Ethics is one of the most challenging things for healthcare professionals to evaluate when they're interacting with and working on a patient and helping them become more healthy in their daily routine. Unfortunately, there is a lot of gray area in certain scenarios where healthcare professionals need to act on key decisions but don't know which one they should choose.
For those healthcare and medical professionals who need a little bit of guidance or advice on which path they should pursue, Clinical Ethicists are vital to the healthcare community in providing that bit of advice when needed.
For instance, healthcare professionals might have ethical questions about how far they should go to ensure a patient is cooperating with their care. They might ask questions like, "Our patient isn't taking their medication, should we hide it in their food?" The desire to help a patient at all costs will make some healthcare professionals question how far they can go even if it is against the wishes of their patient.
Clinical ethics is a practice related to reviewing ethics questions as it relates to clinical questions and helps provide some guidance as to what they should be doing or how they should evaluate certain scenarios. A Clinical Ethicist is someone who helps healthcare professional address ethical issues and answers morally unclear questions on a daily basis.
These may include questions that are as simple as deciding which patient among a group of two should be prioritized when there is only one doctor in the emergency room or as controversial as ones dealing with assisted suicide or stem cell research.
These aren't exactly black and white issues as they may seem, because a patient's wishes might often conflict with the best decision or the decision that has been used in the past in related scenarios.
Another part of a Clinical Ethicist's job description is to provide education for continued staff development. In addition, Clinical Ethicists are responsible for reviewing various institutional and healthcare facility guidance policies and compliance standards to ensure that healthcare professionals are following ethical standards in addition to local, regional, and federal laws that pertain to ethical standards or issues.
Clinical Ethicists are required to make the hard decisions in health care regarding everything from experimental treatments to insurance claims to assisted suicide. The responsibilities below help make clear some of the more in-depth elements of what it takes to be a Clinical Ethicist and elaborate on some of the core responsibilities that Clinical Ethicists have.
Some sit on an institutional ethics committee (IEC) or an institutional review board (IRB), most of which consist of health care professionals like doctors and nurses.
IECs create ethics policies for their facilities and sometimes consult directly on patient cases, while IRBs work with medical research projects by directly regulating and consulting.
It's their job to ensure that the proper ethical protocols are in place and well maintained.
There are usually no right or wrong answers in the world of health care. The answers that are given or the choices that are made are based on policies that are in accordance to the current standards in biomedical ethics that are set by Clinical Ethicists.
Standards vary depending on the patient’s quality of life, rights, privacy, death, and availability of healthcare resources. Clinical Ethicists must have the ability to clearly communicate their views and remain calm during emotional and heated debates.
Clinical Ethicists have to navigate each issue carefully when discussing the potential solutions or ethical answers they provide because different individuals or different Clinical Ethicists will often disagree with each other about the best path to pursue. In addition, other healthcare providers, family members, and patients might often disagree with the recommended decisions or guidance that a Clinical Ethicist is providing.
This means that Clinical Ethicists also need to be aware that there are others who will often disagree with them about what the right decision should be. Clinical Ethicists must become comfortable with the idea that there are going to be other healthcare professionals and advisors who disagree with the recommended decision.
Another aspect of the job description for Clinical Ethicists is that they must work in collaboration with other healthcare professionals, family members, and patients to evaluate certain ethical principals like patient autonomy, the duty and responsibility to prevent harm against others, fairness, and the duty and responsibility to do good for others. These are all different things that need to be considered by a Clinical Ethicists in their daily routine as a healthcare professional.
Another aspect of a Clinical Ethicist's job description is to identify how medical decisions or ethical decisions will change throughout their time as a Medical Ethicist. The reason for this is that the healthcare industry is constantly changing and medical decisions won't always be as simple tomorrow as they are today.
In fact, as new technology is incorporated into the healthcare industry, those ethical questions only grow more complicated, or need to be made faster. This means Clinical Ethicists need to be ready to make ethical decisions and understand how it might be impacted by the use of new technology in the industry.
One example of Clinical Ethicists dealing with changing technology standards is the increasing use of different medical devices that can access patient records at a moment's notice or interact with patients remotely.
These devices are useful for healthcare professionals who need to access a patient's details or communicate with a patient when they aren't in the hospital. The problem with this new technology is that they might not have complete confirmation who they are dealing with on the other end.
When complex decisions need to be made with the consent of a family member, they might be under the assumption that the person who is on the other end is the person they need the confirmation of. In other words, Clinical Ethicists are being tasked with evaluating whether or not new technology can actually be used in making complex medical decisions or approve certain medical actions in various scenarios.
Another part of a Clinical Ethicist's role is to evaluate whether or not a patient can actually understand what the healthcare professional is explaining them, and whether they actually have enough knowledge or understanding to evaluate the different options they have and move forward with one.
One example of this common scenario for Clinical Ethicists to evaluate is when a healthcare professional is speaking to a child about an upcoming procedure. And they have consent from the parents that the child must be the one to make the decision because it will ultimately affect them in the long run. Even if a healthcare professional explains it in the best way they know how the patient might not understand completely what the procedure could do and the benefits or drawbacks of the procedure.
