{"id":4583,"date":"2024-07-10T13:01:36","date_gmt":"2024-07-10T12:01:36","guid":{"rendered":"https:\/\/blogs.bmj.com\/medical-ethics\/?p=4583"},"modified":"2024-07-10T14:15:36","modified_gmt":"2024-07-10T13:15:36","slug":"making-visible-the-invisible-elements-of-clinical-ethics-consultation","status":"publish","type":"post","link":"https:\/\/blogs.bmj.com\/medical-ethics\/2024\/07\/10\/making-visible-the-invisible-elements-of-clinical-ethics-consultation\/","title":{"rendered":"Making visible the invisible elements of clinical ethics consultation"},"content":{"rendered":"

By Clare Delany, Sharon Feldman, Barbara Kameniar, and Lynn Gillam.<\/p>\n

In our article, \u2018Making clinical ethics facilitation visible and accessible: Seven steps of the Critical Dialogue method of Ethics Consultation<\/a>\u2019, we detail our method of clinical ethics facilitation, broken down into seven steps. We also share the rationale for the various steps, and provide concrete examples for how they might be implemented, including suggested scripting in some places.<\/p>\n

The Children\u2019s Bioethics Centre (CBC) at the Royal Children\u2019s Hospital in Melbourne, Australia, was formally established in 2008. Our service supports clinicians and families facing ethical challenges including high stakes decisions, diverging views, conflict and moral distress regarding treatment and decisions about treatment for children.<\/p>\n

In responding to and leading ethics consultations, we recognise the importance of a robust and transparent process. Although there are published models and styles of clinical ethics consultation approaches discussed in the clinical ethics literature, the detailed processes of thinking and clinical ethics \u2018know how\u2019 of a clinical ethicist during a consultation can be\u2019 invisible\u2019 <\/em>(and therefore largely inaccessible) to others.<\/em><\/p>\n

In our clinical ethics service, we have consistently reflected on the goals of ethics consultations and processes of facilitation employed by the ethicist. In these reflections we have sought to unpack and make visible, the reasoning behind the facilitating ethicist\u2019s decisions:\u00a0to speak, to listen, to guide, to raise ethics concepts, to summarise, to advise, to stay quiet and wait.<\/em><\/p>\n

Following clinical ethics consultations with individual clinicians or with clinical teams or with families, our reflective questions have included: What strategies of facilitation did the ethicist use? How did people engage with the ethics discussion? What was the original ethical question framed in the consultation referral and what was the core ethical concern discussed in the meeting? What other ethical concerns emerged through the discussion? Which ethics concepts and theories were introduced by the ethicists? Were there other frameworks or normative concepts that could have been used to shed light on and clarify ethical questions?<\/p>\n

These reflections led us, over time, to formulate and importantly to articulate, the goals and processes of ethics facilitation within consultations. We have been able to detail how the processes of ethics facilitation led to the identification of a principled resolution to an ethical challenge. We were able to \u2018see\u2019<\/em> how the discussion shifted clinicians\u2019 understanding and appreciation of ethical dimensions of their work.<\/p>\n

Our paper contributes to the scholarship of clinical ethics methods by making the \u201cinvisibles<\/em>\u201d of clinical ethics consultation visible<\/em>.<\/p>\n

\n

Paper:<\/strong> Critical dialogue method of ethics consultation: making clinical ethics facilitation visible and accessible<\/a><\/p>\n

Authors:<\/strong> Clare Delany, Sharon Feldman, Barbara Kameniar, and Lynn Gillam<\/p>\n

Competing interests<\/strong>: None declared<\/p>\n","protected":false},"excerpt":{"rendered":"

By Clare Delany, Sharon Feldman, Barbara Kameniar, and Lynn Gillam. In our article, \u2018Making clinical ethics facilitation visible and accessible: Seven steps of the Critical Dialogue method of Ethics Consultation\u2019, we detail our method of clinical ethics facilitation, broken down into seven steps. We also share the rationale for the various steps, and provide concrete […]<\/p>\n

