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The Task of Clinical Healthcare Ethics: Building Right Relationships

June 20, 2014

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Traditionally, the ethics role in healthcare has been threefold: consultation, policy review and development, and education. There appears to be a general misperception about the role of clinical healthcare ethics, characterizing ethicists and ethics committees as an “ethics police force” or as only being relevant when there is something wrong. Some authors have called for the function of clinical healthcare ethics to be more proactive in preventing ethical dilemmas, rather than merely reacting to complex cases that have already arisen. Even though clinical healthcare ethics has progressively become more proactive than simple retrospective case review, I argue that ethicists and ethics committees have neglected an even more antecedent objective than the traditional model’s tripartite function: fostering right relationships. By focusing on relationship building, clinical ethics will become sufficiently proactive. Fostering right relationships should be the primary objective of healthcare ethics because healthcare is intrinsically relational. This paper examines how the traditional model of clinical healthcare ethics has failed to be sufficiently proactive, leading to misperceptions of the ethicist’s role. By making the building of right relationships the primary task of clinical ethics, ethics will become more integrated into the institutional culture of the hospital, ethics services will be utilized more proactively, and the common misperceptions of the ethics role will be mitigated. In the second section, three models are analyzed for their contribution to a framework of ethics as building right relationships: bioethics mediation, the public health model of primary, secondary, and tertiary prevention, and the idea of ministry of presence in nursing and hospital chaplaincy.

Keywords:
Organizational ethics; Ethics committees