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June 26, 1996

Ethics Consultation Quality: Is Evaluation Feasible?

Author Affiliations

JAMA contributor

JAMA. 1996;275(24):1866-1867. doi:10.1001/jama.1996.03530480010005

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LIKE MEDICINE in general, biomedical ethics is in a state of flux, and for those involved in ethics case consultation, changes have been dramatic.

Originally patterned after the medical consult model, ethics consultations have been provided for the last 20 years or so for physicians who requested such advice, and have usually been performed by physicians with some special training in ethics, law, or philosophy.

But as consensus emerged during the last decade about what the process of ethics consultation should entail, it became apparent that the physician's perspective was often insufficient for resolving many of the problems presented. Gradually, other health care professionals—particularly nurses, clergy, and social workers—who were in a position to contribute social, psychological, and cultural insights, were accepted as participants in the ethics decision-making process. In addition, institutional ethics committees, which were formed during the past decade in many of the nation's acute care settings, fostered