Skip to main content

Clinical Ethics: Support

  • Living reference work entry
  • First Online:

Abstract

Clinical ethics support services (CESS) are services that aim at supporting health-care professionals (including ancillary staff, managers, and directors), patients, and their families when being confronted with an ethical concern, question, or dilemma. CESS are increasingly being implemented in the USA, Canada, Europe, and slowly also within other parts of the world. Delivery of CESS is often categorized, broadly speaking, into three different models: clinical ethics committees (CEC), individual ethics consultants (EC), and facilitation of moral case deliberation (MCD). Strengths and weaknesses of these three models are discussed. Furthermore, attention is being paid to the ongoing debate on quality and training of CES. Finally, this entry ends with a brief summary on the current developments concerning the evaluation of CESS, CESS outcomes, and CESS’s impact on quality of care.

This is a preview of subscription content, log in via an institution.

References

  • Abma, T., Molewijk, B., & Widdershoven, G. (2009). Good care in ongoing dialogue. Improving the quality of care through moral deliberation and responsive evaluation. Health Care Analysis, 17(3), 217–235.

    Article  Google Scholar 

  • ASBH. (2010). CECA Report to the board of directors: Certification, accreditation, and credentialing (C/A/C) of clinical ethics consultants.

    Google Scholar 

  • Aulisio, M. P., Arnold, R. M., & Youngner, S. J. (2000). Health care ethics consultation: Nature, goals, and competencies. A position paper from the Society for Health and Human Values-Society for Bioethics Consultation Task Force on Standards for Bioethics Consultation. Ann Intern Med, 133(1), 59–69.

    Article  Google Scholar 

  • Fox, E., Myers, S., & Pearlman, R. A. (2007). Ethics consultation in United States hospitals: A national survey. [Research Support, Non-U.S. Gov’t Research Support, U.S. Gov’t, Non-P.H.S. Research Support, U.S. Gov’t, P.H.S.]. The American Journal of Bioethics, 7(2), 13–25. doi:10.1080/15265160601109085.

    Article  Google Scholar 

  • Molewijk, B., Abma, T., Stolper, M., & Widdershoven, G. (2008). Teaching ethics in the clinic: The theory and practice of moral case deliberation. Journal of Medical Ethics, 34, 120–124.

    Article  Google Scholar 

  • Molewijk, B., Hartman, L., Weidema, F., Voskes, Y., & Widdershoven, G. (2015). Fostering the ethics of ethics consultants in health care: An ongoing participatory approach. The American Journal of Bioethics, 15(5), 60–62.

    Article  Google Scholar 

  • O’Brien, L. A. (2005). Establishing and educating a long-term care regional ethics committee: The NJ model. Journal of the American Medical Directors Association, 6(1), 66–67. doi:10.1016/j.jamda.2004.12.013.

    Article  Google Scholar 

  • Pedersen, R., Hurst, S., Schildmann, J., Schuster, S., & Molewijk, B. (2010). The development of a descriptive evaluation tool for clinical ethics case consultations. Clinical Ethics, 5, 136–141.

    Article  Google Scholar 

  • Schildmann, J., Molewijk, B., Benaroyo, L., Førde, R., & Neitzke, G. (2013). Evaluation of clinical ethics support services and its normativity. Journal of Medical Ethics, 39(11), 681–685.

    Article  Google Scholar 

  • Slowther, A. M., Hope, T., & Bunch, C. (1999). Clinical ethics committees in the UK. Journal of the Royal College of Physicians of London, 33(3), 202–203.

    Google Scholar 

  • Slowther, A. M., McClimans, L., & Price, C. (2012). Development of clinical ethics services in the UK: A national survey. Journal of Medical Ethics, 38(4), 210–214.

    Article  Google Scholar 

  • Stolper, M., Molewijk, B., & Widdershoven, G. (2015). Learning by doing. Training health care professionals to become facilitators of moral case deliberation. HEC Forum, 27(1), 47–59. doi:10.1007/s10730-014-9251-7.

    Article  Google Scholar 

  • Svantesson, M., Karlsson, J., Boitte, P., Schildmann, J., Dauwerse, L., Widdershoven, G., Pedersen, R., Huisman, M., & Molewijk, B. (2014). Outcomes of moral case deliberation – The development of an evaluation instrument for clinical ethics support (the Euro-MCD). BMC Medical Ethics, 15, 30.

    Article  Google Scholar 

  • Tarzian, A., Wocial, L., & The ASBH Clinical Ethics Consultation Affairs Committee. (2015). A code of ethics for healthcare ethics consultants: Journey to the present & implications for the field. The American Journal of Bioethics, 15(5), 60–62.

    Article  Google Scholar 

  • Widdershoven, G., Molewijk, B. (2010). Philosophical foundations of clinical ethics: A hermeneutic perspective. In: J. Schildmann, J-S. Gordon, J. Vollmann (Eds.), Clinical ethics consultation. Theories and methods, implementation, evaluation (pp. 37–51). Farnham: Ashgate.

    Google Scholar 

Further Readings

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

    Google Scholar 

  • Doucet, H., Larouche, J. M., & Melchin, K. R. (Eds.). (2001). Ethical deliberation in multiprofessional health care teams. Ottowa: University of Ottowa Press.

    Google Scholar 

  • Molewijk, B., Slowther, A. M., & Aulisio, M. (2011). The practical importance of theory in clinical ethics support services. Bioethics, 25(7), ii–iii (see the entire thematic issue of Bioethics).

    Article  Google Scholar 

  • Schildmann, J., Gordon, J. S., Vollmann, J. (Eds.). (2010). Clinical ethics consultation. Theories and methods, implementation, evaluation. Farnham: Ashgate.

    Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Bert Molewijk .

Editor information

Editors and Affiliations

Rights and permissions

Reprints and permissions

Copyright information

© 2015 Springer Science+Business Media Dordrecht

About this entry

Cite this entry

Molewijk, B., Slowther, A., Aulisio, M. (2015). Clinical Ethics: Support. In: ten Have, H. (eds) Encyclopedia of Global Bioethics. Springer, Cham. https://doi.org/10.1007/978-3-319-05544-2_87-1

Download citation

  • DOI: https://doi.org/10.1007/978-3-319-05544-2_87-1

  • Received:

  • Accepted:

  • Published:

  • Publisher Name: Springer, Cham

  • Online ISBN: 978-3-319-05544-2

  • eBook Packages: Springer Reference Religion and PhilosophyReference Module Humanities and Social SciencesReference Module Humanities

Publish with us

Policies and ethics