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Education for Ethics Practice: Tailoring Curricula to Local Needs and Objectives

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Abstract

Currently, there is no authoritative credentialing process for individuals engaged in ethics practice, no accreditation system that sets minimum education standards for programs aiming to prepare these individuals for their work, and little evidence available that any particular training model is actually achieving its pedagogical goals. At the same time, a number of healthcare organizations and universities now routinely offer post-graduate programs, clinical fellowships and in-house training specifically devised to prepare graduates for ethics practice. However, while their numbers appear to be growing, information about these programs is limited. In this paper, we describe the goals, content and strategies of three educational programs offered in Ontario, Canada. These case studies highlight the diversity of ethics education available to those who engage in ethics practice and underscore the need to take this variety into account in the development of future education standards that would specify minimally acceptable educational requirements.

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Notes

  1. For example, the Association of Bioethics Program Directors and the American Society for Bioethics and Humanities have established a joint Task Force on Clinical Ethics Consultation Training Program Accreditation with the ultimate goal of proposing an accreditation process for such programs.

  2. This list is not meant to be comprehensive and only includes programs described in the published literature. Examples of other US programs aiming to train practicing healthcare ethicists include: University of Texas Integrated Ethics Fellowship; University of Pennsylvania Mediation Program; Albany Medical College Graduate Certificate in Clinical Ethics; Oregon Health and Science University Fellowship in Ethics; Duke University Clinical Ethics Program; University of Pittsburgh Clinical Ethics Training Program; Medical College of Wisconsin Certificate in Clinical Bioethics and on-line Fellowship programs; Montefiore-Einstein Center for Bioethics internships and intensive course in bioethics consultation skills; McLean Center for Clinical Medical Ethics fellowships and Union College Certificate in Bioethics (with a specialization in clinical ethics).

  3. This unpublished study received ethics approval from the University of Toronto Health Sciences Research Ethics Board.

  4. Other Canadian educational programs include an ethics consultation “boot camp” and an introduction to bioethics distance education course, both offered through the Provincial Health Ethics Network in Alberta; the Clinical Ethics Summer Institute held in Ontario; and Institut d'été en éthique clinique offered through L'Association québécoise en éthique clinique. Over the years individual hospitals have also offered clinical internship and residency programs including the Royal Alexandria Hospital and the Centre for Clinical Ethics, a joint venture of Providence Healthcare, St. Joseph's Health Centre and St. Michael's Hospital.

  5. The current stipend for the JCB Fellowship is CAD $40,000/year plus 4 % vacation pay.

  6. The Centre for Clinical Ethics, a joint venture of Providence Healthcare, St. Joseph's Health Centre and St. Michael's Hospital.

  7. Topic areas include: the nature, kind, and goals of ethics consultation; fellows’ and ethicists’ roles; core knowledge and skill competencies; facilitation and communication skills, including body language; problem-solving frameworks and tools; documentation, e.g., in patient charts, ethics program records; conflict/issue communication/management; follow-up; evaluation, and quality improvement. Numerous standard hypothetical scenarios have been developed for discussion and feedback, along with those raised by Fellows. An experiential sculpting exercise is used to raise awareness of roles, relationships, and positioning, and mock consultations/role plays provide Fellows with the opportunity to practice the healthcare ethics practitioner role with the benefit of feedback from other Fellows, the Director, other faculty mentors, and standardized patients.

References

  • American Society for Bioethics and Humanities (ASBH). (1998). Core competencies for health care ethics consultation. Glenview, IL: ASBH.

    Google Scholar 

  • American Society for Bioethics and Humanities (ASBH). (2011). Improving competencies in clinical ethics consultation: An education guide (2nd ed.). Glenview, IL: ASBH.

    Google Scholar 

  • American Society for Bioethics & Humanities’ (ASBH) Core Competencies Update Task Force. (2011). Core competencies for health care ethics consultation: The report of the American Society for Bioethics and Humanities (2nd ed.). Glenview, IL: ASBH.

    Google Scholar 

  • Beer, J. E., & Stief, E. (1997). The mediator’s handbook. Philadelphia: New Society Publishers.

