During the 1970s, those who functioned as bioethicists1 in the clinical setting typically were either moral philosophers and moral theologians who were invited to apply their knowledge and skills to the health care setting, or physicians whose medical colleagues believed them to be particularly skilled at resolving “hard cases.” Initially, the contribution of these bioethicists was limited to sporadic case consultation and occasional committee work at a supra-institutional level.
KeywordsClinical Ethic Ethic Consultation Prospective Employer Ethic Consultant Case Consultation
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Notes and References
- 1.In this chapter, “bioethicist” is the historical term that refers to those who originally “did ethics” in the clinical setting; “health care ethics consultant” is the contemporary term that refers to those who currently provide ethics case consultation (clinical or research), ethics committee consultation (clinical or research), ethics education, and policy formulation in the clinical setting. Although descriptively accurate, the term “health care ethics consultant” is not widely used. More common are such terms as bioethicist, ethics consultant, clinical ethicist, medical ethicist, nurse ethicist, and philosopher ethicist. These other descriptive terms are problematic, however, because the focus is either too narrow (e.g., medical ethicist) or too broad (e.g., bioethicist). The term “health care ethics consultant” avoids this problem. For ease of reading, “health care ethics consultant” on occasion is shortened to “ethics consultant.”Google Scholar
- 2.Note, this version of the history of health care ethics consultation differs from that told by John LaPuma and E. Rush Priest, who summarily note that “ethics consultation emerged as part of clinical ethics, a field of expertise in medicine.” John La Puma and E. Rush Priest, “Medical Staff Privileges for Ethics Consultants: An Institutional Model,” Quality Review Bulletin 18. 1 (1992): 17.Google Scholar
- 3.David J. Rothman, Strangers at the Bedside ( New York: Basic, 1991 ) 189.Google Scholar
- 4.E.g., a one-year Fellowship at the University of Chicago, United States originally for physicians and now available to others interested in health care ethics consultation; a minimum four-year doctoral program in philosophy with a formal clinical component at the University of Tennessee, United States (and previously at the University of Western Ontario, Canada).Google Scholar
- 3.Health care ethics consultants with informal postcareer training are typically older and, as a group, more predominantly male than health care ethics consultants with specialized training (cf Michael D. Coughlin and John L. Watts, in this vol.).Google Scholar
- 6.E.g., Georgetown University, United States.Google Scholar
- 7.E.g., University of Virginia, United States.Google Scholar
- 8.E.g., McGill University, Canada, and the University of Toronto, Canada.Google Scholar
- 10.Joel Frader and Robert Arnold, “Standards for Clinical Ethics Consultation,” Newsletter of the Society for Bioethics Consultation Winter (1993): 2,3.Google Scholar
- 11.The chapter on “feeder disciplines” begins this application for some of the major contributing academic and professional disciplines.Google Scholar