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Page 1 of 8

Complex Ethics Consultations
  • Cases That Haunt Us in a New Era
  • Volume 2
  • Edited by Denise M. Dudzinski, Kaarkuzhali Babu Krishnamurthy, Paul J. Ford
  • Coming soon
  • Expected online publication date:
    December 2025
    Print publication:
    31 December 2025
  • Clinical ethics consultants navigate some of the most challenging cases in patient care, public health, and healthcare policy. The second volume richly details haunting cases pertaining to perinatal, paediatric, and end-of life issues; neurodiversity; disability; and employment of high-tech devices. Authors explain distinctive features of consultations in rural and pandemic contexts and complicated transitions into and out of inpatient care. Cases are grouped together by theme and organized uniformly. Each chapter includes a case presentation, the authors' professional reflections, description of haunting aspects, case outcome, and questions for discussion. Organizational ethics factors into many of the cases. The authors honestly describe the affective aspects of their work, including lingering regrets, doubts, and moral distress. They pay special attention to justice, equity and inclusivity. It is a fascinating and important read for clinicians and bioethicists engaged in clinical ethics consultations as well as ethics committee members and students.

  • Emotional disorders among children and young people in England from 2004 to 2017: analysis of a probability sample survey series

  • Vicky P. Taxiarchi, Joanna K. Anderson, Kathryn M. Abel, Tamsin J. Ford, Tamsin Newlove-Delgado, Sally McManus, Yushi Bai, Matthias Pierce
  • Journal:
    The British Journal of Psychiatry , FirstView
    Published online by Cambridge University Press:
    23 June 2025, pp. 1-7
    • Article
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      • Open access
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  • Background

    Accumulating evidence shows that an increasing number of children and young people (CYP) are reporting mental health problems.

    Aims

    To investigate emotional disorders (anxiety or depression) among CYP in England between 2004 and 2017, and to identify which disorders and demographic groups have experienced the greatest increase.

    Method

    Repeated cross-sectional, face-to-face study using data from the Mental Health of Children and Young People surveys conducted in 2004 and 2017, allowing use of nationally representative probability samples of CYP aged 5–16 years in England. A total of 13 561 CYP were included across both survey waves (6898 in 2004 and 6663 in 2017). We assessed the prevalence of any emotional, anxiety and depressive disorder assessed using the Development and Well-Being Assessment and classified according to ICD-10 criteria.

    Results

    The prevalence of emotional disorders increased from 3.9% in 2004 to 6.0% in 2017, a relative increase of 63% (relative ratio 1.63, 95% CI 1.38, 1.91). This was largely driven by anxiety disorders, which increased from 3.5 to 5.4% (relative ratio 1.63, 95% CI 1.37, 1.93). The largest relative changes were for panic disorder, separation anxiety, social phobia and post-traumatic stress disorder. Changes were similar for different genders and socioeconomic groups, but differed by ethnicity: the most pronounced increase was among White CYP (relative ratio 1.88, 95% CI 1.59, 2.24), compared with no clear change for Black and minority ethnic CYP (relative ratio 0.85, 95% CI 0.52, 1.39). Comorbid psychiatric conditions were present in over a third of CYP with emotional disorders, with the most common being conduct disorder.

    Conclusions

    Between 2004 and 2017, the increase in emotional disorders among CYP in England was largely driven by anxiety disorders. Socioeconomic inequalities did not narrow. Disaggregating by ethnicity, change was evident only in White CYP, suggesting differential trends in either risk exposure, resilience or reporting by ethnicity.

  • Introduction to the First Edition

  • Edited by Paul J. Ford, The Cleveland Clinic Foundation, Cleveland, Denise M. Dudzinski, University of Washington School of Medicine, Seattle
  • Book:
    Complex Ethics Consultations
    Published online:
    17 May 2025
    Print publication:
    05 June 2025, pp 4-14

  • Summary

    The cases in this volume exemplify a rich cross-section of consultation experiences from which we can learn. The authors tell stories and share personal responses connected to deeply affective clinical ethics cases in which they consulted. None of these authors has selected an easy case. Ambiguity, second-guessing, and regret permeate their stories and reflections. They show great courage in laying bare such things as potential missteps, institutional impotence, and interpersonal struggles. Through their openness, we have amassed a rare collection of stories from which to learn about real-life challenges encountered by clinical ethics consultants in the incredibly complex world of contemporary health care.

  • Introduction

  • Edited by Paul J. Ford, The Cleveland Clinic Foundation, Cleveland, Denise M. Dudzinski, University of Washington School of Medicine, Seattle
  • Book:
    Complex Ethics Consultations
    Published online:
    17 May 2025
    Print publication:
    05 June 2025, pp 1-3

  • Summary

    Clinical ethics consultations can be haunting. Ethics consultants have few opportunities to reflect on the affective impact of their work. This book offers detailed cases, confessions, reflections, regrets, and triumphs experienced by ethics consultants. The authors bravely share what haunts them about the complex and demanding work of ethics consultation. Consultants experience moral distress but it’s rarely discussed. Our values are woven into the consultation. We’re not always sure if this is for better or worse. One poignant case may haunt us for our entire career. The second edition of the book includes the cases written by original authors regarding neonatology, pediatrics, palliative care, psychiatry, religious and cultural values, clinical innovation, professionalism, and organizational ethics. The book includes educational activities for ethics committees, consultants, and students at all levels of study. In the second edition, new authors reflect on clinical ethics practice, highlight how our practices have changed, and reflect on equity and diversity dimensions of patient care and ethics consultations.

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