Read More…<\/a><\/p>\n","protected":false},"author":354,"featured_media":0,"comment_status":"open","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[968,1081],"tags":[],"class_list":["post-4583","post","type-post","status-publish","format-standard","hentry","category-clinical-ethics","category-consultation"],"yoast_head":"\nMaking visible the invisible elements of clinical ethics consultation - Journal of Medical Ethics blog<\/title>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/blogs.bmj.com\/medical-ethics\/2024\/07\/10\/making-visible-the-invisible-elements-of-clinical-ethics-consultation\/\" \/>\n<meta property=\"og:locale\" content=\"en_US\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"Making visible the invisible elements of clinical ethics consultation - Journal of Medical Ethics blog\" \/>\n<meta property=\"og:description\" content=\"By Clare Delany, Sharon Feldman, Barbara Kameniar, and Lynn Gillam. In our article, \u2018Making clinical ethics facilitation visible and accessible: Seven steps of the Critical Dialogue method of Ethics Consultation\u2019, we detail our method of clinical ethics facilitation, broken down into seven steps. We also share the rationale for the various steps, and provide concrete [...]Read More...\" \/>\n<meta property=\"og:url\" content=\"https:\/\/blogs.bmj.com\/medical-ethics\/2024\/07\/10\/making-visible-the-invisible-elements-of-clinical-ethics-consultation\/\" \/>\n<meta property=\"og:site_name\" content=\"Journal of Medical Ethics blog\" \/>\n<meta property=\"article:published_time\" content=\"2024-07-10T12:01:36+00:00\" \/>\n<meta property=\"article:modified_time\" content=\"2024-07-10T13:15:36+00:00\" \/>\n<meta name=\"author\" content=\"Hazem Zohny\" \/>\n<meta name=\"twitter:card\" content=\"summary_large_image\" \/>\n<meta name=\"twitter:label1\" content=\"Written by\" \/>\n\t<meta name=\"twitter:data1\" content=\"Hazem Zohny\" \/>\n\t<meta name=\"twitter:label2\" content=\"Est. reading time\" \/>\n\t<meta name=\"twitter:data2\" content=\"2 minutes\" \/>\n<script type=\"application\/ld+json\" class=\"yoast-schema-graph\">{\"@context\":\"https:\\\/\\\/schema.org\",\"@graph\":[{\"@type\":\"Article\",\"@id\":\"https:\\\/\\\/blogs.bmj.com\\\/medical-ethics\\\/2024\\\/07\\\/10\\\/making-visible-the-invisible-elements-of-clinical-ethics-consultation\\\/#article\",\"isPartOf\":{\"@id\":\"https:\\\/\\\/blogs.bmj.com\\\/medical-ethics\\\/2024\\\/07\\\/10\\\/making-visible-the-invisible-elements-of-clinical-ethics-consultation\\\/\"},\"author\":{\"name\":\"Hazem Zohny\",\"@id\":\"https:\\\/\\\/blogs.bmj.com\\\/medical-ethics\\\/#\\\/schema\\\/person\\\/e73152f6aa4e164c7d625d77cf4fed35\"},\"headline\":\"Making visible the invisible elements of clinical ethics consultation\",\"datePublished\":\"2024-07-10T12:01:36+00:00\",\"dateModified\":\"2024-07-10T13:15:36+00:00\",\"mainEntityOfPage\":{\"@id\":\"https:\\\/\\\/blogs.bmj.com\\\/medical-ethics\\\/2024\\\/07\\\/10\\\/making-visible-the-invisible-elements-of-clinical-ethics-consultation\\\/\"},\"wordCount\":451,\"commentCount\":0,\"publisher\":{\"@id\":\"https:\\\/\\\/blogs.bmj.com\\\/medical-ethics\\\/#organization\"},\"articleSection\":[\"clinical ethics\",\"Consultation\"],\"inLanguage\":\"en-US\",\"potentialAction\":[{\"@type\":\"CommentAction\",\"name\":\"Comment\",\"target\":[\"https:\\\/\\\/blogs.bmj.com\\\/medical-ethics\\\/2024\\\/07\\\/10\\\/making-visible-the-invisible-elements-of-clinical-ethics-consultation\\\/#respond\"]}]},{\"@type\":\"WebPage\",\"@id\":\"https:\\\/\\\/blogs.bmj.com\\\/medical-ethics\\\/2024\\\/07\\\/10\\\/making-visible-the-invisible-elements-of-clinical-ethics-consultation\\\/\",\"url\":\"https:\\\/\\\/blogs.bmj.com\\\/medical-ethics\\\/2024\\\/07\\\/10\\\/making-visible-the-invisible-elements-of-clinical-ethics-consultation\\\/\",\"name\":\"Making visible the invisible elements of clinical ethics consultation - 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