Accountability and the Clinical Practice of Ethics Consultation: Roles, Activities, and the Experience of Doing

摘要

The past few years have seen greater attention directed toward important procedural elements associated with ethics consultation. Examples include considerations about how best to document consultations (Dubler 2013; Bruce, Smith, Tawose, and Sharp 2014), the variety of ways to evaluate consultation outcomes (Chen and Chen 2008; Pf?fflin, Kobert, K., Reiter-Theil 2009), and even how to certify ethics consultants (White, Jankowski, and Shelton 2014). Underlying such considerations are a number of substantive moral concepts that frame the meaning and practice of clinical ethics-several of which we began exploring well over a decade ago (Bliton and Finder 1999; Bliton and Finder 2002). We have been especially interested in questions associated with responsibility in the actual practice of clinical ethics consultation (Bliton and Finder 2010; Finder and Bliton 2001; Finder and Bliton 2008; Finder and Bliton 2011). In that light, we applaudWeise and Daly (2014) turning so explicitly toward the issue of accountability in clinical ethics consultation. Possessing an ability to provide an account for one's actions-and then actually doing so-after all, is a necessary component for being responsible (and hence of fulfilling responsibility).