Historical Context of health care ethics consultant
A health care ethics consultant, at a minimum, is a person who helps to
identify shared values by engaging others in ethical discourse as facilitator
(e.g., mediator, nego- tiator) or other (e.g., confidant), and
assists those who are confronted with ethically complex health care decisions
in making choices that are morally acceptable to themselves and "within
the bounds of communal and institutional acceptability'' It follows that an
effective health care ethics consultant is someone who has the knowledge,
abilities, and attributes of character to facilitate this type of ethical
discourse in case consultation on ethical issues in clinical care or clinical
research, and in ethics consultation to ethics committees, to research ethics boards
(institutional review boards), and to policy formulation committees.
For Peter Singer, expertise in ethics requires
a familiarity with moral concepts, an understanding of the logic of moral
argumentation, and ample time to gather relevant information." Essential
for an ethical expert is:
the ability to reason well and
logically, to avoid errors in one's own arguments, and to detect fallacies when
they occur in the arguments of others ... an understanding of the nature of
ethics and the meaning of moral concepts reasonable knowledge of the major
ethical theories [and finally, knowledge of] the facts of the matter under
discussion.
For Arthur Caplan, this conception of
moral expertise is too narrow. He is critical of the engineering model of applied
ethics-a model that focuses exclusively on conceptual clarification, mastery of
ethical theory, and impartiality-and he underlines the importance of moral
diagnosis and moral judgment. In his view, to be effective in the health care
setting, one must have the ability to identify and classify moral problems not
previously discerned, and the ability to use moral knowledge to view moral
problems from different perspectives. Caplan concedes, however, that in
appropriate circumstances "engineering is a valuable and helpful activity even
in a field such as ethics." That is, at times the engineering model of applied
ethics is a useful art that "requires practical knowledge, theoretical understanding,
and experience.''
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Historical Context
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