Complex Ethics Consultations: Cases that Haunt Us

Clinical ethicists encounter the most emotionally eviscerating medical cases possible. They struggle to facilitate resolutions founded on good reasoning embedded in compassionate care. This book fills the considerable gap between current texts and the continuing educational needs of those actually facing complex ethics consultations in hospital settings. 28 richly detailed cases explore the ethical reasoning, professional issues, and the emotional aspects of these impossibly difficult consultations. The cases are grouped together by theme to aid teaching, discussion and professional growth. The cases inform any reader who has a keen interest in the choices made in real-life medical dilemmas as well as the emotional cost to those who work to improve the situations. On a more advanced level, this book should be read by ethics committee members who participate in ethics consultations, individual ethics consultants, clinicians who seek education about complex clinical ethics cases, and bioethics students.

Table of Contents:
Foreword Albert Jonsen; Introduction Paul J. Ford and Denise M. Dudzinski; Part I. Starting at the Beginning: Prenatal and Neonatal Issues: 1. Quality of life and of ethics consultation in the NICU Robert Macauley and Robert Orr; 2. When a baby dies in pain David Woodrum and Thomas R. McCormick; 3. But how can we choose? Richard M. Zaner; 4. Maternal-fetal surgery and the 'profoundest question in ethics' Mark J. Bliton; Part II. The Most Vulnerable of Us: Pediatrics: 5. She was the life of the party Douglas S. Diekema; 6. Bound by chains Jeffrey Spike; 7. Susie's voice Rosa Lynn Pinkus, Stella Smetanka and Nathan A. Kottkamp; 8. Access to an infant's family D. Micah Hester; Part III. Diversity of Desires and Limits of Liberty: 9. Helping staff help a 'hateful' patient Joy Skeel, Kristi Williams; 10. Ulysses contract Barbara Daly and Cynthia Griggins; 11. Misjudging needs Paul J. Ford; 12. When the patient refuses to eat Debra Craig and Gerald Winslow; Part IV. Withholding Therapy with a Twist: 13. Listening to the husband Ellen W. Bernal; 14. You're the ethicist; I'm just the surgeon Joseph DeMarco and Paul J. Ford; 15. Haunted by a good outcome: the case of Sister Jane George J. Agich; 16. Is a broken jaw a terminal condition? Stuart G. Finder; Part V. The Unspeakable/Unassailable: Religious and Cultural Beliefs: 17. Adolescent pregnancy, confidentiality and culture Donald Brunnquell; 18. Tanya, the one with Jonathan's kidney Tarris Rosell; 19. Futility, Islam and death Kathryn Weise; 20. Suffering as God's will Kathrin Ohnsorge and Paul J. Ford; Part VI. Human Guinea Pigs and Miracles: Clinical Innovations and Unorthodox Treatment: 21. Amputate my arm please - I don't want it anymore Denise M. Dudzinski; 22. Feuding surrogates, herbal therapies, and a dying patient Alissa Hurwitz Swota; 23. One way out: destination therapy by default Alice Chang and Denise M. Dudzinski; 24. Altruistic organ donation: Credible? Acceptable? Ronald B. Miller; Part VII. The Big Picture: Organizational Issues: 25. It's not my responsibility Mary Beth Foglia and Bob Pearlman; 26. Intra-operative exposure to sporadic Creutzfeldt-Jakob disease: to disclose or not to disclose Joel Potash; 27. Why do we have to discharge this patient? Sarah E. Shannon; 28. Who's that sleeping in my bed?: an institutional response to an organizational ethics problem Daryl Pullman, Rick Singleton and Janet Templeton; 29. Final reflections, activities and resources Denise M. Dudzinski and Paul J. Ford; Index.

About the Author :
Paul J. Ford is Associate Staff, Bioethics and Neurology, The Cleveland Clinic Foundation and Assistant Professor, Cleveland Clinic Lerner College of Medicine of Case Western Reserve University, Cleveland, USA. Denise M. Dudzinski is Assistant Professor in the Department of Medical History & Ethics at the University of Washington School of Medicine. She is Chief of the Ethics Consultation Service and provides organizational ethics consultation at University of Washington Medical Center, USA.

Review :
'The cases that are presented in this marvellous and disturbing casebook include a wide variety of clinical situations that are eerily familiar. … The editors and authors of this book give a nice snapshot of an evolving professional discipline. They illustrate all the ways in which ethics consultation is imperfect, tentative and open to ongoing questioning and discussion. … The cases are presented concisely and give enough information for readers to make judgements about what ought to have been done. The editors even include a useful guide in which cases are organised by theme and suggestions for further study are offered. These features, along with the quality of the case presentations and the personal nature of the reflections, make the book a useful tool for training members of hospital ethics committees. It will also be helpful to others who are interested in understanding the evolving practice of ethics consultation.' New England Journal of Medicine