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1. The National Catholic Bioethics Quarterly: Volume > 18 > Issue: 1
Becket Gremmels In This Issue
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2. The National Catholic Bioethics Quarterly: Volume > 18 > Issue: 1
Daniel J. Hurst Colloquy
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3. The National Catholic Bioethics Quarterly: Volume > 18 > Issue: 1
Greg Schleppenbach Washington Insider
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4. The National Catholic Bioethics Quarterly: Volume > 18 > Issue: 1
Courtenay R. Bruce, Jocelyn Lapointe, Peter Koch, Katarina Lee, Savitri Fedson Building a Vibrant Clinical Ethics Consultation Service
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The authors work in a variety of clinical ethics consultation services (CECSs) that employ a range of methods and approaches. This article discusses the approach to ethics consultation at the Center for Medical Ethics and Health Policy at Baylor College of Medicine and describes the development and transformation of the authors’ CECSs. It discusses how one CECS shifted from a nascent program with only fifty consultations a year to a vibrant, heavily staffed service with five hundred ethics consultations a year.
5. The National Catholic Bioethics Quarterly: Volume > 18 > Issue: 1
Jason Lesandrini, Alan Muster Practical Steps for Integrating an Ethics Program
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The field of health care ethics continues to grow as the ethics structures in health care organizations become well established. While the literature is saturated with reports on clinical ethics consultation services, very little is known about the development and success of ethics programs. The following describes the development and growth of an ethics program at the largest health care provider in Georgia. With a focus on nine key components of an ethics program, the paper reviews what one system did on its path to a flourishing program and what others can learn from it.
6. The National Catholic Bioethics Quarterly: Volume > 18 > Issue: 1
Birgitta Sujdak Mackiewicz Essential Goals of Ethics Committees and the Role of Professional Ethicists
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Ethics committees in Catholic health care are responsible for con­sultation, education, and policy development and review. Historically, ethics committees were reactive and had no articulated goals. This article argues that the essential goals of Catholic ethics committees are (1) to promote the human dignity of patients and staff; (2) to promote the common good; (3) to promote institutional identity, integrity, and ethical climate; and (4) to improve quality of care. These goals are most effectively met when ethics committees are proactive and integrated in the institution, embrace systems thinking, and utilize professional ethicists locally or regionally.
7. The National Catholic Bioethics Quarterly: Volume > 18 > Issue: 1
Mark Repenshek Examining Quality and Value in Ethics Consultation Services
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The American Society for Bioethics and Humanities poses a chal­lenge in Core Competencies for Healthcare Ethics Consultation: health care ethics consultation services “should be able to demonstrate their value to those who pay for the service, as well as to those whom the service is intended to serve.” To respond to this challenge, this article provides a brief review of the literature on evaluating ethics consultation in its traditional frameworks of quality outcomes. The author follows this discussion with a new methodology to evaluate ethics consultation on the basis of the intrinsic good of the service. He ends with a novel risk-based assessment to complement the evaluation of clinical ethics services grounded in the Ethical and Religious Directives for Catholic Health Care Services.
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8. The National Catholic Bioethics Quarterly: Volume > 18 > Issue: 1
Mary E. Homan Factors Associated with the Timing and Patient Outcomes of Clinical Ethics Consultation in a Catholic Health Care System
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Little is known about how certain patient characteristics can affect the timing of an ethics consultation, which has been hypothesized to affect patient length of stay. This study assessed how specific patient characteristics affect the timing of an ethics consultation, namely, age (over 65 years), race, Medicaid status, the presence of a living will, the presence of a health care proxy, and the absence of decisional capacity. Moving beyond the typical case-series evaluation of an ethics consultation service, this study used an innovative approach to model how predisposing, enabling, and need factors affect health behavior and subsequently affect health outcomes for patients who received an ethics consultation at a Catholic health care system in Oklahoma.
9. The National Catholic Bioethics Quarterly: Volume > 18 > Issue: 1
Matthew R. Kenney A System Approach to Proactive Ethics Integration
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Although ethics consultation services often engage in some of the most complex and delicate clinical situations, little is known about the qual­ity of these services or their effect on patient care and patient and provider satisfaction. There is still significant work to be done in the areas of training, credentialing, and standardization. This article articulates the essential “build­ing blocks” of the Proactive Ethics Integration model developed at Ascension as well as the lessons we have learned along the way.
10. The National Catholic Bioethics Quarterly: Volume > 18 > Issue: 1
Nicholas J. Kockler, Kevin M. Dirksen Integrating Ethics Services in a Catholic Health System in Oregon
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At Providence St. Joseph Health in Oregon, many factors contribute to the integration and success of the ethics services. There are three principal lenses through which one can understand the distinct way in which the ethics services are operationalized and integrated: the theological foundations of ethics as a service, the institutional ecology, and the professionalization of the field of health care ethics. The authors review key realities that have shaped their work through these three lenses and then describe the activities of the Providence Center for Health Care Ethics regarding its strategic objectives and clinical and administrative integration.