From Avocation to Vocation

Working Conditions for Clinical Health Care Ethics Consultants
  • Benjamin Freedman
Part of the Contemporary Issues in Biomedicine, Ethics, and Society book series (CIBES)


Other health care ethics consultants may have shared this experience. When I began my current clinical appointment, no formal orientation took place (no informal one either, as far as I can recall). Nobody sat me down to tell me what I was supposed to be doing there; if the question was raised at all, it was in the form of options or possibilities, joined by saying, “You’re really the expert; you’ll be teaching us.” Nobody told me for whom I was working or to whom I was to report. (Some time after I started, somebody told me I worked for him. I told him—no hard feelings—he was mistaken. A year or so later, I decided he was mostly right and, from time to time, have occasion to reconsider yet again...) There were plans to have an Ethics Committee on which I would serve (or with which I would work—not settled), but there were no terms of reference established, a task that had awaited my arrival. There had been apparently a few preliminary discussions between my clinical and academic institutions about the relative proportions of my time that should be spent at each institution. These desultory negotiations had not resulted in agreement, and so the two decided to leave this up to me as well. I had been assigned neither office space nor secretarial assistance (not surprising, perhaps, since nobody knew what I was going to do in one or with the other). I was, however, given a choice of either a beeper or an answering machine, in order that I not miss any calls.


Clinical Ethic Ethic Consultation Ethic Consultant Moral Commitment Legal Counsel 
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Notes and References

  1. 1.
    At some point, the duty to report wrongdoing may even cause the ethicist to risk his or her job.“ John A. Robertson, ”Clinical Medical Ethics and the Law: The Rights and Duties of Ethics Consultants,“ Ethics Consultation in Health Care,eds. John C. Fletcher, Norman Quist, and Albert R. Jonsen (Ann Arbor, MI: Health Administration, 1989) 168. NB: Lots there on duties; nothing on rights I could make out.Google Scholar
  2. 2.
    The tradition’s roots certainly include Kant’s efforts at “transcendental deduction” of the conditions allowing for perceived experience and Descartes’ derivation of personal existence from the fact of posing the question.Google Scholar
  3. 3.
    Lon L. Fuller, The Morality of Law ( New Haven: Yale University Press, 1964 ).Google Scholar
  4. 4.
    Reprinted in Benjamin Freedman and Bernard Baumrin, eds., Moral Responsibility and the Professions ( New York: Haven, 1984 ) 79–84.Google Scholar
  5. 5.
    Benjamin Freedman, “A Meta-Ethics for Professional Morality,” Ethics 89 (1978): 1–19; see further Benjamin Freedman, “What’s Really Special about Professional Ethics: Response to Michael Martin,” Ethics 91 (1981): 626–630.CrossRefGoogle Scholar
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    Mark Siegler, “Defining the Goals of Ethics Consultations: A Necessary Step for Improving Quality,” editorial, Quality Review Bulletin 18.1 (1992): 15,16.Google Scholar
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    Canadian Nurses Association, Code of Ethics for Nursing (Ottawa: CNA, 1985). (The Code was revised once again in 1991; the latter version is reprinted in Françoise Baylis and Joycelyn Downie, Codes of Ethics: Ethics Codes, Standards, and Guidelines for Professionals Working in a Health Care Setting in Canada [Toronto: Department of Bioethics, The Hospital for Sick Children, 1992] 40–50.)Google Scholar
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    TB Beitza 39.Google Scholar
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    Kenneth Simpson, “The Development of a Clinical Ethics Consultation Service in a Community Hospital,” Journal of Clinical Ethics 3 (1992): 124–130.PubMedGoogle Scholar
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    Simpson 125.Google Scholar
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    Daniel J. Anzia and John La Puma, “Cultivating Ethics Consultation,” Journal of Clinical Ethics 3 (1992): 131–3; Henry Perkins, “Clinical Ethics Consultation: Reasons for Optimism, but Problems Exist,” Journal of Clinical Ethics 3 (1992): 133–137.Google Scholar
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    Simpson 126.Google Scholar
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    Benjamin Freedman, “Bringing Codes to Newcastle: Ethics for Clinical Ethicists,” Clinical Ethics: Theory and Practice, eds. Barry Hoffmaster, Benjamin Freedman, and Gwen Fraser ( Clifton, NJ: Humana, 1989 ) 125–139.Google Scholar
  14. 14.
    Edmund G. Howe, “When Physicians Impose Values on Patients: An Ethics Consultant’s Responsibilities,” Ethics Consultation in Health Care, eds. John C. Fletcher, Norman Quist, and Albert R. Jonsen ( AnnArbor, MI: Health Administration, 1989 ) 137–148.Google Scholar
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    James F. Drane, “Hiring a Hospital Ethicist,” Ethics Consultation in Health Care,eds. John C. Fletcher, Norman Quist, and Albert R. Jonsen (Ann Arbor, MI: Health Administration, 1989) 117–134.Google Scholar
  20. 20.
    Drane 127,128.Google Scholar
  21. 21.
    A5 opposed to a job opportunity; of my own experience above.Google Scholar

Copyright information

© Springer Science+Business Media New York 1994

Authors and Affiliations

  • Benjamin Freedman

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