Theoretical Medicine

, Volume 12, Issue 2, pp 141–149 | Cite as

The clinical ethicist at the bedside

  • John la Puma
  • David L. Schiedermayer


In this paper we attempt to show how the goal of resolving moral problems in a patient's care can best be achieved by working at the bedside.

We present and discuss three cases to illustrate the art and science of clinical ethics consultation. The sine qua non of the clinical ethics consultant is that he or she goes to the patient's bedside to obtain specific clinical and ethical information. Unlike ethics committees, which often depend on secondhand information from a physician or nurse, clinical ethics consultants personally speak with and examine patients and review their laboratory data and medical records. The skills of the clinical ethics consultant include the ability to delineate and resolve ethical problems in a particular patient's case and to teach other health professionals to build their own frameworks for clinical ethical decision making. When the clinical situation requires it, clinical ethics consultants can and should assist primary physicians with case management.

Key words

clinical ethics clinical decision making clinician ethics ethics consultation medical consultation 


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Copyright information

© Kluwer Academic Publishers 1991

Authors and Affiliations

  • John la Puma
    • 1
  • David L. Schiedermayer
    • 2
  1. 1.Center for Clinical EthicsPark RidgeUSA
  2. 2.Center for the Study of BioethicsMedical College of WisconsinMilwaukeeUSA

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