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Complex Ethics Consultations 1st Edition by Paul J Ford, Denise M Dudzinski ISBN 0521697158 9780521697156

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Author(s): Paul J. Ford, Denise M. Dudzinski
ISBN(s): 9780521697156, 0521697158
Edition: 1
File Details: PDF, 2.32 MB
Year: 2008
Language: english
SKU: EB-2220966 Category: Tags: ,

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ISBN 10: 0521697158 
ISBN 13: 9780521697156
Author: Paul J Ford, Denise M Dudzinski

Clinical ethicists encounter the most emotionally eviscerating medical cases possible. They struggle to facilitate resolutions founded on good reasoning embedded in compassionate care. This book fills the considerable gap between current texts and the continuing educational needs of those actually facing complex ethics consultations in hospital settings. 28 richly detailed cases explore the ethical reasoning, professional issues, and the emotional aspects of these impossibly difficult consultations. The cases are grouped together by theme to aid teaching, discussion and professional growth. The cases inform any reader who has a keen interest in the choices made in real-life medical dilemmas as well as the emotional cost to those who work to improve the situations. On a more advanced level, this book should be read by ethics committee members who participate in ethics consultations, individual ethics consultants, clinicians who seek education about complex clinical ethics cases, and bioethics students.

Complex Ethics Consultations 1st Table of contents:

Part I: Laying the Groundwork: Understanding Complexity in Ethics Consultation

Chapter 1: The Nature of Ethical Complexity in Healthcare

  • 1.1 Beyond the Simple Dilemma: Introducing Nuance and Ambiguity
  • 1.2 Sources of Complexity: Competing Values, Conflicting Information, Emotional Intensity
  • 1.3 The Role of Uncertainty in Clinical and Ethical Decision-Making
  • 1.4 The Intersection of Clinical Reality, Patient Values, and Institutional Constraints
  • 1.5 The Ethics Consultant as Facilitator, Educator, and Navigator

Chapter 2: Advanced Ethical Frameworks for Complex Cases

  • 2.1 Reconsidering Principlism: Moving Beyond the Four Principles
  • 2.2 Virtue Ethics and Professional Integrity in Challenging Situations
  • 2.3 Narrative Ethics: Understanding the Patient’s Story and Perspective
  • 2.4 Casuistry and Analogical Reasoning: Learning from Prior Cases
  • 2.5 Ethics of Care: Relationships, Vulnerability, and Responsiveness
  • 2.6 Integrating Multiple Frameworks for Holistic Analysis

Chapter 3: The Advanced Consultation Process: From Referral to Resolution

  • 3.1 Recognizing and Triaging Complex Referrals
  • 3.2 Deep Information Gathering: Beyond the Chart to Nuanced Conversations
  • 3.3 Identifying All Stakeholders and Understanding Their Perspectives
  • 3.4 Framing the Ethical Dilemma: Avoiding Oversimplification
  • 3.5 Facilitation Techniques for High-Conflict Situations
  • 3.6 Crafting Meaningful Recommendations and Strategies for Implementation
  • 3.7 Documentation, Follow-up, and Evaluation of Consultations

Part II: Navigating Specific Categories of Complex Consultations

Chapter 4: Surrogacy, Capacity, and Contested Decision-Making

  • 4.1 Assessing Decision-Making Capacity in Borderline or Fluctuating States
  • 4.2 Navigating Disagreements Among Surrogates and Families
  • 4.3 When Surrogates Request Non-Beneficial or Potentially Harmful Treatment
  • 4.4 Managing Family Dysfunction and Intra-Family Conflict
  • 4.5 The Unbefriended Patient and the Role of the Ethics Consultant

Chapter 5: End-of-Life Care: When Values Collide

  • 5.1 Defining and Managing Medically Ineffective (Futile) Treatment Controversies
  • 5.2 Withdrawal/Withholding of Life-Sustaining Treatment: Beyond the Basics
  • 5.3 Palliative Care and Hospice Conflicts: When Goals of Care Diverge
  • 5.4 Requests for Hastened Death and Physician-Assisted Dying (where legal/relevant)
  • 5.5 Moral Distress in Clinicians and Families Facing End-of-Life Decisions

Chapter 6: Conflicts of Interest and Professionalism

  • 6.1 Identifying and Addressing Clinician-Patient Conflicts of Interest
  • 6.2 Institutional Conflicts of Interest: Research, Resource Allocation, and Financial Pressures
  • 6.3 Managing Physician Moral Distress and Burnout
  • 6.4 The Role of Whistleblowing and Professional Responsibility
  • 6.5 Ethics of Self-Care for the Ethics Consultant

Chapter 7: Cultural, Religious, and Spiritual Diversity

  • 7.1 Understanding and Respecting Diverse Belief Systems in Healthcare Decisions
  • 7.2 When Religious or Cultural Practices Conflict with Standard Medical Care
  • 7.3 Navigating Requests for Unorthodox or Non-Evidenced-Based Treatments
  • 7.4 The Challenge of Cultural Humility vs. Cultural Competence
  • 7.5 Practical Strategies for Engaging with Spiritual Leaders and Community Elders

Chapter 8: Psychiatric Ethics and Behavioral Challenges

  • 8.1 Ethical Issues in Involuntary Treatment and Coercion
  • 8.2 Managing Patients with Unrealistic Demands or Threatening Behavior
  • 8.3 The Interplay of Mental Illness, Capacity, and Autonomy
  • 8.4 Ethical Considerations in the Use of Restraints and Seclusion
  • 8.5 Addressing Implicit Bias in Psychiatric Care

Chapter 9: Pediatric and Neonatal Ethics: Special Vulnerabilities

  • 9.1 Balancing Parental Authority, Child Assent/Dissent, and Best Interests
  • 9.2 Ethical Dilemmas in Neonatal Intensive Care: Periviability and Severe Disability
  • 9.3 Adolescent Autonomy and Confidentiality in Healthcare
  • 9.4 When Parents Refuse Medically Indicated Treatment for Their Child
  • 9.5 Child Protection and Safeguarding Concerns

Part III: The Ethics Consultant in Context

Chapter 10: Institutional Roles and Policy Development

  • 10.1 The Ethics Committee: Structure, Function, and Evolution
  • 10.2 The Role of Ethics in Institutional Policy Development and Review
  • 10.3 Integrating Ethics into Quality Improvement and Patient Safety Initiatives
  • 10.4 Ethics Education for Healthcare Professionals and the Public
  • 10.5 Beyond the Bedside: Organizational Ethics and Systemic Issues

Chapter 11: Educating for Complex Consultations

  • 11.1 Designing Training Programs for Ethics Consultants
  • 11.2 Utilizing Simulation and Role-Playing in Ethics Education
  • 11.3 Mentorship and Supervised Practice in Clinical Ethics
  • 11.4 The Role of Self-Reflection and Peer Review
  • 11.5 Continuing Professional Development for Ethics Consultants

Chapter 12: Future Challenges and the Evolving Role of Ethics Consultation

  • 12.1 Emerging Technologies: AI, Gene Editing, Data Ethics
  • 12.2 Health Equity, Social Justice, and Ethics Consultation
  • 12.3 Global Bioethics and Cross-Cultural Ethics Consultation
  • 12.4 The Integration of Ethics into Value-Based Care and Population Health
  • 12.5 Sustaining the Field: Research, Professionalization, and Impact

Conclusion: The Enduring Value of Complex Ethical Inquiry

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Tags: Paul J Ford, Denise M Dudzinski, Complex, Consultations