Ethics Consultation: Responding to Ethics Questions in Health Care (3 credit hours)

Program Summary:  Ethics consultations are occurring not only in inpatient clinical settings but also increasingly in outpatient clinics, long term care facilities, home care, and other settings.  This course explores ethics consultation in health care and uses the CASES approach to systematically guide the consultation.  The course describes proficiencies and critical success factors for ethics consultation.  The course offers guidance for formulating ethics questions and offers specific approaches to ethical analysis.  Common misconceptions about ethics consultation are identified.

This course is recommended for social workers and is appropriate for beginning and intermediate levels of practice.  This course is not recommended for NBCC ethics credit.

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Publisher:  National Center for Ethics in Healthcare, Veterans Health Adminstration

Course Objectives:  To enhance professional practice, values, skills, and knowledge by identifying key issues related to ethics consultation.

Learning Objectives:  Describe the strengths and weakness of the three ethics consultation models.  Describe the process for formulating the central ethics perspectives and the ethics question.  Identify different approaches to ethical analysis.  Identify the three legitimate types of rationales that may be used for an ethical argument.

Review our pre-reading study guide.

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1: Executive Summary:  The general goal of health care ethics consultation is to
2: The CASES approach includes all of the following except:
3: Part 1:  Which of the following best describes an ethics consultation?
4: Which of the following best describes case consultation?
5: Ethics consultation in health care settings date back to the ______________, when the first consultation services were established.
6: The Joint Commission requires specific evidence that hospitals have and use
7: Which of the following models is generally appropriate only for the most straightforward consultations and for the most proficient ethics consultants?
8: In this model, responsibility for a given ethics consultation is shared by a small group of qualified consultants chosen on the basis of their complementary perspectives and expertise relevant to the specifics of the consultation:
9: Two thirds of hospitals in the US have reported that they use the ______________ model more commonly than either of the other two models.
10: The 2011 ASBH report discusses proficiencies required to perform ethics consultation including all of the following except:
11: Ethics consultation requires specific skills.  Clearly articulating the ethical concern and the central ethics question would be considered a(n)
12: Establishing realistic expectations about the consultation process is a(n)
13: Which of the following is not a critical success factor for ethics consultation?
14: Ethics consultation should be
15: A growing percentage of ethics consultations are occurring in
16: Requests for ethics consultations that pertain to an active patient case should only be accepted from someone who has 'standing' in the case.  Which of the following is an example of an individual who would not have standing in the case?
17: Anonymous requests for ethics consultation are
18: Part II:  The first step in the CASES approach is to
19: As a general principle, if the requester thinks that a circumstance raises an ethical concern, the assumption should be that it does.
20: Which of the following request is appropriate for ethics consultation?
21: Ethics consultations are often ____________ complex than they are intitially presented or perceived to be.
22: An ethics consultant can
23: 'Truth-telling,' 'equality,' and 'stewardship,' are examples of
24: Using Figure 4, which of the following is at the bottom of The Building Blocks of the Ethics Question?
25: Figure 4 describes five sequential steps for formulating the __________________.
26: The patient's authorized surrogate believes that the patient should not have a DNR order because he does not want to feel complicit in the patient's death.  This is an example of a(n)
27: The patient believes he should not have to divulge his Hepatitis C status to his caregiver because he has a right to control his health information, but the home care staff believes that the caregiver should have the information so that she can protect herself from infection.  This is an example of a(n)
28: The second step of the CASES approach is to
29: Ethics consultants make medical decisions and offer medical opinions.
30: Which of the following does not describe the role of the ethics consultant?
31: A face-to-face visit with the patient is desirable
32: Under HIPAA, ethics consultation on an active patient case is considered
33: If the consultation is about a spouse who is refusing to honor a patient's advance directive, information gathering should focus on
34: Whenever possible, consultants should collect information
35: Participation in ethics consultation is always voluntary for
36: Which of the following terms would be considered a 'value judgment?'
37: The third step in the CASES approach requires the consultant to
38: When explaining a probability to participants in a meeting, it is better to
39: Which of the following approaches to ethical analysis applies a cost-benefit analysis to the situation?
40: Which of the following is a legitimate type of rationale that may be used for an ethical argument?
41: Which of the following describes the Credo rationale?
42: Which of the following describes the Consequence rationale?
43: Writing a DNR order on this comatose patient without consulting the surrogate is not ethically justifiable because it is inconsistent with Hospital Policy 123.  This is an example of an ethical argument based on
44: Who is the ethically appropriate decision maker for identifying the range of treatments or procedures that are medically indicated and appropriate?
45: A patient or surrogate has the right to
46: The fourth step in the CASES approach requires the ethics consultant to
47: All ethics case consultations should be well documented in
48: The fifth step in the CASES approach requires the consultant to

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Free State Social Work, LLC, provider #1235, is approved as a provider for social work continuing education by the Association of Social Work Boards (ASWB), through the Approved Continuing Education (ACE) program. Free State Social Work, LLC maintains responsibility for the program. ASWB Approval Period: 9/6/2018 - 9/6/2021. Social Workers should contact their regulatory board to determine course approval. Social Workers participating in this course will receive 3 continuing education clock hours.

Free State Social Work has been approved by NBCC as an Approved Continuing Education Provider, ACEP NO. 6605. Programs that do not qualify for NBCC credit are clearly identified. Free State Social Work is solely responsible for all aspects of the programs.

G.M. Rydberg-Cox, MSW, LSCSW is the Continuing Education Director at Free State Social Work and responsible for the development of this course.  She received her Masters of Social Work in 1996 from the Jane Addams School of Social Work at the University of Illinois-Chicago and she has over 20 years of experience.  She has lived and worked as a social worker in Chicago, Boston, and Kansas City.  She currently practices in the area of hospital/medical social work.  The reading materials for this course were developed by another organization.