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Skill-Building and Evaluation in Ethics Consultation...
The Neiswanger Institute for Bioethics at Loyola University Chicago is committed to the education and attestation for healthcare professionals who conduct ethics consultation and sit on ethics committees. Following the outline of the Core Competencies for Health Care Ethics Consultation published by the American Society for Bioethics and Humanities (ASBH), and the Striving for Excellence in Ethics report (Copyright 2014 Catholic Health Association of the United States and Ascension Health), we offer formal training, educational materials and evaluation assessment for conducting clinical ethics consultation.
Our Bioethics & Health Policy graduate programs offer an:
- Ethics Consultation Simulation Seminar course that provides simulated ethics consultation, practice in communication and interaction skills, and provides constructive feedback.
- In the Advanced Clinical Ethics Skills course, participants receive advanced simulation training and develop their ethics consultation portfolios for quality attestation.
SKILL-BUILDING MATERIALS FOR ETHICS CASE CONSULTATION
For the use of ethics committees and educators unable to attend our seminars, we provide a variety of materials to assist you in developing ethics consultation skill training. These materials, assembled from our simulation seminars, include presentations that provide an overview of what we know about ethics case consultation in the United States, and an introduction of how to conduct an ethics consultation. Four different case videos are provided with associated case outlines and evaluation templates.
The links below provide a variety of materials to assist you in this effort. We have video presentations that: (1) provide an overview of what we know about ethics case consultation in the United States, and (2) the process to conduct an ethics consultation and how to evaluate your efforts. In addition, you will find question guidelines and a template for evaluating an ethics consultant's work. The ETHICS CONSULTATION CASES FOR SIMULATION provide an outline and video links to recorded case simulations. We also offer a variety of ethics simulation case videos on our Loyola Bioethics You Tube channel.
► An Overview of Ethics Committees and Ethics Consultation in the U.S. (pdf file)
Provides an overview of what we know about ethics case consultation in the United States.
► Questions for Evaluating Ethics Consultation (pdf file)
Guideline of questions for rating the ethics consultant's work.
► Template for Evaluating Ethics Consultation (pdf file)
Dimensions on which you rate the ethics consultant’s interview.
ETHICS CONSULTATION CASES FOR SIMULATION
CASE 1: Jacques Jones
Single ethics consultation model This case involves a patient who has had a stroke and has difficulty at this time speaking for herself in making her medical decisions. Due to swallowing difficulties, her physicians are strongly recommending placing a tube to deliver artificial nutrition and hydration (a PEG tube). The Case Outline below will tell you more about the situation. The video illustrates an individual consultant conducting the case (the other videos on this site employ a two-person team model). This video shows some very strong personalities, particularly the patient’s daughter and the neurologist, in conflict. As a result of their vocal natures, you will see that the consultant sees his role as allowing the discharge of that energy before entering the dialogue to facilitate resolution. You can assess how effective you believe this strategy to be.
Video File links:
- Part 1: Ethics Consultant Jacques Jones Meets Case Physicians (8:48 mins)
- Part 2: The Case Conference (17:40 mins)
CASE 2: Stroke Patient
This case also involves a patient who has had a significant cerebrovascular event. It shows a physician who wishes to continue life support until further evaluation can be completed in conflict with a surrogate decision maker who believes the patient would wish no further intervention. The case is especially interesting from a mediational perspective. That is, the consultants and health care professionals must honor the legitimate wishes and rights of the patient but it is important to make sure that the surrogate decision maker understands the situation and considers how the patient’s values and previous directives apply to the present situation. You might wish to consider what kind of compromises are available and legitimate in such a situation and whether the resolution reached is satisfactory. This case is also pertinent to many of our current clinical dilemmas because it challenges us to consider whether categories such as “terminal” are applicable to the patient or of what uses such distinctions might be in reaching resolution.
Video File links:
- Part 1: The ethicist(s) meet with Dr. Murphy (16:48 mins)
- Part 2: Ms. Harper meets with the ethicist(s) and Dr. Murphy (10:33 mins)
- Part 3: The ethics consultation concludes (16:18 mins)
CASE 3: Returning Hero
This case is an effort to process a conflict between to family members, i.e., the patient’s wife and his adult son from his first marriage. It also has two other features that are different from previous videos: (1) The attending physician is unable to be present at the meeting, and (2) a chaplain is part of the meeting. As a result, of these differences, this consultation has many different dynamics than the other videos.
Video File links:
- Part 1: The ethicists meet with Mrs. Abrams (9:08 mins)
- Part 2: Jeremy, pastoral care and Mrs. Abrams meet with the ethicists (14:56 mins)
- Part 3: The ethics consultation concludes (14:55 mins)
CASE 4: Futility Case
This case involves a patient for whom resuscitative efforts would likely bring no benefits but would impose great burdens. However, the last statements/directives of the patient included “wanting everything done.” The consultants are challenged by an attending physician whose style lacks subtlety and must try to blunt the force of her approach and try to help the surrogate decision maker to interpret the patient’s wishes in an effort to develop a consensus on a treatment plan.
Video File links: