Thesis (Ph.D.)--The University of Texas Graduate School of Biomedical Sciences at Galveston, 1998
In this dissertation, I describe and assess the current practice of bioethics consultation and recommend a direction for its future. Today, bioethics consultation is characterized by diversity and ambiguity. I argue that the controversial question of who can be a bioethics consultant is related to the location of bioethics among academic disciplines. Thus, if bioethics is a branch of philosophy, then only philosophers should be bioethics consultants; if it is an integral part of medical practice, then clinicians are the logical choice for bioethics consultants; and if it is multidisciplinary, then bioethics consultants will represent many disciplines. I make a critical distinction between multi-disciplinary and interdisciplinary, and I argue that bioethicists should strive to nurture and sustain a distinct mode of thinking, a unique perspective, and the imagination to solve ethical problems within an integrated and interdisciplinary paradigm rather than from an individual philosophical, medical, legal, or political perspective
I review the connotations of the terminology used to discuss bioethics and I determine that, in the context of consultation, 'bioethics' and 'healthcare ethics' are understood to include persons from diverse backgrounds; whereas the terms 'medical ethics,' 'clinical ethics,' and 'biomedical ethics' have narrow and exclusive associations. I develop a typology that divides healthcare ethicists into three categories: academic ethicists, ethics committee members, and bioethics consultants. Differentiating the consulting role from other practices of bioethicists was a necessary prelude to discussing the issues of standards, training, and educational requirements for healthcare ethics consultants. I review and compare six categories of training programs for bioethicists and conclude that to achieve more accountability, curriculums need to target the specific skills and knowledge needed by consultants
I argue that boundaries between bioethics consultation and other practices, such as counseling, can be established by clarifying appropriate roles and methods for healthcare ethics consultants. I discuss six procedural roles that bioethics consultants can utilize to assist others in resolving ethical problems in a healthcare setting. Finally, after examining bioethics consultation within a theoretical and sociohistorical context, I conclude that it is not a profession, but it is moving in the direction of greater professional status