    Google Scholar 

  • Chidwick, P., Bell, J., Connolly, E., Coughlin, M., Frolic, A., Hardingham, L., et al. (2010). Exploring a model role description for ethicists. HEC Forum, 22(1), 31–40.

    Article  Google Scholar 

  • Chidwick, P., Faith, K., Godkin, D., & Hardingham, L. (2004). Clinical education of ethicists: the role of a clinical ethics fellowship. BMC Medical Ethics, 5(6). doi:10.1186/1472-6939-5-6.

  • Dubler, N. N., & Blustein, J. (2007). Credentialing ethics consultants: An invitation to collaboration. The American Journal of Bioethics, 7(2), 35–37.

    Article  Google Scholar 

  • Dubler, N., & Leibman, C. B. (2004). Bioethics mediation: A guide to shaping shared solutions. New York, NY: United Hospital Fund.

    Google Scholar 

  • Glover, J. J., & Nelson, W. (2003). Innovative educational programs: A necessary first step in improving quality in ethics consultation. In M. P. Ausilio, R. M. Arnold, & S. J. Younger (Eds.), Ethics consultation: From theory to practice (pp. 53–69). Baltimore: The Johns Hopkins University Press.

    Google Scholar 

  • Kipnis, K. (2009). The certified clinical ethics consultant. HEC Forum, 21(3), 249–261.

    Article  Google Scholar 

  • MacRae, S., Chidwick, P., Berry, S., Secker, B., Hebert, P., Zlotnik Shaul, R., Faith, K., & Singer, P. A. (2005). Clinical bioethics integration, sustainability, and accountability: the Hub and Spokes strategy. The Journal of Medical Ethics, 31, 256–261.

  • Practicing Healthcare Ethicists Exploring Professionalization. (2011, April). PHEEP Survey of Directors Aiming to Educate and Train Practicing Healthcare Ethicists, SurveyMonkey.

  • Smith, M. L., Sharp, R. R., Weise, K. L., & Kodish, E. (2010). Toward competency-based certification of clinical ethics consultants: A four-step process. The Journal of Clinical Ethics, 21(1), 14–22.

    Google Scholar 

  • Spike, J. P. (2009). Resolving the vexing question of credentialing: Finding the Aristotelian Mean. HEC Forum, 21(3), 263–273.

    Article  Google Scholar 

  • Swiderski, D. M., Ettinger, K. M., Webber, M., & Dubler, N. (2010). The clinical ethics credentially project: Preliminary notes from a pilot project to establish quality measures for ethics consultation. HEC Forum, 22, 65–72.

    Article  Google Scholar 

  • Tarzian, A. J. (2009). Credentials for clinical ethics consultation—Are we there yet? HEC Forum, 21(3), 241–248.

    Article  Google Scholar 

  • United States Department of Veteran Affairs National Center for Ethics in Health Care, Integrated Ethics Program at http://www.ethics.va.gov/integratedethics/.

  • Volpe, R. (2011). Training currently practicing members of the ethics consultation service: one institution’s experience. The Journal of Clinical Ethics, 22(3), 217–222.

    Google Scholar 

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Authors and Affiliations

  1. Queen’s University, 78 Barrie Street, Kingston, ON, K7L 2N6, Canada

    Cheryl Cline

  2. Toronto Rehabilitation Institute, University Health Network, University Centre, 550 University Avenue, Room N7-063, Toronto, ON, M5G 2C4, Canada

    Ann Heesters

  3. Joint Centre for Bioethics, University of Toronto, 155 College Street, Suite 754, Toronto, ON, M5T 1P8, Canada

    Barbara Secker

  4. Hamilton Health Sciences, 1200 Main St. West, Hamilton, ON, L8N 3Z5, Canada

    Andrea Frolic

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  1. Cheryl Cline
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  2. Ann Heesters
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  3. Barbara Secker
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  4. Andrea Frolic
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Correspondence to Cheryl Cline.

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Cline, C., Heesters, A., Secker, B. et al. Education for Ethics Practice: Tailoring Curricula to Local Needs and Objectives. HEC Forum 24, 227–243 (2012). https://doi.org/10.1007/s10730-012-9187-8

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