Narrative inquiry in bioethics最新文献

This symposium includes twelve personal narratives from those who have received clinical ethics consultation (CEC) services as a healthcare provider, patient, family member, or patient advocate. Three commentaries on these narratives are also included, authored by experts and scholars in bioethics, healthcare ethics consultation and certification, narrative medicine, and policy. The goal of this symposium is to call attention to the experiences of people who have received clinical ethics consultation (CEC) services as a healthcare provider, patient, family member, or patient advocate.

Ethical questions surrounding withdrawal of life support can be complex. When life support therapies are the result of a suicide attempt, the potential ethical issues take on another dimension. Duties and principles that normally guide clinicians' actions as caregivers may not apply as easily. We present a case of attempted suicide in which decisions surrounding withdrawal of life support provoked conflict between a patient's family and the medical team caring for him. We highlight the major unresolved philosophical questions and contradictory normative values about suicide that underlie this conflict. Finally, we show how these considerations were practically applied to this particular case.

This commentary discusses 12 stories about receiving ethics consultation in hospitals. Five stories are by physicians, three by nurses, and four by family members; three of the writers have training in bioethics. Some writers requested the consultation, others experienced the consultation as an imposition forced upon them, and in two cases, the story is about the absence of any consultation service. Three types of narrative are found to structure the stories: the genuine dilemma narrative, the institutional intransigence narrative, and the relational care narrative. Throughout, the question is what makes for a valuable consultation, and the general answer is whether consultation enables the development of mutually supportive relationships.

This symposium collection of twelve narratives from individuals who experienced clinical ethics consultations provides perspectives from a group that has not been adequately explored in the bioethics literature. The authors represent a variety of stakeholders who received ethics consultations: healthcare providers and family members. This commentary will focus on three themes addressed in the different narrative accounts: the reasons for requesting an ethics consultation; the expectations of the narrators from the consultation; and the conclusions the authors drew from their experience of the ethics consultation.

This commentary reflects on twelve stories of participants in clinical ethics consultations from the perspective of family members, some of whom are ethics consultants, and healthcare professionals. Together they reveal expectations of ethics consultations and suggest descriptions of the service. Some common themes emerge, including the role of the clinical ethics consultant in navigating complex situations, assuring all stake-holder voices are heard, attending to moral distress, addressing issues that seem beyond medical practice, and being accessible. They are almost uniformly positive about the experience, with criticism primarily about lack of access to the service.