In this case, the Clinical Ethicist has to evaluate this patient-physician relationship and evaluate whether or not the patient was capable of making a sound decision or choice in this scenario.
Another role Clinical Ethicists have is to offer any legal advice or policy advice to advisory committees or senior leadership to hospitals and healthcare facilities that might have some questions about some upcoming initiatives they have, policies they are looking to implement, procedure changes, and more. Clinical Ethicists are responsible for educating those senior leadership members and informing them about potential missteps they might be having.
In some cases, advisors or leadership roles that a Clinical Ethicist might hold will require years of experience before being able to climb to that position or require additional degrees and certifications. Some of those requirements are 4 to 7 years of experience, a Master's Degree, or a Ph.D.
Clinical Ethicists aren't just responsible for ethics consulting, they are also in charge of education in a variety of other scenarios. Clinical Ethicists are tasked with educating other healthcare professionals about what they can expect in their role as a healthcare professional and how challenging scenarios might arise that are in an ethical gray area.
Education is one of the first steps that ensure healthcare professionals can make more sound decisions when they arise. In addition, it helps to lighten the burden that Clinical Ethicists might face in the future because more healthcare professionals will be aware of the best ethical decision to make.
In addition, this education role involves educating parents and their family members about some of the reasons behind why healthcare professionals make certain decisions, or why they are recommending certain decisions for the safety and well-being of the patient.
Another key role for Clinical Ethicists is that they are often tasked with the education and management of certain projects or initiatives. Clinical Ethicists are used as great project managers to ensure that there are no ethical boundaries that are crossed throughout the duration of a project's development phase or an initiative's implementation phase. Some ways that a Clinical Ethicist might be used as a project manager relates to clinical research.
A lot of times, healthcare professionals like to experiment with new treatment techniques to potentially increase the effectiveness of one certain treatment method, or potentially improve the patient's well-being at a much quicker rate. To ensure that the clinical research isn't breaking any ethical boundaries, Clinical Ethicists are perfect for ensuring the proper ethical procedures are being followed, and clinical researchers are apprised at all times in regards to things they can do and shouldn't do.
Another role that Clinical Ethicists might be in charge of relates to writing official documentation that other healthcare professionals can fall back on when they are evaluating which decision they are going to implement. This documentation is really useful when a Clinical Ethicist cannot be reached immediately for immediate consultation and guidance. Instead, their documentation can serve to provide guidance in their absence.
In some cases, Clinical Ethicists will work as part of the staff on a hospital or healthcare facility or will be on retainer in the event that a healthcare professional, patient, or a patient's family member needs their services.
Clinical Ethicists aren't just ethicists for healthcare professionals or medical professionals. Clinical Ethicists can also provide guidance to patients and their family members about some topics that they're unfamiliar with.
Using our example earlier with how a patient might not completely understand what the medical procedure is that they're being asked to make a decision upon, a parent or family member might not understand what the procedure entails either.
In this case, they could be asking the child to make a complex decision when they don't understand the entire problem that they are asking their child to make a decision on.
Clinical Ethicists who work with patients and their family members will also make recommendations about what they should do with Do Not Resuscitate (DNR) orders, organ donations, refusal of medical treatment, living wills, and problem pregnancies.
Another role that is part of a Clinical Ethicist's job description is to evaluate previous hospital case and procedures. This is to ensure that the healthcare professionals are following the ethics rules and regulations and that every single healthcare personnel is behaving ethically.
Another aspect of a Clinical Ethicist's job description is to review different genetic testing and genetic profiling experiments and proposed research.
The healthcare industry is always one of the leading industries trying to push the boundaries of science. One such way that the healthcare industry is trying to reduce the ways in which people get sick or potentially reduce the chances of getting diagnosed with certain conditions is through genetic manipulation.
The problem with this is that there is always going to be a healthy debate about whether or not it is ethical to perform genetic manipulations to potentially reduce exposure to certain diseases or ailments. In addition, Clinical Ethicists are responsible for evaluating whether or not gene therapy is ethical behavior.
For those individuals who are considering a potential career as a Clinical Ethicist, a glimpse into what a normal day's routine might consist of will help provide a little bit more information about whether or not this is a career they can see themselves in. Here are some of the most common activities that Clinical Ethicists do each day and will provide a great example of what it's like working as a Clinical Ethicist.
• Review Ethics Related Questions
The most common activity on the job for Clinical Ethicists is to review ethics-related questions. This involves listening or observing the ethical dilemma, reviewing it past similar scenarios or decisions in the past, and coming up with a formulated opinion on the ethical answer based on modern ethical guidelines and ethical compliance concerns.
• Answer Morally Unclear Questions
Once the Clinical Ethicist has reviewed the ethical question and come up with an answer to the ethical dilemma, Clinical Ethicists are responsible for presenting and answering the ethical dilemma. Answering the morally unclear questions involves backing up your reasoning for certain ethical recommendations based on previous cases, similar examples, and modern practices and guidelines.
