Credentialing Character
Andrea Thornton, PhD(c), BCC, Saint Louis University
In the process of professionalization, the American Society of Bioethics and the Humanities (ASBH) has emphasized process and knowledge as core competencies for clinical ethics consultants. While these two pillars are necessary, they are not sufficient for demonstrating expertise or guaranteeing quality ethics consultation services. Indeed, quality ethics consultation and ethics expertise have been challenged as concepts, let alone goals, by Giles R. Scofield and H. Tristram Engelhardt. Despite these critiques, the existence and integration of ethics consultation services into health care delivery systems has been established, and the process of certification has begun.
Although the question of expertise cannot be resolved completely, the concern underneath these critiques seems to be one of hubris, which can be addressed to some degree in professionalization. Drawing on the virtue ethics literature of Alasdair MacIntyre and Edmund D. Pellegrino, I argue that medicine is a moral community in which ethics experts are moral agents with a duty to foster the virtue of humility (or what Pellegrino and Thomasma call self-effacement). The implications of this argument include a requirement for self-reflection in one’s role as a moral agent and reflection on one’s progress toward developing or deepening virtuous engagement with the moral community of medicine. I will recommend that professionalization of clinical ethics consultants include a self-reflective narrative component in the initial certification and ongoing renewal of certification where clinical ethics consultants address the emotional dimensions of their work as well as their own moral development.
Although the question of expertise cannot be resolved completely, the concern underneath these critiques seems to be one of hubris, which can be addressed to some degree in professionalization. Drawing on the virtue ethics literature of Alasdair MacIntyre and Edmund D. Pellegrino, I argue that medicine is a moral community in which ethics experts are moral agents with a duty to foster the virtue of humility (or what Pellegrino and Thomasma call self-effacement). The implications of this argument include a requirement for self-reflection in one’s role as a moral agent and reflection on one’s progress toward developing or deepening virtuous engagement with the moral community of medicine. I will recommend that professionalization of clinical ethics consultants include a self-reflective narrative component in the initial certification and ongoing renewal of certification where clinical ethics consultants address the emotional dimensions of their work as well as their own moral development.