The Limits of Competence: Encountering the "Ethics" of Clinical Ethics Consultation in Ordinary, Everyday Practice
Thursday, October 12, 2023
2:30 PM – 3:45 PM ET
Location: Bristol (Third Floor)
While much in the field of ethics consultation has changed since the Core Competencies (published 25 years ago) and HEC-C (introduced 5 years ago) moved toward standardization within the profession, in actual practice ethics consultants may confront challenging questions about their proper role, orientation, goals, and activities. In this presentation, the author recounts a seemingly straightforward ethics consultation that exposes such questions as still relevant, ongoing…and perhaps unresolvable.
By many of the “objective” standards by which ethics consultants often measure themselves, the consultation presented by the author was successful: it was conducted in a timely and competent manner, a solution was reached satisfying all stakeholders involved, and the patient’s care was improved. Indeed, the consultation could easily be cited as an example of the positive value ethics consultants bring to an organization.
And yet in the process, the ethics consultant may have overstepped boundaries, undermined communication among clinicians, and inappropriately stripped clinical stakeholders of their responsibilities to themselves, each other, and their patient. Thus, in “competently” performing the consultation in line with prevailing standards of practice, the ethics consultant may have made it easier for clinicians to ignore their own ethical obligations and worsened the moral culture of the organization.
Through problematizing what appears to be a successful ethics consultation, the author argues that even with robust professionalization, clinically-based issues will continue to confront ethics consultants with a variety of fundamental questions that cannot be resolved administratively or by algorithm or rule, thus amplifying the “ethics” embedded in “clinical ethics.”