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  1. Evaluating the Effectiveness of Clinical Ethics Committees: A Systematic Review.Chiara Crico, Virginia Sanchini, Paolo Giovanni Casali & Gabriella Pravettoni - 2021 - Medicine, Health Care and Philosophy 24 (1):135-151.
    Clinical Ethics Committees, as distinct from Research Ethics Committees, were originally established with the aim of supporting healthcare professionals in managing controversial clinical ethical issues. However, it is still unclear whether they manage to accomplish this task and what is their impact on clinical practice. This systematic review aims to collect available assessments of CECs’ performance as reported in literature, in order to evaluate CECs’ effectiveness. We retrieved all literature published up to November 2019 in six databases, following PRISMA guidelines. (...)
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  • Quality in Ethics Consultations.Gerard Magill - 2013 - Medicine, Health Care and Philosophy 16 (4):761-774.
    There is an increasing need for quality in ethics consultations, though there have been significant achievements in the United States and Europe. However, fundamental concerns that place the profession in jeopardy are discussed from the perspective of the U.S. in a manner that will be helpful for other countries. The descriptive component of the essay (the first two points) explains the achievements in ethics quality (illustrated by the IntegratedEthics program of the Veterans Health Administration) and the progress on standards and (...)
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  • Health Care Ethics Consultation Competences and Standards: A Roadmap Still Needing a Compass.Keith Swetz & C. Hook - 2013 - American Journal of Bioethics 13 (2):20-22.
  • Functions, Operations and Policy of a Volunteer Ethics Committee: A Quantitative and Qualitative Analysis of Ethics Consultations From 2013 to 2018.Bryan Kaps & Gary Kopf - 2022 - HEC Forum 34 (1):55-71.
    Few institutions have published reviews concerning the case consultation history of their ethics committees, and policies used by ethics committees to address inappropriate treatment are infrequently reviewed. We sought to characterize the operation of our institution’s ethics committee as a representative example of a volunteer ethics committee, and outline its use of a policy to address inappropriate treatment, the Conscientious Practice Policy. Patients were identified for retrospective review from the ethics consultation database. Patient demographics, medical admission information, and consultation information (...)
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  • Clinical Ethics Case Consultation in a University Department of Cardiology and Intensive Care: A Descriptive Evaluation of Consultation Protocols.Michel Noutsias, Daniel Sedding, Jochen Dutzmann, Henning Rosenau, Kim P. Linoh, Nicolas Heirich, Stephan Nadolny, Jan Schildmann & Andre Nowak - 2021 - BMC Medical Ethics 22 (1):1-12.
    BackgroundClinical ethics case consultations provide a structured approach in situations of ethical uncertainty or conflicts. There have been increasing calls in recent years to assess the quality of CECCs by means of empirical research. This study provides detailed data of a descriptive quantitative and qualitative evaluation of a CECC service in a department of cardiology and intensive care at a German university hospital.MethodsSemi-structured document analysis of CECCs was conducted in the period of November 1, 2018, to May 31, 2020. All (...)
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  • Identifying Disincentives to Ethics Consultation Requests Among Physicians, Advance Practice Providers, and Nurses: A Quality Improvement All Staff Survey at a Tertiary Academic Medical Center.Yiran Zhang, Laura Dibsie, Cassia Yi, Lawrence Friedman, Edward Cachay, Jamie Nicole LaBuzetta & Lynette Cederquist - 2021 - BMC Medical Ethics 22 (1):1-8.
    BackgroundEthics consult services are well established, but often remain underutilized. Our aim was to identify the barriers and perceptions of the Ethics consult service for physicians, advance practice providers, and nurses at our urban academic medical center which might contribute to underutilization.MethodsThis was a cross-sectional single-health system, anonymous written online survey, which was developed by the UCSD Health Clinical Ethics Committee and distributed by Survey Monkey. We compare responses between physicians, APPs, and nurses using standard parametric and non-parametric statistical methods. (...)
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  • Is There a Need for a Clear Advice? A Retrospective Comparative Analysis of Ethics Consultations with and Without Recommendations in a Maximum-Care University Hospital.Roman Pauli, Dominik Groß & Dagmar Schmitz - 2021 - BMC Medical Ethics 22 (1):1-10.
