Models of Training for Clinical Ethics Consultants and Approaches to Quality Assessment and Improvement

Abstract

AbstractClinical ethics consultation (CEC) is a multidisciplinary specialty within bioethics. The variety of pathways into CEC highlights the need for clear guidelines for training ethics consultants, standards, and approaches to Quality Assessment (QA). Traditional pathways for training have included shadowing another ethics consultant, short courses, or additional degrees in bioethics. Because of its proximity to medicine, the gold standard for training clinical ethics consultants has become the fellowship model. Yet, many clinical ethicists are full-time physicians, nurses, chaplains or other clinicians and leaving those roles for 1–2 years for a fellowship is unrealistic and not possible. Alternative models for training including online and flexible certificates or degree programs, intensive immersion courses, and short internships are needed to provide opportunities to the range of practitioners doing this work. The American Society for Bioethics and Humanities (ASBH) provides Core Competencies for Healthcare Ethics Consultants and any training must draw on them. Setting standards for training inevitably leads to the need for QA and Quality Improvement (QI) for individual clinical ethicists and ethics consultation services more broadly. This chapter examines these needs in the field and offers practical suggestions for training, competency evaluation, QA and QI.KeywordsClinical ethicsEthics consultationQuality assessmentQuality improvementTraining