Friday, August 15, 2008

Expertise in "Doing" Ethics

John Lantos, MD
John B. Francis Chair in Bioethics
August 15, 2008

There is a big debate in the world of bioethics about the nature of expertise in ethics. That debate spawns two sub-debates.

One focuses on the lack of any certification or accreditation of bioethicists. Anybody who considers themselves ethical enough can hang out their shingle and start practicing.

Membership on ethics committees is extremely democratic - anybody can serve. Some folks take a course, others read the Hastings Center Report, still others just claim to have a virtuous moral character. Whether or not this seems scandalous depends, in part, on whether or not one thinks that specific training actually helps.

That is the second debate. If we are going to train ethicists, we need to decide on the content of that training. We, at the Center for Practical Bioethics, have ongoing discussions and debates about the nature of that training.

We work with our ethics committee consortium partners to refine our orientation and training programs for ethics committees. But we still haven't gotten it right, or even come to consensus.

The technique of role playing with professional actors is an interesting approach. It seems to start with the assumption that ethics consultation is less about what you know and more about what you say and do.

Ethics consultation, by this view, is a practical skill or craft than it is an intellectual discipline. It is one that people master by doing, rather than by studying. It implicitly claims that everything we need to know to do ethics consults we learned in kindergarten.

This approach can help ethics consultants refine the mediation skills that are important to many ethics consultations. It does not address the need for ethics consultants to be familiar with a growing body of knowledge and learned opinion in law, philosophy, and theology that inform judgments about whether any particular outcome of a mediation is right or wrong, better or worse.

What do you think? Share or view comments by clicking on "comments" after this post.


Ethics consultants get doses of realism through simulations, American Medical News, August 11

The minefield of medical morals, BBC News, August 1, 2008


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