    BackgroundThe theory and practice of ethics consultations in health care are still characterized by many controversies, including, for example, the practice of giving recommendations. These controversies are complicated by an astonishing lack of evidence in the whole field. It is not clear how often a recommendation is issued in ethics consultations and when and why this step is taken. Especially in a facilitation model in which giving recommendations is optional, more data would be helpful to evaluate daily practice, ensure that (...)
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  • Evaluating Assessment Tools of the Quality of Clinical Ethics Consultations: A Systematic Scoping Review From 1992 to 2019.Nicholas Yue Shuen Yoon, Yun Ting Ong, Hong Wei Yap, Kuang Teck Tay, Elijah Gin Lim, Clarissa Wei Shuen Cheong, Wei Qiang Lim, Annelissa Mien Chew Chin, Ying Pin Toh, Min Chiam, Stephen Mason & Lalit Kumar Radha Krishna - 2020 - BMC Medical Ethics 21 (1):1-11.
    BackgroundAmidst expanding roles in education and policy making, questions have been raised about the ability of Clinical Ethics Committees s to carry out effective ethics consultations. However recent reviews of CECs suggest that there is no uniformity to CECons and no effective means of assessing the quality of CECons. To address this gap a systematic scoping review of prevailing tools used to assess CECons was performed to foreground and guide the design of a tool to evaluate the quality of CECons.MethodsGuided (...)
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  • Health Care Ethics Programs in U.S. Hospitals: Results From a National Survey.Christopher C. Duke, Anita Tarzian, Ellen Fox & Marion Danis - 2021 - BMC Medical Ethics 22 (1):1-14.
    BackgroundAs hospitals have grown more complex, the ethical concerns they confront have grown correspondingly complicated. Many hospitals have consequently developed health care ethics programs that include far more than ethics consultation services alone. Yet systematic research on these programs is lacking.MethodsBased on a national, cross-sectional survey of a stratified sample of 600 US hospitals, we report on the prevalence, scope, activities, staffing, workload, financial compensation, and greatest challenges facing HCEPs.ResultsAmong 372 hospitals whose informants responded to an online survey, 97% of (...)
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  • Patient Participation in Dutch Ethics Support: Practice, Ideals, Challenges and Recommendations—a National Survey.Bert Molewijk, Wieke Ligtenberg, Janine de Snoo-Trimp & Marleen Eijkholt - 2022 - BMC Medical Ethics 23 (1):1-14.
    BackgroundPatient participation in clinical ethics support services has been marked as an important issue. There seems to be a wide variety of practices globally, but extensive theoretical or empirical studies on the matter are missing. Scarce publications indicate that, in Europe, patient participation in CESS varies from region to region, and per type of support. Practices vary from being non-existent, to patients being a full conversation partner. This contrasts with North America, where PP seems more or less standard. While PP (...)
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  • Ethics Consultation in Surgical Specialties.Nicole A. Meredyth, Joseph J. Fins & Inmaculada de Melo-Martin - 2022 - HEC Forum 34 (1):89-102.
    Multiple studies have been performed to identify the most common ethical dilemmas encountered by ethics consultation services. However, limited data exists comparing the content of ethics consultations requested by specific hospital specialties. It remains unclear whether the scope of ethical dilemmas prompting an ethics consultation differ between specialties and if there are types of ethics consultations that are more or less frequently called based on the specialty initiating the ethics consult. This study retrospectively assessed the incidence and content of ethics (...)
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  • Perceived Benefits of Ethics Consultation Differ by Profession: A Qualitative Survey Study.Annie B. Friedrich, Elizabeth M. Kohlberg & Jay R. Malone - forthcoming - AJOB Empirical Bioethics:1-5.
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  • Patient Participation in Clinical Ethics Support Services – Patient-Centered Care, Justice and Cultural Competence.Angela J. Ballantyne, Elizabeth Dai & Ben Gray - 2017 - Clinical Ethics 12 (1):11-18.
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  • Counteracting COVID-19 Healthcare Inequity: Supporting Antiracist Practices at Bedside.Crystal E. Brown & Georgina D. Campelia - 2021 - American Journal of Bioethics 21 (2):79-82.
