“… Has Knowledge of [Interpersonal] Facilitation Techniques and Theory; Has the Ability to Facilitate [Interpersonally]… ”

Fact or Fiction?
  • Abbyann Lynch
Part of the Contemporary Issues in Biomedicine, Ethics, and Society book series (CIBES)


Various authors, including members of the Network, have identified facilitation as one of several forms of knowledge (K5) and abilities (A6) essential to the sound pursuit of the health care ethics consultation process.1 In this context, facilitation (an individual’s ability to make easy, to promote, to help forward an action or result) can be understood to comprise at least two quite different, but complementary activities.


Ethical Dilemma Clinical Ethic Ethic Consultation Ethic Consultant Interpersonal Aspect 


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Notes and References

  1. 1.
    Jacqueline J. Glover, David T. Ozar, and David C. Thomasma, “Teaching Ethics on Rounds: The Ethicist as Teacher, Consultant, and Decision maker,” Theoretical Medicine 7 (1986): 19; Terrence F. Ackerman, “Moral Problems, Moral Inquiry, and Consultation in Clinical Ethics,” Clinical Ethics: Theory and Practice, Barry Hoffmaster, Benjamin Freedman, and Gwen Fraser (Clifton, NJ: Humana, 1989) 153; Françoise Baylis, A Profile of the Health Care Ethics Consultant, in this vol.Google Scholar
  2. 2.
    Terrence F. Ackerman, “The Role of an Ethicist in Health Care,” Health Care Ethics: A Guide for Decision makers, Gary R. Anderson and Valerie A. Glesnes-Anderson (Rockville, MD: Aspen, 1987) 313, 314.Google Scholar
  3. 3.
    Glover 19.Google Scholar
  4. 4.
    Jonathan D. Moreno, “Ethics Consultation as Moral Engagement,” Bioethics 5.1 (1991): 55.Google Scholar
  5. 5.
    John La Puma and David L. Schiedermayer, “Ethics Consultation: Skills, Roles, and Training,” Annals of Internal Medicine 114.2 (1991): 155–160.Google Scholar
  6. 6.
    The reference to those who “own” the moral problem is borrowed from F. Baylis, “Ethics Consultation: The Hospital for Sick Children Initiative” HEC Forum 3;5 (1991): 289. This notion may be fleshed out with reference to Christine Mitchell’s response to the question “who should decide about the goals of care?” Her response includes: those who bear the burden of both care and conscience; those with special knowledge (technical knowledge and experiential knowledge); and those health professionals with the most continuous, committed, and trusting relationship. Christine Mitchell, “Care of Severely Impaired Infant Raises Ethical Issues,” The American Nurse 16.3 (1984): 9.Google Scholar
  7. 7.
    For a comparison of the various activities, see L. N. Rangarajan, The Limitation of Conflict: A Theory of Bargaining and Negotiation (London: Croom, 1985 ) 258,259; more generally, see Paul Wehr, Conflict Regulation ( Boulder, CO: Westview, 1979 ).Google Scholar
  8. 8.
    Cf. Blair H. Sheppard, Kathryn Blumenfeld-Jones, and Jonelle Roth, “Informal Thirdpartyship: Studies of Everyday Conflict Intervention,” Mediation Research: The Process and Effectiveness of Third-Party Intervention, eds. Kenneth Kressel, Dean G. Pruitt and Associates. ( San Francisco, CA: Jossey, 1989 ) 166–189.Google Scholar
  9. 9.
    Cf. Steven J. Brams, Negotiation Games: Applying Game Theory to Bargaining and Arbitration (New York: Routledge, 1990); Howard Raiffa, The Art and Science of Negotiation (Cambridge: Harvard University Press, 1982 ); H. Peyton Young, Negotiation Analysis ( Ann Arbor: University of Michigan Press 1992 ).Google Scholar
  10. 10.
    Cf Jay Folberg and Alison Taylor, Mediation: A Comprehensive Guide to Resolving Conflicts without Litigation (San Francisco, CA: Jossey, 1984); Sarah Childs Grebe, Karen Irvin, and Michael Lang, “A Model for Ethical Decision making in Mediation,” Mediation Quarterly 7 (1989): 133–48; Janice A. Roehl and Roger F. Cook, “Mediation in Interpersonal Disputes: Effectiveness and Limitations,” Mediation Research: The Process and Effectiveness of Third-Party Intervention, Kenneth Kressel, Dean G. Pruitt and Associates. ( San Francisco, CA: Jossey, 1989 ), 31–52.Google Scholar
  11. 11.
    Mary Beth West and Joan McIver Gibson, “Facilitating Medical Ethics Case Review: What Ethics Committees Can Learn from Mediation and Facilitation Techniques,” Cambridge Quarterly of Healthcare Ethics 1 (1992): 63–74.PubMedCrossRefGoogle Scholar
  12. 12.
  13. 13.
    West 71; cf William A. Donohue, “Communicative Competence in Mediators,” Mediation Research: The Process and Effectiveness of Third-Party Intervention, Kenneth Kressel, Dean G. Pruitt and Associates. ( San Francisco, CA: Jossey, 1989 ) 322–343.Google Scholar
  14. 14.
    Baylis, A Profile of the Health Care Ethics Consultation, p. 40.Google Scholar
  15. 15.
    Folberg 35.Google Scholar
  16. 16.
    Kent E. Menzel, “Judging the Fairness of Mediation: A Critical Framework,” Mediation Quarterly 9 (1991): 3–20; cf Folberg 245–250, regarding fairness in the context of mediation in divorce and family disputes.Google Scholar
  17. 17.
    West 66,67.Google Scholar
  18. 18.
    West 71; Bernard Mayer, “The Dynamics of Power in Mediation and Negotiation,” Mediation Quarterly 16 (1987): 78.Google Scholar
  19. 19.
    Cf Folberg 249.Google Scholar
  20. 20.
  21. 21.
    Bethany June Spielman, “A Mediation Model of Clinical Medical Ethics,” (unpublished).Google Scholar
  22. 22.
    With reference to ethics consultation, cf West 70; Joel Frader, “Politics and Interpersonal Aspects of Ethics Consultation,” Theoretical Medicine 13 (1992): 31–44; with reference to mediation more generally, cf Folberg 140.Google Scholar
  23. 23.
    Folberg 263 ff.Google Scholar
  24. 24.
    Raiffa 232.Google Scholar
  25. 25.
    Folberg 232–243.Google Scholar
  26. 26.
    Folberg 236 ff.Google Scholar
  27. 27.
    Folberg 240.Google Scholar
  28. 25.
    Folberg 237.Google Scholar
  29. 29.
    Folberg 241.Google Scholar
  30. 30.

Copyright information

© Springer Science+Business Media New York 1994

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  • Abbyann Lynch

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