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Ethics Consultation: Skills, Roles, and Training

John La Puma, MD; and David L. Schiedermayer, MD
[+] Article and Author Information

Grant Support: In part by the Lutheran General Medical Group.

Requests for Reprints: John La Puma, MD, Center for Clinical Ethics, Lutheran General Hospital, 1775 Dempster Street, Park Ridge, IL 60068.

Current Author Addresses: Dr. La Puma: Center for Clinical Ethics, Lutheran General Hospital, 1775 Dempster Street, Park Ridge, IL 60068.

Dr. Schiedermayer: Center for the Study of Bioethics, 8701 Watertown Plank Road, Medical College of Wisconsin, Milwaukee, WI 53226.


©1991 American College of PhysiciansAmerican College of Physicians


Ann Intern Med. 1991;114(2):155-160. doi:10.7326/0003-4819-114-2-155
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A clinical ethics consultant gathers information firsthand at the patient's bedside. The consultant's special clinical skills include the ability to identify and analyze ethical problems; use reasonable clinical judgment; communicate effectively; negotiate and facilitate negotiations; and teach others how to construct their own ethical frameworks for medical decision making. Appropriate roles for the consultant include those of professional colleague, negotiator, patient and physician advocate, case manager, and educator. The training necessary for an ethics consultant includes substantial patient care experience, instruction in health care law and moral reasoning, and preparation in medical humanism. We favor a clinical model for ethics consultation. When urgent care is needed, other consultants promptly see the patient; the clinical ethics consultant can be expected to do the same.

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