November 12, 2013 | Posted By Bruce White, DO, JD

With the endorsement of the American Society for Bioethics and Humanities (ASBH) Board of Directors, and the publication of a process to confer eventually a “quality attestation” credential on successful candidates, the ASBH Quality Attestation Presidential Task Force (QAPTF) has begun a pilot procedure to assess those involved in providing clinical ethics consultation services. Importantly, it’s unclear at this point if the Task Force will be looking at those who provide consultation as an individual, or as a member of a small group of consultants or as a member of a larger ethics committee.

As part of the pilot to refine the process, the QAPTF has asked those interested to submit a letter of intent. (It is not a requirement that one be an ASBH member to submit a letter of intent.) The Task Force will review the submitted letters and select a representative sample (“a cross-section of eligible candidates whose professions represent the distribution of professions among Clinical Ethics Consultants”). Those selected to submit a portfolio – first of a two-part procedure to ultimately achieve the quality attestation credential – must meet several eligibility criteria:

  • “[P]ractice CEC [meaning presumably, Clinical Ethics Consultation]”;
  • “[H]ave at least a Master’s degree in a relevant discipline or provide evidence of their education and training qualifications”; and
  • “[H]ave sufficient CEC experience to be able to provide the following:
    • Detailed summary and discussion of 6 consultations and descriptions of 6 additional consultations.
    • Summary of their CEC experience.
    • Statement of their philosophy of CEC.
    • Three (3) letters of evaluation from individuals responsible for clinical oversight of the candidate.”

From comments made at several ASBH meetings in Atlanta last month by a number of those who presently serve on the Task Force, the eligibility criteria that were adopted were a compromise or acceptable group-consensus position. “Compromise” in the sense that some Task Force members wanted more rigorous educational criteria and some wanted less; some wanted a more robust portfolio of cases to be submitted, and some fewer cases. One wonders though – that with this minimal educational requirement and the very few number of cases in the portfolio submission – if the compromise has established a standard that is so low that the Task Force will not be able to distinguish the trained and skilled from the inept and incompetent, from those who are deliver “quality” clinical ethics consultation services from those who do not.

However, perhaps we shouldn’t view this process as a “standard.” The Task Force has been clear that this initial process is an important “first step.” It may be that the QAPTF will use the information gathered to develop a set of criteria for submission that looks quite different from the one used to request letters of intent?

Regardless, this is an important initial step – one that has some political significance – and one that individual clinical ethics consultants must take to establish peer qualifications as they struggle to professionalize.

The Alden March Bioethics Institute offers a Master of Science in Bioethics, a Doctorate of Professional Studies in Bioethics, and Graduate Certificates in Clinical Ethics and Clinical Ethics Consultation. For more information on AMBI's online graduate programs, please visit our website.

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BIOETHICS TODAY is the blog of the Alden March Bioethics Institute, presenting topical and timely commentary on issues, trends, and breaking news in the broad arena of bioethics. BIOETHICS TODAY presents interviews, opinion pieces, and ongoing articles on health care policy, end-of-life decision making, emerging issues in genetics and genomics, procreative liberty and reproductive health, ethics in clinical trials, medicine and the media, distributive justice and health care delivery in developing nations, and the intersection of environmental conservation and bioethics.