Credentialing Ethics Expertise

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This article refers to:

What the HEC-C? An Analysis of the Healthcare Ethics Consultant-Certified Program: One Year in

Notes

1 I have argued with a colleague elsewhere against the disturbing trend among theorists of clinical ethics consultation who deny ethicists have ethics expertise (Brummett and Ostertag 2018).

2 By “positive view,” I mean a view that affirms clinical ethicists have ethics expertise, understood as the ability to make justified ethical recommendations in active cases. A more complete taxonomy of views of clinical ethics expertise has recently been published in The American Journal of Bioethics (Brummett and Salter 2019).

3 After all, the emphasis of modern clinical ethics that the patient, and not the physician, ought to be the one making medical decisions is itself a substantive ethical claim that required a revolution in thought to overturn the traditional paternalistic medical morality. Any process that aims to designate a decision maker for a patient who is unable to give informed consent necessarily requires moral commitments, e.g., adult children should be considered before parents.

4 Ethical considerations for deciding whether to honor an incapacitated refusal include, “the patient’s current level of capacity, the degree to which the refusal is in line with the patient’s previous statements, the burden of treatment, and the expected benefit” (Humanities 2017, 11).

5 Belief in redemptive suffering can sometimes motivate a surrogate to request that pain medication not be administered to a patient.