• Clearly Communicate
The next thing that Clinical Ethicists do on a daily basis is to clearly communicate. Clinical Ethicists will be interacting with healthcare professionals, board members, administration staff, patients, and patient family members. With each sub-section of individuals that a Clinical Ethicist could potentially interact with and communicate with, the Clinical Ethicist has to communicate effectively and appropriately.
Each one has a different background and knowledge-base that they bring to the table when you're answering some of the ethical decisions that they have, or providing recommendations based on ethical standards based on your experience.
Breaking down the ethical decisions, why they should be made, and more is part of a Clinical Ethicist's job in clearly communicating in the best way to the appropriate audience.
• Remain Calm in Debates
Another common activity on the job for Clinical Ethicists is to remain calm in debates or opposition to their ethical recommendations. Unfortunately, as we've stated before, there is a lot of gray area when it comes to ethical standards and ethical recommendations. This means that there could potentially be a host of individuals or healthcare professionals who will oppose your view and get into a debate with you about your recommendations.
It might not just be healthcare professionals, it could also be a patient or the patient's family members. Often times these debates will also center around questioning your expertise and experience for providing those ethical recommendations.
In those tense moments, Clinical Ethicists must remain calm and firm with their ethical recommendations and once again provide adequate reasoning as to why they are providing those recommendations or advice.
• Work and Collaborate with Other Healthcare Professionals
The healthcare industry is a collaborative environment, and Clinical Ethicists will be frequently interacting with and collaborating with other healthcare professionals on a daily basis.
• Educate Patients and their Family Members
Another common activity on the job for Clinical Ethicists is to educate patients and their family members about the reasoning behind why certain decisions should be made.
Each family member will have different levels of education or familiarity with a topic, and your role as a Clinical Ethicist is to identify their knowledge and educate them about topics that they are unfamiliar with. In addition, educating the patients revolves around breaking down the information in a way that is easy to understand. Because some healthcare topics are quite complex, figuring out how to disseminate this information in an easy to understand format can take some time to develop.
• Review Research Proposals for Ethical Standards
Another common activity that Clinical Ethicists face on the job is to review research proposals. Clinical Ethicists are a vital aspect in making sure that the research will not cross any ethical boundaries or call any ethical standards into question. In addition to reviewing the research proposals, Clinical Ethicists will be tasked with providing recommendations on how the research proposal can be adapted to fall within the ethical guidelines that the healthcare industry should follow.
Part of reviewing the research proposals is to make sure that the research policies the hospital and healthcare facility follow are up to modern ethical guidelines.
• Oversee Research Projects for Ethical Procedures and Guidelines
The next daily or common activity on the job for Clinical Ethicists is to act as a project manager or consultant on various research projects or initiatives that a hospital or healthcare facility attempt to roll out. Often times Clinical Ethicists will be assigned to oversee certain initiatives or projects throughout the course of their lifetime to ensure that they fully follow ethical standards and don't cross any inappropriate lines.
• Stay Up To Date On Industry Trends
Clinical Ethicists are also responsible for staying up to date on how the industry is changing or being shaped each day. One of the most exciting things about working in the healthcare industry is that it is a growing and evolving industry each day. Modern techniques aren't the same ones that were used a decade ago.
This means that healthcare professionals need to be able to adapt to the ever-evolving trends and be ready to implement them when necessary.
One way that Clinical Ethicists stay up to date on industry trends in their daily routine is by reading research journals, attending conferences, watching webinars, reading healthcare industry blogs and news feeds, and more. When a Clinical Ethicist is aware of the industry trends, they can also make stronger ethical decisions because they understand how ethical standards have changed over time and might continually change in the future for the better.
• Complete Continuing Education Credit Requirements
Another common activity on the job for Clinical Ethicists is to complete continuing education credit requirements. Nearly every single healthcare professional is required to complete CECs to ensure that each healthcare professional is staying up to date on modern techniques, skills, and education.
These requirements ensure that all healthcare professionals are doing their best to provide the most efficient and effective care to patients and their family members. For Clinical Ethicists, this ensures that they are providing the most effective counseling and ethical advice to their patients, their family members, healthcare professionals, and administrative staff.
Sharp reasoning skills are a must for this position. Clinical ethicists are required to look at issues from all angles, and try to understand the position of each.
They should be capable of recognizing and discussing moral conflicts, understanding the perspectives of all involves parties, and formulating and justifying morally acceptable solutions to conflicts.
Other skills that lead to success for clinical ethicists include the ability to reduce uncertainty and build a consensus, to facilitate meetings and keep records, and work with a team.
Active listening and highly developed communication skills are desirable as crafting a strong argument is fundamental to the job.
Clinical ethicists are required to serve in hospitals, academic institutions, medical research centers, insurance companies, federal agencies and physician group practices.
These ethicists can work as teachers in educational institutions or advisors in the pharmaceutical industry to ensure that medical research and product development are being carried out within the framework of current standards of biomedical ethics.
Working nurses or physicians can serve the role of clinical ethicists as well.
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