Whether ethics is too important to be left to the experts or so important that it must be is an age-old question. The emergence of clinical ethicists raises it again, as a question about professionalism. What role clinical ethicists should play in healthcare decision making – teacher, mediator, or consultant – is a question that has generated considerable debate but no consensus.
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1. La Puma, J, Schiedermayer, DL. Ethics consultation: skills roles and training. Annals of Internal Medicine 1991;114:155–60.
2. Singer, PA, Pellegrino, ED, Siegler, M. Ethics committees and consultants. Journal of Clinical Ethics 1990;1:263–7.
3. Fletcher, JC. Needed: a broader view of ethics consultation. Quality Review Bulletin 1992; 18(1): 12–4.
4. La Puma, J, Priest, ER. Medical staff privileges for ethics consultants: an institutional model. Quality Review Bulletin 1992; 18(1): 17–20.
5. Siegler, M. Defining the goals of clinical ethics: consultation a necessary step for improving quality. Quality Review Bulletin 1992; 18(1): 15–6.
6. Fletcher, JC, Brody, H. Clinical ethics. In: Reich, WT, ed. Encyclopedia of Bioethics. 2nd ed.New York: Macmillan (in preparation).
7. Jonsen, AR, Siegler, M, Winslade, WJ. Clinical Ethics: A Practical Approach to Ethical Decisions in Clinical Medicine. 3rd ed.New York: MacGraw-Hill, 1992.
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12. Center for Biomedical Ethics, University of Minnesota. Graduate and Post-Doctoral Programs in Bioethics and Medical Humanities. August, 1992. The document lists 28 total programs, including 13 with an M. A. (11) or a 1-year fellowship (2). The remainder also offer Ph.D. programs or special academic opportunities. An additional listing of 60 graduate programs in bioethics has been published by the Hastings Center. This document, Bioethics Education, 1993, lists 14 programs for clinical ethics. These institutions offer an M. A. program with a concentration either in bioethics with clinical practicum or in clinical ethics: Georgetown University, Loyola University of Chicago, University of Pittsburgh, University of Tennessee, University of Virginia, University of Washington, and Medical College of Wisconsin. Others have 1-year fellowships in clinical ethics: Loyola University of Chicago, Lutheran General Hospital (Park Ridge, 1L), University of Chicago, Clinical Center, National Institutes of Health, Cleveland Clinic Foundation, and the University of Pittsburgh.
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20. Hastings Center Project on Bioethics Education. Bioethics Education. Expanding the Circle of Participants. Briarcliff Manor, New York: The Hastings Center, 1993.
21. Joint Commission for Accreditation of Health Care Organizations. Accreditation Manual for Hospitals, Vol. 1. Standards, 1991 ed. Oakbrook Terrace, Illinois, 1992.
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