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41 - Innovative strategies to improve effectiveness in clinical ethics
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- By Jennifer L. Gibson, Assistant Professor University of Toronto, M. Dianne Godkin, Clinical Ethicist and Manager Center for Clinical Ethics Toronto, Canada, C. Shawn Tracy, Research Associate, Primary Care Research Unit University of Toronto, Canada, Susan K. MacRae, Deputy Director and the Director of the Clinical Ethics Fellowship University of Toronto, Canada
- Edited by Peter A. Singer, University of Toronto, A. M. Viens, University of Oxford
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- Book:
- The Cambridge Textbook of Bioethics
- Published online:
- 30 October 2009
- Print publication:
- 31 January 2008, pp 322-328
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- Chapter
- Export citation
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Summary
A large tertiary healthcare organization has a full-time clinical ethicist who is responsible for ethics consultation, education, policy development, and research. A recent accreditation survey identified a number of gaps in clinical ethics services across the organization. The clinical ethicist is already over-extended and is at risk of burning out. The Vice-President responsible for overseeing the ethics portfolio wonders what can be done to enhance support for the clinical ethicist, strengthen ethics capacity across the organization, and improve the overall effectiveness of clinical ethics services.
What is clinical ethics effectiveness?
The ultimate goal of any clinical ethics delivery model is improved patient care. As more healthcare resources are invested in clinical ethics services, questions are increasingly raised about whether these services are effective in improving the quality of patient care and whether they justify investments of limited healthcare resources. In this chapter, we identify some key challenges to existing clinical ethics delivery models and suggest four innovative strategies to improve effectiveness in clinical ethics services in healthcare organizations.
Since 1995, when James Tulsky and Ellen Fox convened the Conference on Evaluation of Case Consultation in Clinical Ethics (AHCPR, 1995), there has been a marked increase in scholarly attention to the study and evaluation of clinical ethics, particularly related to the ethics consultation component of clinical ethics (e.g., McClung et al., 1996; Orr et al., 1996; Schneiderman et al., 2000). This has been described as a new phase in the clinical ethics movement (Aulisio, 1999).