Abstract
There are several important conceptual issues and questions about the practice of healthcare ethics that can, and should, inform the development of any practice standards. This paper provides a relatively short overview of seven of these issues, with the invitation for further critical reflection and examination of their relevance to and implications for practice standards. The seven issues described include: diversity (from the perspective of training and experience); moral expertise and authority/influence; being an insider or outsider; flexibility and adaptability (for local contexts of practice); the relative weighting of procedural and normative aspects of ethics practice; making mistakes or errors; and conflicts of interest in practice.
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Notes
See definition in Introduction to this issue (Simpson 2012).
The issues described in this paper are also of relevance in terms of exploring professionalization broadly speaking; I focus here on these issues in relation to practice standards.
See, for example, Susan Sherwin’s (2011) article on the past, present and future of the field of bioethics.
This role is also variously referred to as the health care ethics consultant, ethics consultant, and so on. I use the language of clinical ethics consultant here to remind the reader that the focus of many of these discussions was/is on the role of the ethicist in clinical situations (as opposed to more organizational and policy issues). As indicated in Reel (2012), there is interest in expanding the discussion of practice standards to include these other roles that PHEs take on.
On a related note, it was pointed out at the symposium funded by the Canadian Institutes for Health Research (see Frolic and Practicing Healthcare Ethicists Exploring Professionalization 2012) that we also need to take stock of our field from another diversity perspective—namely, how well or poorly do we as PHEs reflect the communities that we serve?
See definition of “standard practices”, as opposed to practice standards, in Reel (2012).
It is interesting to consider these points in relation to the earlier discussion in the field which drew attention to the need for ethics consultants to consider how they did their work, such as Walker (1993), in terms of creating room for consideration of ethics issues and questions.
This discussion also relates to another thread of analysis and debate within the field of health care ethics practice related to taking a stand on important ethics issues and standing up to one’s organization and/or those in leadership positions. See, for example, Freedman (1996), Baylis (2004), and Rowell (2004).
I thank George Webster and Pat Murphy, in particular, for their identification of this point.
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Simpson, C. Mapping Our Practice? Some Conceptual “Bumps” for us to Consider. HEC Forum 24, 219–226 (2012). https://doi.org/10.1007/s10730-012-9188-7
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DOI: https://doi.org/10.1007/s10730-012-9188-7