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Is Consent Necessary for Ethics Consultation?

Published online by Cambridge University Press:  01 October 2009

STUART G. FINDER
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Extract

Is consent necessary prior to the initiation of a specific clinical ethics consultation? This is not a question that has received much attention despite the fact that the issue of consent is one of the earliest considerations associated with bioethics. Perhaps this is because of how clinical ethics consultation, as a formidable clinical practice, came into being. Specifically, although the place and time of its conception is not readily identifiable, it is not unreasonable to say it was born on March 31, 1976, when the New Jersey Supreme Court stated, in its Quinlan decision, that consultation would be necessary with “the hospital ‘Ethics Committee’ or like body of the institution in which Karen is then hospitalized. [And i]f that consultative body agrees that there is no reasonable possibility of Karen's ever emerging from her present comatose condition [then her] life-support system may be withdrawn.”

Type
Special Section: Coming of Age in Clinical Ethics Consultation: Time for Assessment and Evaluation
Information
Cambridge Quarterly of Healthcare Ethics , Volume 18 , Issue 4 , October 2009 , pp. 384 - 396
Copyright
Copyright © Cambridge University Press 2009

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References

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21. See note 13, Wolf 1991:803; Fletcher 1992:292; Roberts et al. 1995:548.

22. It should be noted that the merit of the two most common arguments favoring the need for consent prior to proceeding with ethics consultation, that is, concerns about information disclosure and due process, were not accepted by all; see, for instance, Agich GJ, Youngner SJ. For experts only? Access to hospital ethics committees. The Hastings Center Report 1991;21(5):17–25; Finder SG. Should competent patients or their families be able to refuse to allow HEC case review? No. HEC Forum 1995;7(1):51–3.

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37. See note 25, Zaner 1988:30–6.

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39. See note 25, Zaner 1988:30–2.

40. This brief example is based on an actual clinical ethics consultation. Although the details have been changed in order to protect the confidentiality of all participants, the core issue regarding why ethics consultation was requested is an accurate report from the physician requester.

41. Reiter-Theil S, Mertz M, Meyer-Zehnder B. The complex roles of relatives in end-of-life decision-making: An ethical analysis. HEC Forum 2007;19(4):338–61.

42. See note 14, Bliton, Finder 1999:72–5.

43. See note 25, Zaner 1988:69–71, 105.

44. See note 9, Walker 1993.

45. See note 19, Zaner 2000:271.

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