Cambridge Quarterly of Healthcare Ethics

Special Section: Coming of Age in Clinical Ethics Consultation: Time for Assessment and Evaluation

Clinical Ethics Consultation and Ethics Integration in an Urban Public Hospital

MARK P. AULISIO, JESSICA MOORE, MAY BLANCHARD, MARCIA BAILEY and DAWN SMITH

Clinical ethics committees, with their typical threefold function of education, policy formation, and consultation, are present in nearly all U.S. hospitals today, and they are increasingly common in other healthcare settings such as long-term care and even home care. Ethics committees are at least as prevalent in Canadian hospitals as they are in U.S. hospitals, and their presence is growing in Europe, much of Asia, and Central and South America. Although ethics committees serve a variety of needs, their ultimate goal ought to be to promote ethical practices or, in other words, to engender the integration of ethics into the life of the medical center. Of the three primary functions of ethics committees, ethics consultation has historically been the most controversial and problematic, and consult services in many healthcare institutions have struggled to thrive.

Mark P. Aulisio, Ph.D., is Director of the Center for Biomedical Ethics at MetroHealth Medical Center, Director of the Master of Arts in Biomedical Ethics program, and Associate Professor in the Department of Bioethics at Case Western Reserve University in Cleveland, Ohio.

Jessica Moore, D.H.C.E., is a Clinical Ethicist in the Center for Biomedical Ethics at MetroHealth Medical Center and Research Associate, Department of Bioethics, Case Western Reserve University, Cleveland, Ohio.

May Blanchard, M.D., is Assistant Professor of Obstetrics, Gynecology, and Reproductive Sciences and Director of General Obstetrics and Gynecology, University of Maryland School of Medicine, Baltimore, Maryland.

Marcia Bailey, R.N., M.S.N., is the Director of Nursing, Pediatrics, and Rehabilitation Medicine at MetroHealth Medical Center, Cleveland, Ohio.

Dawn Smith, M.A., is a Clinical Ethics Specialist in the Center for Biomedical Ethics at MetroHealth Medical Center and the Department of Bioethics, Case Western Reserve University, Cleveland, Ohio.

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