    In “Racism and Bioethics: the myth of color blindness” Braddock convincingly argues that a “color blind” approach to triage and resource allocation in the setting of the COVID-19 pandemic pe...
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  • Race and Power at the Bedside: Counter Storytelling in Clinical Ethics Consultation.Aleksandra E. Olszewski, Maya Scott, Arika Patneaude, Elliott M. Weiss & Aaron Wightman - 2021 - American Journal of Bioethics 21 (2):77-79.
    Counter storytelling, used in critical race theory and narrative ethics, is a tool used to contradict and expose the oppression in a dominant narrative, by focusing attention on the stories of the...
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  • Preventive Ethics Through Expanding Education.Anita Ho, Lisa Mei-Hwa MacDonald & David Unger - 2016 - HEC Forum 28 (1):69-74.
    Healthcare institutions have been making increasing efforts to standardize consultation methodology and to accredit both bioethics training programs and the consultants accordingly. The focus has traditionally been on the ethics consultation as the relevant unit of ethics intervention. Outcome measures are studied in relation to consultations, and the hidden assumption is that consultations are the preferred or best way to address day-to-day ethical dilemmas. Reflecting on the data from an internal quality improvement survey and the literature, we argue that having (...)
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  • Strangers at the Benchside: Research Ethics Consultation.Mildred K. Cho, Sara L. Tobin, Henry T. Greely, Jennifer McCormick, Angie Boyce & David Magnus - 2008 - American Journal of Bioethics 8 (3):4 – 13.
    Institutional ethics consultation services for biomedical scientists have begun to proliferate, especially for clinical researchers. We discuss several models of ethics consultation and describe a team-based approach used at Stanford University in the context of these models. As research ethics consultation services expand, there are many unresolved questions that need to be addressed, including what the scope, composition, and purpose of such services should be, whether core competencies for consultants can and should be defined, and how conflicts of interest should (...)
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  • Framework for Evaluation Research on Clinical Ethical Case Interventions: The Role of Ethics Consultants.Joschka Haltaufderheide, Stephan Nadolny, Jochen Vollmann & Jan Schildmann - 2022 - Journal of Medical Ethics 48 (6):401-406.
    Evaluation of clinical ethical case consultations has been discussed as an important research task in recent decades. A rigid framework of evaluation is essential to improve quality of consultations and, thus, quality of patient care. Different approaches to evaluate those services appropriately and to determine adequate empirical endpoints have been proposed. A key challenge is to provide an answer to the question as to which empirical endpoints—and for what reasons—should be considered when evaluating the quality of a service. In this (...)
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  • Trauma Informed Ethics Consultation.Elizabeth Lanphier & Uchenna E. Anani - 2021 - American Journal of Bioethics 22 (5):45-57.
    We argue for the addition of trauma informed awareness, training, and skill in clinical ethics consultation by proposing a novel framework for Trauma Informed Ethics Consultation (TIEC). This approach expands on the American Society for Bioethics and Humanities (ASBH) framework for, and key insights from feminist approaches to, ethics consultation, and the literature on trauma informed care (TIC). TIEC keeps ethics consultation in line with the provision of TIC in other clinical settings. Most crucially, TIEC (like TIC) is systematically sensitive (...)
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  • Clinical Ethics and Patient Satisfaction: The Practical Significance of Distinguishing Ethics and Morals.David C. Landy, Kenneth W. Goodman & Jeffrey P. Brosco - 2012 - American Journal of Bioethics 12 (5):20-22.
    The American Journal of Bioethics, Volume 12, Issue 5, Page 20-22, May 2012.
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  • The Instrumental Role of Hospital Ethics Committees in Policy Work.Nanibaa’ A. Garrison & David Magnus - 2012 - American Journal of Bioethics 12 (11):1-2.
  • The Good, the Bad, and the Inconvenient.Giles Scofield - 2022 - American Journal of Bioethics 22 (4):73-75.
    Whatever else these articles demonstrate, they reveal that two efforts closely associated with professionalizing healthcare ethics consultants —surveying the practice and certificating its pra...
