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Models of Ethics Consultation Used by Canadian Ethics Consultants: A Qualitative Study


This article describes a qualitative study of models of ethics consultation used by ethics consultants in Canada. We found four different models used by Canadian ethics consultants whom we interviewed, and one sub-variant. We describe (1) the lone ethics consultant model, (1a) the hub-and-spokes sub-variant of this model; (2) the ethics committee model; (3) the capacity-building model; and (4) the facilitated model. Previous empirical studies of ethics consultation describe only two or three of these models.

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  1. The requirement to protect participant confidentiality entails that we cannot identify which provinces.


  • Bean, S. (2011). Navigating the murky intersection between clinical and organizational ethics: A hybrid case taxonomy. Bioethics, 25(6), 320–325.

    Article  Google Scholar 

  • Fox, E., Berkowitz, K.A., Chanko, B.L., & Powell, T. (2006). Ethics consultation: Responding to ethics questions in health care. Accessed 2 July 2015.

  • 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.

    Article  Google Scholar 

  • Gaudine, A., Lamb, M., LeFort, S. M., & Thorne, L. (2011). The functioning of hospital ethics committees: A multiple-case study of four Canadian committees. HEC Forum, 23(3), 225–238.

    Article  Google Scholar 

  • Godkin, M. D., Faith, K., Upshur, R. E. G., MacRae, S. K., & Tracy, C. S. (2005). Project examining effectiveness in clinical ethics (PEECE): Phase 1—descriptive analysis of nine clinical ethics services. Journal of Medical Ethics, 31(9), 505–512.

    Article  Google Scholar 

  • Greenberg, R. A., Anstey, K. W., Macri, R., Heesters, A., Bean, S., & Zlotnik Shaul, R. (2014). Bioethics consultation practices and procedures: A survey of a large Canadian community of practice. HEC Forum, 26(2), 135–146.

    Article  Google Scholar 

  • Jonsen, A. R., Siegler, M., & Winslade, W. J. (2010). Clinical ethics: A practical approach to ethical decisions in clinical medicine (7th ed.). Toronto: McGraw-Hill.

    Google Scholar 

  • MacRae, S., Chidwick, P., Berry, S., Secker, B., Hébert, P., Zlotnik Shaul, R., et al. (2005). Clinical bioethics integration, sustainability, and accountability: The Hub and Spokes strategy. Journal of Medical Ethics, 31(5), 256–261.

    Article  Google Scholar 

  • Silva, M. (1998). Organizational and administrative ethics in health care: An ethics gap. The Online Journal of Issues in Nursing, 3(3), Accessed 2 July 2015.

  • Silva, D. S., Gibson, J. L., Sibbald, R., Connolly, E., & Singer, P. A. (2008). Clinical ethicists’ perspectives on organisational ethics in healthcare organisations. Journal of Medical Ethics, 34(5), 320–323.

    Article  Google Scholar 

  • Tarzian, A. J., & ASBH Core Competencies Update Task Force (2013). Health care ethics consultation: An update on core competencies and emerging standards from the American Society for Bioethics and Humanities’ Core Competencies Update Task Force. The American Journal of Bioethics, 13(2), 3–13.

    Article  Google Scholar 

  • Tulsky, J. A., & Fox, E. (1996). Evaluating ethics consultation: Framing the questions. Journal of Clinical Ethics, 7(2), 109–115.

    Google Scholar 

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Correspondence to Chris Kaposy.

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Kaposy, C., Brunger, F., Maddalena, V. et al. Models of Ethics Consultation Used by Canadian Ethics Consultants: A Qualitative Study. HEC Forum 28, 273–282 (2016).

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