Requisite Abilities,The ability to identify ethical issues

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Requisite Abilities,The ability to identify ethical issues

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1. The ability to identify ethical issues coupled with the ability to sensitize others to ethical issues.

2. The ability to acquire relevant information (e.g., clinical information, psychosocial information) when gaps are revealed, coupled with the ability to know which questions to ask when attempting to fill in the gaps.

3. The ability to bring systematic thinking to ethical problem-solving.

a. The ability to analyze the meanings of concepts and principles. Such analysis should include a consideration of the meaning of words in casual everyday contexts, their technical meaning, and their idiosyncratic use.

b. The ability to identify underlying assumptions and to question those that are believed to be flawed or misleading.

c. The ability to reframe a presenting ethical problem when appropriate (i.e., not in an attempt to evade or to distract), and thereby to shift the ethical discussion so as to allow for a consideration of alternative options that might otherwise not be considered.

4. The ability to make and defend sound ethical judgments that reflect an understanding of the values of others, including:

a. The ability to identify possible alternative courses of action. to outline the associated values and possible consequences. and to provide the best arguments for and against the various options; and

b. The ability to provide a recommendation "for consideration." without attempting to manipulate the decision making process.

5. The ability to communicate effectively with (which includes actively listen to) health care workers, patients, patients' families, administrators, and social agencies.!'

a. The ability to elicit, appreciate, explore, and (when necessary) help clarify the evolving/ changing viewpoints, beliefs, and values of others.

b. The ability to represent the evolving/changing viewpoints, beliefs, and values of one party to another.

c. The ability to observe and perceive interests and relationships that influence discussion and behavior.

6. The ability to facilitate (e.g., mediate, negotiate, and arbitrate), coupled with an ability to ascertain when one or more of these activities is appropriate.

7. The ability to recognize and work within the limits of one's knowledge balanced with the ability to accept challenges.

8. The ability to recognize one's own partiality and not to introduce personal beliefs (i.e., values or traditions one finds persuasive) in an inappropriate manner. Specifically, personal beliefs and value commitments should be identified in a timely fashion when there is an overriding commitment to a specific value system that is informing the discussion (e.g., religious or political beliefs). Personal beliefs and value commitments should not be introduced: (a) in a clandestine or subliminal way, or (b) under false colors-as facts when they are not, as consensually agreed on when they are not, or as legal requirements when they are not.

9. The ability to participate in group decision making, even when this may generate a conclusion with which one disagrees, and a willingness to tolerate such group decisions. This ability must be coupled with a strong sense of personal and professional integrity so that one may distinguish outcomes that one will not, on moral grounds, endorse/sanction (e.g., an outcome that violates an important moral principle, but is chosen to avoid confrontation) from outcomes that one disagrees with, but will endorse/sanction (e.g., an outcome within communal and institutional norms).

10. The ability to withstand the influence of public opinion and to question existing traditions, customs, and laws.

To be sure, different clinical settings and different clinical situations necessarily require the exercise of different abilities. The Profile attempts to provide a reasonably complete listing of the minimum skills one should be able to draw on, as necessary. It is not expected, nor for that matter would it be productive, for an ethics consultant to exercise all of these abilities at anyone time. Consider, for example, the ability to facilitate (e.g., mediate, negotiate, and arbitrate) (A6). Clearly, different facilitation roles