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

Kaposy, Chris; Maddalena, Victor; Singleton, Richard

doi:10.1007/s10730-015-9299-z

Cited by 6 publications

(5 citation statements)

References 9 publications

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“…6 Second, consider the different models for clinical ethics consultation; for example, single consultants might not need a theory or practices to resolve disagreement in the same way as ethics committees would, just to suggest one obvious structural difference. For a helpful explanation of different models, both the aforementioned and others, as employed in Canada, see the work of Kaposy C et al 7 However, we do take notice of the prominence of principlism, which is our reason for highlighting it. As noted in a recently published guide for healthcare ethics committees, which adopts a principlist framework, while mentioning others:Autonomy is the ethical principle widely considered most central to health care decision making.…”

Section: Introductionmentioning

confidence: 75%

Nursing ethics as a distinct entity within bioethics: Implications for clinical ethics practice

Pilkington,

Giuliante

2023

Nurs Ethics

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The question of whether nursing ethics is a distinct entity within bioethics is an important and thought-provoking one. Though fundamental bioethical principles are appreciated and applied within the practice of nursing ethics, there exist distinct considerations which make nursing ethics a unique subfield of bioethics. In this article, we focus on the importance of relationships as a distinguishing feature of the foundation of nursing ethics, evidenced in its education, practice, and science. Next, we consider two objections to our claim of distinctiveness: first, that nursing ethics is merely an application of bioethical principles; second, that many bioethical subfields emphasize relationships. We respond by highlighting that throughout nursing education and generally in every career path that follows, the creation and nurturing of relationships is emphasized. Compassion and respect for the dignity of every patient is the framework upon which these therapeutic relationships are built. Much of the focus of nursing science rests on creating meaningful interpersonal experiences and human connection. After responding to each objection, we turn to the implications of this distinctiveness on clinical ethics practice, arguing that the strengths of our approach outweigh the limitations. The deep emphasis on creating meaningful interpersonal experiences and human connection supports a greater integration of relationships and social contexts into the evaluation of whether an action is ethically permissible, which is an important benefit in addressing the challenging human situations that patients face. Moreover, this perspective allows nurse ethicists to account for diverse and complex social structures and their influence in making ethical determinations. These strengths outweigh the limitations of potential inconsistencies between nurse and non-nurse clinical ethicists on the same service, a result we attribute to nursing ethics—and, in turn, the practice of the nurse ethicist—being framed by relationships to a larger extent than other bioethical subfields.

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Section: Introductionmentioning

confidence: 75%

Nursing ethics as a distinct entity within bioethics: Implications for clinical ethics practice

Pilkington,

Giuliante

2023

Nurs Ethics

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“…They work from a paradigm of analysing the problem and making recommendations on ethically acceptable ways forward. The US and Canadian models, whilst also having such committees also rely on clinical ethics consultants 21,35,36 ; their role may be more as advisors than as mediators, but mediation also may be part of the process.…”

Section: Discussionmentioning

confidence: 99%

(Mis)understandings and uses of ‘culture’ in bioethics deliberations over parental refusal of treatment: Children with cancer

Gray

2017

Clinical Ethics

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We developed this study to examine the issue of parental refusal of treatment, looking at the issue through a cultural competence lens. Recent cases in Canada where courts have declined applications by clinicians for court orders to overrule parental refusal of treatment highlight the dispute in this area. This study analyses the 16 cases of a larger group of 24 cases that were selected by a literature review where cultural or religious beliefs or ethnic identity was described as important reasons behind the refusal. The most significant finding was that nearly all of the cases cited unacceptable side effects as the main reason for declining treatment. We then analysed the detail of the cases and concluded that in the first instance a skilled clinical approach to develop an agreed management plan is by far the best approach. In the event that agreement cannot be reached we recommend engaging a mediator to help the clinician and parents/child to find an agreeable way forward. We argue that the option of seeking a court order was of significant detriment to many of the children in our cases and that this option should be used sparingly. There is a need for empirical research on the outcome of cases where a court order is sought.

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“…First, the individual ethics consultant, with or without support of health care professionals with ethics training (a "hub and spokes" approach), provides guidance with regard to particular cases upon request [20]. Second, the capacity-building consultant focuses on training health care staff in ethics decision making, often using a particular framework [20]. Third, in a facilitation or team approach an ethics consultant (responsible for ethics analysis and framing), a facilitator (responsible for the process and ensuring procedures are followed), and, with luck, a recorder join other resource people and stakeholders to address an ethics issue [20].…”

Section: Ethics Consultationmentioning

confidence: 99%

“…Ethics committees are the main approach to addressing ethical issues in hospitals in the US [19], although ethics consultation can take many forms. First, the individual ethics consultant, with or without support of health care professionals with ethics training (a "hub and spokes" approach), provides guidance with regard to particular cases upon request [20]. Second, the capacity-building consultant focuses on training health care staff in ethics decision making, often using a particular framework [20].…”

Section: Ethics Consultationmentioning

confidence: 99%

“…Second, the capacity-building consultant focuses on training health care staff in ethics decision making, often using a particular framework [20]. Third, in a facilitation or team approach an ethics consultant (responsible for ethics analysis and framing), a facilitator (responsible for the process and ensuring procedures are followed), and, with luck, a recorder join other resource people and stakeholders to address an ethics issue [20]. Ethicists and ethics committees can and do play a role developing, implementing, and reviewing organizational policy [21].…”

Section: Ethics Consultationmentioning

confidence: 99%

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What Is the Role of Ethics Consultation in the Moral Habitability of Health Care Environments?

Austin

2017

AMA Journal of Ethics

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

Cited by 6 publications

References 9 publications

Nursing ethics as a distinct entity within bioethics: Implications for clinical ethics practice

Nursing ethics as a distinct entity within bioethics: Implications for clinical ethics practice

(Mis)understandings and uses of ‘culture’ in bioethics deliberations over parental refusal of treatment: Children with cancer

What Is the Role of Ethics Consultation in the Moral Habitability of Health Care Environments?

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