Political and Interpersonal Aspects of Ethics Consultation
Frader, Joel E.
Theoretical Medicine. 1992 Mar; 13(1): 31-44.
Previous papers on ethics consultation in medicine have taken a positivistic approach and lack critical scrutiny of the psychosocial, political, and moral contexts in which consultations occur. This paper discusses some of the contextual factors that require more careful research. We need to know more about what prompts and inhibits consultation, especially what factors effectively prevent house officers and nonphysicians from requesting consultation despite perceived moral conflict in cases. The attitudes and institutional power of attending medical staff seem important, especially where innovative interventions raise ethical questions. Ethics consultants also need to address the thorny problems of the origin(s) of the consultant's authority, whistleblowing, conflicts of interest that affect the consultant, persistently poor communications in hospitals, systemic inequity in the availability or quality of services for some, and the standing of the consultant's recommendations, including their appearance in the patient's medical record.
Accountability; Administrators; Attitudes; Bioethical Issues; Clinical Ethics; Clinical Ethics Committees; Communication; Competence; Conflict of Interest; Consultation; Dissent; Ethicists; Ethics; Ethics Committees; Ethics Consultation; Evaluation; Family Members; Health; Hospitals; Institutional Policies; Interprofessional Relations; Medical Records; Medicine; Misconduct; Patient Advocacy; Patient Care; Patients; Professional Competence; Professional Ethics; Power; Records; Research; Social Dominance; Standards; Technical Expertise; Whistleblowing;
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Frader, Joel E. (1992-03)Previous papers on ethics consultation in medicine have taken a positivistic approach and lack critical scrutiny of the psychosocial, political, and moral contexts in which consultations occur. This paper discusses some ...