This volume brings together a group of researchers from different European countries and disciplines who are involved in Clinical Ethics Consultation (CEC). The work provides a discussion on the theories and methods underlying CEC and on the issues of implementation and evaluation. The first section deals with different possible approaches in CEC. The authors explore the question of how we should decide complex cases in clinical ethics, that is, which ethical theory, approach or method is most suitable in order to make an empirically based well-informed ethical decision. It also discusses whether clinical ethicists should be ethicists by education or rather well-trained facilitators with some ethical knowledge. The second section deals with the implementation of CEC structures both at the macro and micro levels in both developed and transitional countries. The third section deals with the vital issue of the evaluation of CEC. Evaluation is essential with regard to the question of whether CEC has been successfully implemented and is reliable and promotes the process of ethical decision - making.
Evaluation may indicate that the particular method of CEC in operation should be adjusted to the special needs of the place of application. These empirical findings are important for the philosophical evaluation because they could be used to improve the methodology of the particular ethical approach in CEC. The combination of theories and methods, implementation and evaluation of CEC in this volume shows the close connection between philosophical reasoning and empirical findings in medicine. By bringing together theorists and healthcare practitioners, the book addresses the criticism that 'clinical ethics' does not appeal appropriately to theories and methods.
General introduction; Part I Theories and Methods: Ethics as a method, John Stewart Gordon; Ethics - empiricism - consultation. Defining a complex relationship, Uwe Fahr and Markus Rothaar; Philosophical foundations of clinical ethics; a hermeneutic perspective, Guy Widdershoven and Bert Molewijk; Discourse ethics and ethics consultation, Uwe Fahr; Implementation of clinical ethics consultation in conflict with professional conscience? Suggestions for reconciliation, Laszlo Kovacs; Ethics consultation: facilitating reflection on professional norms in medicine, Christiane Stuber.; Part II Implementation: The implementation process of clinical ethics consultation: concepts, resistance, recommendations, Jochen Vollmann; What does the ethical expertise of a moral philosopher involve in clinical ethics consultancy?, Beate Herrmann; Moving towards clinical ethics consultation in Italy: practical; experience, foundational and methodological considerations, Nunziata Comoretto; Demand and needs in clinical ethics consultation in Georgia, Nino Chikhladze and Nato Pitskhelauri; Clinical ethics consultation in Croatia, Ana Borovecki; Clinical ethics in the Netherlands. Moral case deliberation in health care organisations, Margreet Stolper, Sandra van der Dam, Guy Widdershoven and Bert Molewijk; Clinical ethics consultation and bedside rationing, Daniel Strech.; Part III Evaluation: Experience in ethical decision-making and attitudes towards ethics consultation of regional hospital physicians in Bulgaria, Silviya Aleksandrova; Ethical decision - making in nursing homes - a literature study, Georg Bollig; Evaluation of clinical ethics consideration: a systematic review and critical appraisal of research methods and outcome criteria, Jan Schildmann; Index.