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  • It’s About Heterogeneity! Strategies to Advance the Evaluation of Ethics Consultation.Joschka Haltaufderheide, Stephan Nadolny, Jochen Vollmann & Jan Schildmann - 2022 - American Journal of Bioethics 22 (4):56-58.
    In their national follow-up study on ethics consultation in the U.S., Fox et al. report the worrying finding of a decline in efforts to evaluate ECs. Compared to the findings of Fox et...
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  • View Across the Pond: Insights From a National Survey on Clinical Ethics Services in Switzerland.Ralf J. Jox & Rouven C. Porz - 2022 - American Journal of Bioethics 22 (4):50-52.
    In the three target articles, Ellen Fox et al. present data from their seminal study on ethics consultation in US general hospitals (Fox, Danis, et al. 2022, Fox and Duke 2022, Fox, Tarzian, et al....
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  • Incorporating Ethics Consultations Into Public Health Practice.Efthimios Parasidis & Amy L. Fairchild - 2022 - American Journal of Bioethics 22 (4):47-50.
    In target articles for this special issue, Fox et al. report that ethics consultation practices have not improved significantly since 2000, and question whether the status quo affords patients...
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  • Ethics Consultation in U.S. Hospitals: Opinions of Ethics Practitioners.Ellen Fox, Anita J. Tarzian, Marion Danis & Christopher C. Duke - 2021 - American Journal of Bioethics 22 (4):19-30.
    To design effective strategies to improve ethics consultation practices, it is important to understand the views of ethics practitioners. Previous U.S. studies of ethics practitioners have ove...
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  • Quality Healthcare Ethics Consultation: How Do We Get It and How Do We Measure It.Alexander A. Kon - 2022 - American Journal of Bioethics 22 (4):38-40.
    Shocking. There seems no other response to the Fox findings. The bioethics community has been working for decades to improve the quality of, and access to, competent healthcare ethics consultation....
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  • A Call for Evidence-Based Clinical Ethics Consultation.Janet Malek - 2022 - American Journal of Bioethics 22 (4):40-42.
    Fox, Danis, Tarzian, and Duke have made a substantial contribution to the field of bioethics through the project described in this issue’s target articles (Fox, Tarzian, et al. 2022; Fox, Danis, et...
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  • Ethics Consultation in U.S. Hospitals: Determinants of Consultation Volume.Ellen Fox & Christopher C. Duke - 2021 - American Journal of Bioethics 22 (4):31-37.
    The annual volume of ethics consultations has been a topic of interest in the bioethics literature, in part because of its presumed relationship to quality. To better understand factors assoc...
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  • Ethics Consultation in U.S. Hospitals: A National Follow-Up Study.Ellen Fox, Marion Danis, Anita J. Tarzian & Christopher C. Duke - 2021 - American Journal of Bioethics 22 (4):5-18.
    A 1999–2000 national study of U.S. hospitals raised concerns about ethics consultation practices and catalyzed improvement efforts. To assess how practices have changed since 2000, we administ...
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  • Ethics Consultation: Data and the Path to Professionalization.Felicia Cohn - 2022 - American Journal of Bioethics 22 (4):1-4.
    In this issue, Ellen Fox and colleagues report on their national study on ethics consultation in U.S. hospitals, following up on the previous 1999–2000 landmark study. Th...
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  • Knowledge of Pediatric Ethics: Results of a Survey of Pediatric Ethics Consultants.Jennifer C. Kesselheim, Nita Bhatia, Angel Cronin, Eric Kodish & Steven Joffe - 2015 - AJOB Empirical Bioethics 6 (4):19-30.
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  • The Proper Locus of Professionalization: The Individual or the Institutions?David Magnus & Bela Fishbeyn - 2015 - American Journal of Bioethics 15 (5):1-2.
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  • Barriers and Challenges in Clinical Ethics Consultations: The Experiences of Nine Clinical Ethics Committees: Country Reports.Reidar Pedersen - 2009 - Bioethics 23 (8):460-469.
    Clinical ethics committees have recently been established in nearly all Norwegian hospital trusts. One important task for these committees is clinical ethics consultations. This qualitative study explores significant barriers confronting the ethics committees in providing such consultation services. The interviews with the committees indicate that there is a substantial need for clinical ethics support services and, in general, the committee members expressed a great deal of enthusiasm for the committee work. They also reported, however, that tendencies to evade moral disagreement, (...)
