Clinical ethics consultants navigate some of the most challenging cases in patient care, public health, and healthcare policy. The second volume richly details haunting cases pertaining to perinatal, pediatric, and end-of-life issues; neurodiversity; disability; and employment of high-tech devices. Authors explain distinctive features of consultations in rural and pandemic contexts and complicated transitions into and out of inpatient care. Cases are grouped together by theme and organized uniformly. Each chapter includes a case presentation, the authors' professional reflections, a description of haunting aspects, the case outcome, and questions for discussion. Organizational ethics factor into many of the cases. The authors honestly describe the affective aspects of their work, including lingering regrets, doubts, and moral distress. They pay special attention to justice, equity, and inclusivity. It is a fascinating and important read for clinicians and bioethicists engaged in clinical ethics consultations as well as ethics committee members and students.
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In volume two, clinical ethics consultants relay narratives of fraught, compelling and complex consultations that continue to haunt them.
Introduction; Part I. Perinatal Dilemmas:
1. God's telling me I can't
trust you Kathy Johnson Neely;
2. High stakes, time pressure, and inadequate
information: balancing risks in labor and delivery Annette Mendola;
3.
Balancing autonomy and interdependence: ethical considerations in shared
decision making and reproductive rights Jennifer M. Wimbley and Teresa Ellis;
4. Dying Together: a pandemic story Eli Weber; Part II. From Childhood to
Adulthood:
5. Reasoning from faith or fact Elizabeth Lanphier and Joseph
Fanning;
6. Overriding parental authority for a dying adolescent Ann Kessler
and Olubukunola M. Dwyerage;
7. Can medicine fix a broken story? When a
broken body is only part of the tragedy Joel Wu, Justin Penny and Jaime
Konerman-Sease;
8. When we commit harm by omission: failing our most
vulnerable Jessie Roske and Peter Bauck; Part III. Neurodiversity,
Disability, and Respect:
9. The noble intent of clinicians and the
limitations of substituted judgment in deciding for others Liz Blackler;
10.
Silenced Bridget Carney;
11. It could have been me Emma J. Kagel;
12.
Excluded from society: whose job is it to care (if not mine)? Elizabeth
Sivertsen; Part IV. End of Life (EOL) Decision-Making: Variations on a Theme:
13. No communication, no collaboration, no trust Patricia A. Mayer;
14. Keep
on keeping on? Erin Paquette, Joel Frader and Angira Patel;
15. Locked in
Marion Danis;
16. The legacy of social determinants in a question of
non-beneficial interventions Kristin Furfari; Part V. Hi-Tech Devices and
Techniques: Challenging Paradigms:
17. Is she being doubly victimized?
Vulnerabilities in LVAD eligibility Laura Guidry-Grimes and Evan DeRenzo;
18.
Really, most sincerely dead? The challenge of declaring circulatory death on
VA ECMO M. Jeanne Wirpsa;
19. Who controls the medical technology placed in
our bodies? Maggi A. Budd and Rod Dismukes;
20. Who says it is a bridge to
nowhere? Louis Voigt and Amy E. Scharf;
21. I will just go home and die Paul
Ford; Part VI. Pandemic and Rural Context:
22. ECMO in the Covid-19 pandemic:
weighing conflicting duties in the face of scarcity and vulnerability Kelly
Turner, Jordan Potter and Jason Lesandrini;
23. Well beyond rural: Alaska,
Alaskan culture, and medicine Mark F. Carr;
24. Cultural differences,
misalignment, and moral distress Don C. Postema and Marlane J. Brown;
25.
When a fight for life initiates a search for trust Laura B. Webster; Part
VII. Complex Admissions, Stays, and Discharges:
26. Doing it to themselves:
can repeated foreign body ingestion provide us ethical considerations for
repeated self harm? Sara Kolmes, Kayla Tabari House and L. McLean House II;
27. Withholding food to save a life: safe medical care or human rights
violation? Can it be both? Heidi Funke and Bryan Gish;
28. Relentless
debridement: responding to moral distress provoked by non-beneficial surgical
intervention Lauren Sankaray and Georgina Morley;
29. What's in a name?
Kaarkuzhali Babu Krishnamurthy; Part VIII. Organizational Ethics Issues:
30.
Disability, dignity, and risk of death: who decides? Lori Eckel and Celeste
Weber;
31. Balancing facts and feelings: when patient rights and employee
safety collide Katie DiDomenico, Lyla Correoso-Thomas and Yelena Zatulovsky;
32. Off the hook? TA-NRP and the pressures of organ procurement Denise
Dudzinski and James N. Kirkpatrick;
33. When institutional and personal
conscience collide: navigating trauma exposure and dual roles as an ethics
consultant Andrea Frolic; Concluding Remarks; Index.
Denise M. Dudzinski is Professor in Bioethics & Humanities and Pediatrics, Division of Bioethics & Palliative Care at the University of Washington School of Medicine, Seattle. She is Director of the Ethics Consultation Service at UW Medicine and Director of Organizational Ethics at Seattle Children's Hospital. Kaarkuzhali Babu Krishnamurthy is Vice-Chair of the Department of Neurology, Division Head, Epilepsy and EEG, and Chair of the Ethics Committee at Boston Medical Center-Brighton. She is also a member of the Center for Bioethics at Harvard Medical School and a staff neurologist at Beth Israel Deaconess Medical Center in Boston, MA. Her clinical practice is focused on the care of women with epilepsy. Paul J. Ford specializes in ethical challenges in neurological diseases and directs the NeuroEthics Program at the Cleveland Clinic Foundation with a faculty appointment in the Case Western Reserve School of Medicine, Cleveland. He has performed more than two thousand ethics consultations and authored more than one hundred publications.
