Abstract
In a recent publication Giles Scofield has asked, once again, why “the field continues to be plagued by the problem of describing, explaining, and justifying how and why it is that others should seek…[its] expert advice.” Ethics consultation, he asserts, is a field “which, for some mysterious reason, seems to be in perpetual need of having its life saved.”
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Notes
- 1.
Giles Scofield. “What—If Anything—Sets Limits to the Clinical Ethics Consultant’s ‘Expertise’?” Perspectives in Biology and Medicine, Volume 61. 4 (2018): 595.
- 2.
Ibid., 596.
- 3.
Ibid.
- 4.
Ibid.
- 5.
Although Margaret Urban Walker might be disinclined to accept my emphasis on adjudication (which I stress only because it is often regarded as the most contentious part of the work), I believe that we share an understanding of how best to prepare PHEs for their roles. In response to the professionalization movement she has noted that the academic preparation typically provided to those who study ethics at the graduate level is inadequate to the task of performing ethics consultation in the hierarchical, and very complex, clinical environment.
In her words, “The old staples of conceptual and analytical skills, honed specifically for medical and clinical contexts, remain important tools. They are necessary to keep track of where the discussion has (and has not) been going. But knowing where the discussion might or could go, and how the process is shaped not only by ideas but concretely by actors and environments, requires other sorts of preparation as well.”
Among the other kinds of preparation she recommends, are “wide (and critical) conversance with the actual terms …of moral assessment in the society the institution takes as its community.” In addition, she notes that the PHE must have a “sensitivity to configurations of authority and dynamics of relationship that can either help structure that space or deform it,” Walker 1993, 39.
We would do well to construct PHE apprenticeship programs that draw on these insights, and I agree heartily with her recommendations that the field provide apprenticeship opportunities that are interdisciplinary, clinically-situated, and that they explore what she calls “[f]lexible networks of inside and outside ethicists, linking the moral space of particular institutions to other sites of ‘the reflexive social dialogue.’” Ibid.
- 6.
Ibid., 595.
Bibliography
Walker, Margaret Urban. 1993. Keeping Moral Space Open: New Images of Ethics Consulting. Hastings Center Report 23 (2): 33–40.
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Heesters, A.M. (2022). Professionalizing PHEs: The Promise of a Practice Worth Wanting. In: How Legal Theory Can Save the Life of Healthcare Ethics. The International Library of Bioethics, vol 101. Springer, Cham. https://doi.org/10.1007/978-3-031-14035-8_5
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