For quite some time now, there have been discussions and debates in North America in the field of ethics concerning professionalization . From a talk given to graduate and undergraduate university students, the author tells the personal journey of an ethicist in the province of Quebec, Canada, and offers a narrative to illustrate some of the issues she faced since starting her work in the field of ethics at the end of the 1990s. Instead of taking the usual “for” and (...) “against” positions, the author addresses the issue of professionalization of healthcare ethics from her own point of view. Referring to her experience with ethics committees and research ethics boards and to the works of George A. Legault in Crise d’identité professionnelle et Professionnalisme (Presses de l’Université du Québec, Sainte-Foy, 2003 ), she pleads for the development of practice standards and the creation of a deliberative process (see Kirby and Simpson in this issue of HEC Forum 2012 ), a dialogical space for assuring professionalism in healthcare ethics interventions, not solely the act of becoming a profession. (shrink)

This article outlines one element of the work carried out by a group of Canadian ethicists [Practicing Healthcare Ethicists Exploring Professionalization (PHEEP)]—to begin the deliberative development of a set of practice standards for the Canadian context. To provide a backdrop, this article considers the nature and purpose of practice standards as they are used by regulated professions and how they relate to other practice-defining texts such as competencies, codes of ethics and statements of scope of practice. A comparative review of (...) current practice-defining documents developed within the field of healthcare ethics practice suggests that practice standards are not yet among them. A review of the practice standards and related texts articulated by various other professions, both regulated and not yet regulated, indicates that while these groups of documents serve to define and clarify various dimensions of practice in individual disciplines, there is no clear standardized approach to the terminology, structure and content across these documents. It is suggested that this variability presents a degree of flexibility that ought to allay many of the anxieties that have been expressed about practice standards in healthcare ethics: practitioners, PHEs, are at liberty to define their practice as they see fit, albeit within reasonable parameters if regulation is sought. A proposal for a draft structure and potential content for Canadian healthcare ethics practice standards is offered. (shrink)

Early on in the development of Practicing Healthcare Ethicists Exploring Professionalization (PHEEP), the founding members recognized the need to address and meet two important goals: (1) the creation of a dynamic, rigorous process to support the exploratory work, and (2) the establishment of the means—deliberative engagement—to generate and justify the substantive content of professionalization-related products, such as practice standards and position statements. Drawing from social justice and deliberative democracy conceptions and insights (among others), the authors identify and describe the core (...) elements of the “process scaffolding” and “deliberative means” that inform PHEEP’s deliberative engagement methodology. The paper demonstrates how these process and substantive features have been meaningfully instantiated in the decision making framework established by PHEEP for its use in the development of professionalization-related products by Canadian practicing healthcare ethicists. (shrink)

I argue that it is possible to reframe the current debates over professionalization in a way that can account for disagreement without insisting that its advocates and opponents are adversaries. Giles Scofield, and critics like him, may be understood as engaging in the sort of theoretical disagreement that is an inescapable and vital part of our practice. The field could profit from the work of legal theorist Ronald Dworkin who has long argued that people of good will and great competence (...) need not share foundational assumptions. They may, instead, be advancing rival interpretations of what the practice of healthcare ethics (PHE) requires. (shrink)

Canadian ethicists have a long legacy of leadership in advocating for standards and quality in healthcare ethics. Continuing this tradition, a grassroots organization of practicing healthcare ethicists (PHEs) concerned about the lack of standardization in the field recently formed to explore potential options related to professionalization. This group calls itself “practicing healthcare ethicists exploring professionalization” (PHEEP). This paper provides a description of the process by which PHEEP has begun to engage the Canadian PHE community in the development of practice standards (...) and related projects. By making our process and its ethical and cultural underpinnings transparent, we hope to prompt PHEs around the world to reflect on the importance of context, process and principles (not just outcomes) in the exploration of and possible movement towards professionalization. By sharing some of our key successes and challenges, we also hope to inspire our colleagues to recognize the value in developing practice standards and to contribute to this endeavor. (shrink)

As ethics services have become more integrated into healthcare organizations, the controversy regarding the possible professionalization of healthcare ethics practices has re-emerged. Some of the debate focuses on whether healthcare ethics practice possesses the attributes of a ‘true profession.’ This study examines the history of the professions and the relevance of this historical material, as well as sociological insights, for contemporary concerns. It explores whether the mismatch between traditional models of professional knowledge and the knowledge foundation for healthcare ethics is (...) at the core of these concerns. It also takes the position that given the role healthcare ethics plays in assisting patients, families, healthcare providers, and others with complex moral decisions it is important to work towards developing standards that can be used to guide and evaluate the work. (shrink)

Currently, there is no authoritative credentialing process for individuals engaged in ethics practice, no accreditation system that sets minimum education standards for programs aiming to prepare these individuals for their work, and little evidence available that any particular training model is actually achieving its pedagogical goals. At the same time, a number of healthcare organizations and universities now routinely offer post-graduate programs, clinical fellowships and in-house training specifically devised to prepare graduates for ethics practice. However, while their numbers appear to (...) be growing, information about these programs is limited. In this paper, we describe the goals, content and strategies of three educational programs offered in Ontario, Canada. These case studies highlight the diversity of ethics education available to those who engage in ethics practice and underscore the need to take this variety into account in the development of future education standards that would specify minimally acceptable educational requirements. (shrink)