Accreditation 

Notes

Acknowledgement

We thank Carol Pavlish for her constructive and helpful feedback on an earlier draft. We also thank our anonymous reviewers for their insightful advice.

References

  1. American Society for Bioethics and Humanities (2010). Report to the board of directors, American Society for Bioethics and Humanities: Certification, accreditation, and credentialing of clinical ethics consultants.Google Scholar
  2. Andereck, W. S., McGaughey, J. W., Schneiderman, L. J., & Jonsen, A. R. (2014). Seeking to reduce nonbeneficial treatment in the ICU: An exploratory trial of proactive ethics intervention. Critical Care Medicine, 42(4), 824–830.CrossRefGoogle Scholar
  3. Dowdy, M. D., Robertson, C., & Bander, J. A. (1998). A study of proactive ethics consultation for critically and terminally ill patients with extended lengths of stay. Critical Care Medicine, 26(2), 252–259.CrossRefGoogle Scholar
  4. Fiester, A. (2007). The failure of the consult model: Why “mediation” should replace “consultation”. The American Journal of Bioethics, 7(2), 31–32.CrossRefGoogle Scholar
  5. Fiester, A. (2014). Bioethics mediation & the end of clinical ethics as we know it. Cardozo Journal of Conflict Resolution, 15, 501–513.Google Scholar
  6. Fox, E., Myers, S., & Pearlman, R. A. (2007). Ethics consultation in United States hospitals: A national survey. The American Journal of Bioethics, 7(2), 13–25.CrossRefGoogle Scholar
  7. Gaudine, A., Thorne, L., LeFort, S. M., & Lamb, M. (2010). Evolution of hospital clinical ethics committees in Canada. J Med Ethics, 36(3), 132–137.CrossRefGoogle Scholar
  8. Pavlish, P., Brown-Saltzman, K., Dirksen, K. M., & Fine, A. (2015). Physicians’ perspectives on ethically challenging situations: Early identification and action. AJOB Empirical Bioethics (in press).Google Scholar
  9. Puma, J., Stocking, C. B., Silverstein, M. D., DiMartini, A., & Siegler, M. (1988). An ethics consultation service in a teaching hospital: Utilization and evaluation. JAMA, 260(6), 808–811.CrossRefGoogle Scholar
  10. Robblee, J. A., & Heidemann, E. G. (2004). Hospital accreditation and the surgeon: The Canadian experience. The Surgeon, 2(6): 321–326.Google Scholar
  11. Schneiderman, L. J., Gilmer, T., Teetzel, H. D., Dugan, D. O., Blustein, J., Cranford, R., et al. (2003). Effect of ethics consultations on nonbeneficial life-sustaining treatments in the intensive care setting: A randomized controlled trial. JAMA, 290(9), 1166–1172.CrossRefGoogle Scholar
  12. Schneiderman, L. J., Gilmer, T., Teetzel, H. D., Dugan, D. O., Goodman-Crews, P., & Cohn, F. (2006). Dissatisfaction with ethics consultations: The Anna Karenina principle. Cambridge Quarterly of Healthcare Ethics, 15(1), 101–106.CrossRefGoogle Scholar
  13. The Joint Commission. (2011). Comprehensive accreditation manual for hospitals: The official handbook. Oakbrook Terrace, IL: The Joint Commission.Google Scholar

Copyright information

© Springer Science+Business Media Dordrecht 2015

Authors and Affiliations

  • Anita Ho
    • 1
    • 2
    • 3
  • Lisa Mei-Hwa MacDonald
    • 2
  • David Unger
    • 3
  1. 1.Yong Loo Lin School of MedicineNational University of SingaporeSingaporeSingapore
  2. 2.W. Maurice Young Centre for Applied EthicsUniversity of British ColumbiaVancouverCanada
  3. 3.Providence Health CareVancouverCanada

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