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  • Quality Attestation for Clinical Ethics Consultants: A Two‐Step Model From the American Society for Bioethics and Humanities.Eric Kodish, Joseph J. Fins, Clarence Braddock, Felicia Cohn, Nancy Neveloff Dubler, Marion Danis, Arthur R. Derse, Robert A. Pearlman, Martin Smith, Anita Tarzian, Stuart Youngner & Mark G. Kuczewski - 2013 - Hastings Center Report 43 (5):26-36.
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  • Developing, Administering, and Scoring the Healthcare Ethics Consultant Certification Examination.Courtenay R. Bruce, Chris Feudtner, Daniel Davis & Mary Beth Benner - 2019 - Hastings Center Report 49 (5):15-22.
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  • Health Policy, Patient‐Centred Care and Clinical Ethics.Leah M. McClimans, Michael Dunn & Anne-Marie Slowther - 2011 - Journal of Evaluation in Clinical Practice 17 (5):913-919.
  • Antiracist Activism in Clinical Ethics: What's Stopping Us?Holly Vo & Georgina D. Campelia - 2021 - Hastings Center Report 51 (4):34-35.
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  • Ethics Outside of Inpatient Care: The Need for Alliances Between Clinical and Organizational Ethics.Rachelle Barina - 2014 - HEC Forum 26 (4):309-323.
    The norms and practices of clinical ethics took form relative to the environment and relationships of hospital care. These practices do not easily translate into the outpatient context because the environment and relational dynamics differ. Yet, as outpatient care becomes the center of health care delivery, the experiences of ethical tension for outpatient clinicians warrant greater responses. Although a substantial body of literature on the nature of the doctor–physician relationship has been developed and could provide theoretical groundwork for an outpatient (...)
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  • Evaluating Parents' Perspectives of Pediatric Ethics Consultation.Frances Rieth Ward - 2013 - HEC Forum 25 (2):183-189.
    Ethics consultation is a familiar concept to clinicians, and there are site-specific guidelines detailing procedures for both obtaining and performing these consults. Evaluative data about clinician experiences with ethics consults are becoming more extensive but information about family experiences, especially parent perceptions, of the same is lacking. Without a better understanding of those family experiences, an evidence base for ethics consultations cannot be built. This manuscript describes the reasons for obtaining this necessary information, details prior research designed to obtain knowledge (...)
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  • Ethics Consultation in U.S. Hospitals: New Findings About Consultation Practices.Ellen Fox, Marion Danis, Anita J. Tarzian & Christopher C. Duke - 2022 - AJOB Empirical Bioethics 13 (1):1-9.
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  • Mediation and Surrogate Decision-Making for LGBTQ Families in the Absence of an Advance Directive: Comment on “Ethical Challenges in End-of-Life Care for GLBTI Individuals” by Colleen Cartwright.Lance Wahlert & Autumn Fiester - 2012 - Journal of Bioethical Inquiry 9 (3):365-367.
    In this commentary on a clinical ethics case pertaining to a same-sex couple that does not have explicit surrogate decision-making or hospital-visitation rights (in the face of objections from the family-of-origin of one of the queer partners), the authors invoke contemporary legal and policy standards on LGBTQ health care in the United States and abroad. Given this historical moment in which some clinical rights are guaranteed for LGBTQ families whilst others are in transition, the authors advocate for the implementation of (...)
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  • Ethics Consultation in U.S. Hospitals: Adherence to National Practice Standards.Anita Tarzian, Ellen Fox, Marion Danis & Christopher C. Duke - 2022 - AJOB Empirical Bioethics 13 (1):10-21.
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  • Clinical Ethics Consultation: A Need for Evidence.David Magnus - 2015 - American Journal of Bioethics 15 (1):1-2.
  • Re-Thinking Degrees in Clinical Ethics – a Contextual Experience.Pierre Mallia - 2018 - International Journal of Ethics Education 3 (1):5-29.
    The University of Malta has had a Master of Arts in Bioethics for several years delivered by the Faculty of Theology. Although there were medics invited to teach in this degree the Bioethics Research Programme of the Faculty of Medicine noted that the degree was top theoretical and was not meeting the needs of the Faculty and the attached hospital. Rather it contended that it needed to train medics in Clinical Ethics and to prepare some of them to specialise in (...)
