The Quality Attestation Presidential Task Force's recent proposal for "quality attestation" (QA) of clinical ethics consultants was advanced on the premise that, "gjiven the importance of clinical ethics consultation, the people doing it should be asked to show that they do it well."1 To this end, the task force attempted to develop "a standardized system for proactively assessing the knowledge, skills, and practice of clinical ethicists."2 But can this proposed method of QA deliver on the promise of a discriminating assessment of clinical ethics consultants? Assessing the assessment method before the program launches is of paramount importance because, if the proposed QA process is flawed, it will have the adverse effect of labeling clinical ethicists as qualified to do clinical ethics consultations (CECs) when they are not. The result will be the creation of a new, likely intractable, problem of CEC "false positives:" consultants who have passed QA without actually possessing the requisite knowledge and skills to perform CECs. Coming from the American Society for Bioethics and Humanities (ASBH)--the national bioeth-ics organization-the QA imprimatur will be seen as having weeded out the incompetent and untrained. Therefore, false positives in QA would do more harm than good: instead of uncertainty about the quality of consultants, we would have a specious confidence and reassurance about their qualifications.
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