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22 September 2006 C. Fox, WSU-College of Health Professions Creating Moral Space The Proactive Role of Ethics Committees Kansas Health Ethics Developing.

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Presentation on theme: "22 September 2006 C. Fox, WSU-College of Health Professions Creating Moral Space The Proactive Role of Ethics Committees Kansas Health Ethics Developing."— Presentation transcript:

1 22 September 2006 C. Fox, WSU-College of Health Professions Creating Moral Space The Proactive Role of Ethics Committees Kansas Health Ethics Developing Ethics Committees

2 Charles R. Fox, OD, PhD Associate Dean Academic Affairs & Research College of Health Professions Wichita State University

3 22 September 2006C. Fox, WSU-College of Health Professions Ethical Resource Saturation  We are saturated with resources designed to educate the conscience  We have more ethical resources than we know what to do with - Ethics Committees (13,100,000 hits) Ethics CommitteesEthics Committees - Ethics Education (58,800,000 hits) Ethics EducationEthics Education - Ethics Institutes (27,300,000 hits) Ethics InstitutesEthics Institutes - Health Care Ethics (49,200,000 hits) Health Care EthicsHealth Care Ethics

4 22 September 2006C. Fox, WSU-College of Health Professions Resources are ubiquitous  Ethics Teachers, Advisers, Consultants  Ethics Institutes & Committees  Ethics Books, Journals & Web Sites  Ethics Is A Stated Priority Of:  Schools  Universities  Professional Associations  Businesses  Governments

5 22 September 2006 C. Fox, WSU-College of Health Professions

6 22 September 2006C. Fox, WSU-College of Health Professions Birth of Ethics Committees January 1992 JCAHO requires health care organization establish organizational mechanisms for formulating ethics policy and addressing ethical conflicts within the institutional setting

7 – SO – ???Why Aren’t We More Ethical???

8 22 September 2006 C. Fox, WSU-College of Health Professions Ethical Failure Wealth Of Resources   Ethical Success More Likely: Ironic Symptom Of Ethical Failure

9 – SO – So Why Are We Failing?

10 22 September 2006C. Fox, WSU-College of Health Professions Resources Are Poorly Designed  Quantity Of Resources Not The Problem  student honor codes  industry standards  professional assoc codes  ethics laws  ethics committees Quality Is The Problem

11 22 September 2006C. Fox, WSU-College of Health Professions Bioethics: A Committee Approach Brendan Minogue (1995) “When health care providers seek advice, the ethics committee convenes and discusses the cases …” (p. xvii)  Q: “What then is a hospital ethics committee?”  A: “… a group … who meet regularly to address ethical problems that emerge … (p. 2)”

12 Oh - OK We are failing because we take a REACTIVE APPROACH

13 22 September 2006 C. Fox, WSU-College of Health Professions A Modest Proposal (with apologies to J. Swift) Ethics Committees should proactively create a Moral Environment i.e., Quality Improvement (CQI)

14 22 September 2006C. Fox, WSU-College of Health Professions Creating Moral Space  Moral reasoning is:  basically a communal and a collaborative affair  An external scaffolding  allowing human social cognition and the development of ‘moral space’  Discursive Construction Of Moral Space

15 22 September 2006C. Fox, WSU-College of Health Professions Moral Discourse As Process  Moral ground comes into view as an object of human cognition  Moral discourse both creates & navigates moral space  Dialogue creates new domains  e.g., Cruzan Case

16 22 September 2006C. Fox, WSU-College of Health Professions Cruzan vs Missouri  The right to refuse medical treatment  even when necessary to prolong life  Dialogue created whole new moral domain  the right to die claim  Reframed moral landscape from: Physician-assisted suicide as moral issue – TO – – TO – Rights based argument re: physician-assisted suicide  Re-shaped moral space  Made it accessible to reason

17 22 September 2006 C. Fox, WSU-College of Health Professions Discursive Construction of Moral Space Public moral discussion creates moral sensitivity Analogy (Andy Clark)  50 yrs ago, financial landscape very different  New financial institutions creates the space for individuals to trade in stocks, futures, etc.  General public much more sensitive to financial landscape

18 22 September 2006C. Fox, WSU-College of Health Professions Reactive Ethics  Rules, maximums & guidelines that characterize reactive ethics never display the full, rich content of an ethical culture  At best they play a facilitating role / provide reference points to allow  collaborative moral reasoning & discussion  deeper & more penetrating moral thought

19 22 September 2006C. Fox, WSU-College of Health Professions Bioethics: A Committee Approach Brendan Minogue (1995)  “… such committees have an educational function.”  … policies that are not taught are frequently not used  (if not used) ethics policies can never be evaluated and rewritten  This educational function is necessary BUT NOT SUFFICIENT BUT NOT SUFFICIENT

20 22 September 2006C. Fox, WSU-College of Health Professions Proactive Ethics Job of Ethics Committees Is To Proactively Create Moral Space Do This By Creating An Environment Where Moral Discourse Occurs

21 22 September 2006C. Fox, WSU-College of Health Professions

22 22 September 2006C. Fox, WSU-College of Health ProfessionsQUESTIONS?


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