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  • Jonsen’s Four Topics Approach as a Framework for Clinical Ethics Consultation.Hui Jin Toh, James Alvin Low, Zhen Yu Lim, Yvonne Lim, Shahla Siddiqui & Lawrence Tan - 2018 - Asian Bioethics Review 10 (1):37-51.
    This was an in-depth qualitative study that looked at the reasons patients were referred to the Clinical Ethics Committee of an acute hospital in Singapore and explore how the CEC approached cases referred. Jonsen’s four topics approach was applied in the deliberative process for all cases. A comprehensive review of the case records of 28 patients referred consecutively to the CEC from 1 January 2012 to 31 December 2014 was conducted. Data and information was collated from the referral forms, patient (...)
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  • Mental Illness, Lack of Autonomy, and Physician-Assisted Death.Jukka Varelius - 1st ed. 2015 - In Jukka Varelius & Michael Cholbi (eds.), New Directions in the Ethics of Assisted Suicide and Euthanasia. Springer Verlag. pp. 59-77.
    In this chapter, I consider the idea that physician-assisted death might come into question in the cases of psychiatric patients who are incapable of making autonomous choices about ending their lives. I maintain that the main arguments for physician-assisted death found in recent medical ethical literature support physician-assisted death in some of those cases. After assessing several possible criticisms of what I have argued, I conclude that the idea that physicianassisted death can be acceptable in some cases of psychiatric patients (...)
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  • Conceptualizing Boundaries for the Professionalization of Healthcare Ethics Practice: A Call for Empirical Research.Nancy C. Brown & Summer Johnson McGee - 2014 - HEC Forum 26 (4):325-341.
    One of the challenges of modern healthcare ethics practice is the navigation of boundaries. Practicing healthcare ethicists in the performance of their role must navigate meanings, choices, decisions and actions embedded in complex cultural and social relationships amongst diverse individuals. In light of the evolving state of modern healthcare ethics practice and the recent move toward professionalization via certification, understanding boundary navigation in healthcare ethics practice is critical. Because healthcare ethics is endowed with many boundaries which often delineate concerns about (...)
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  • Sollte es ein favorisiertes Modell klinischer Ethikberatung für Krankenhäuser geben? – Erfahrungen aus den USA.Dr med Eva C. Winkler - 2009 - Ethik in der Medizin 21 (4):309-322.
    In den USA haben sich im Wesentlichen drei verschiedene Organisationsformen klinischer Ethikberatung entwickelt: der einzelne Berater, das große Komitee und das Beratungsteam teilweise mit Rückbindung an ein größeres Komitee. Bislang gibt es jedoch weder empirische Daten noch ein Ergebnis der anfänglichen theoretischen Diskussion, ob es ein favorisiertes Modell für die klinische Ethikberatung geben sollte und welches dieses sei. Dieser Artikel argumentiert, dass die Vorzüge, Nachteile und die Erfolgsfaktoren der verschiedenen Organisationsformen in Abhängigkeit von der Zielsetzung klinischer Ethikdienste (KED) bewertet werden (...)
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  • Communication and Conflict Management Training for Clinical Bioethics Committees.Lauren M. Edelstein, Evan G. DeRenzo, Elizabeth Waetzig, Craig Zelizer & Nneka O. Mokwunye - 2009 - HEC Forum 21 (4):341-349.
    Communication and Conflict Management Training for Clinical Bioethics Committees Content Type Journal Article Pages 341-349 DOI 10.1007/s10730-009-9116-7 Authors Lauren M. Edelstein, Johns Hopkins Medicine’s Howard County General Hospital 5755 Cedar Lane Columbia MD 21044 USA Evan G. DeRenzo, Washington Hospital Center Center for Ethics 110 Irving St Washington, D.C. NW 20010 USA Elizabeth Waetzig, Change Matrix Inc. 485 Maylin St. Pasadena CA 91105 USA Craig Zelizer, Georgetown University Department of Government 3240 Prospect St. Washington, D.C. NW 20057 USA Nneka O. (...)
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