Peer Review, Peer Education, and Modeling in the Practice of Clinical Ethics Consultation: The Zadeh Project

This open access book about the Zadeh Project demonstrates and explores a core question in clinical ethics: how can ethics consultants be accountable in the face of a robust plurality of ethical standpoints, especially those that underwrite practices and methods for doing ethics consultation as well as those viewpoints and values encountered in daily clinical ethics practice? Underscoring this question is the recognition that the field of clinical ethics consultation has arrived at a crucial point in its maturation. Many efforts are underway to more formally -professionalize- the field, with most aimed toward stabilizing a specific set of institutional considerations. Stretched between these institutional and practical initiatives resides a crucial set of of ethical considerations, chief among them the meaning and scope of responsibility for clinical ethics consultants. Developed around a long-form case scenario, the Zadeh Project provides a multi-layered series of -peer-reviews-: critique of the actions of the case scenariös ethics consultant; reflection on clinical ethics method; examination of the many ways that commitments to method and practice can, and do, intersect, overlap, and alter one another. The design and format of this book thus models a key element for clinical ethics practice: the need and ability to provide careful and thoughtful explanation of core moral considerations that emerge among diverse standpoints. Specifically designed for those studying to become and those who are ethics consultants, this book, with its innovative and multi-layered approach, allows readers to share a peer-review-like experience that shows accountability to be what it is, an ethical, not merely procedural or administrative, undertaking.

EDITOR BIOS: Stuart G. Finder, Ph.D., is the Director of the Center for Healthcare Ethics at Cedars-Sinai Medical Center in Los Angeles, CA, where he also serves as the Chief of the Clinical Ethics Consultation Service and is Co-chair of Cedars-Sinai's Bioethics Committee. He also is the Ethics representative to the Cedars-Sinai Medical Staff's Chief of Staff Advisory Council and is a member of Cedars-Sinai's Stem Cell Research Oversight Committee/IRB Committee 4 and the IRB Leadership Group. Finder is also Leader for the Research Ethics Consortium organized under the UCLA Clinical and Translational Science Institute (in which Cedars-Sinai, along with Charles Drew University and Harbor UCLA also participates). Finder holds academic appointments as Professor in Cedars-Sinai's Department of Surgery and Department of Biomedical Sciences as well as in the Department of Medicine at the UCLA David Geffen School of Medicine. Finder spent the first 16years of his career at Vanderbilt University Medical Center in Nashville, TN, as a faculty member in the Center for Clinical and Research Ethics and one of VUMC's Clinical Ethics Consultants; he also held academic appointments in both the Department of Medicine (School of Medicine) and the Department of Philosophy (College of Arts & Sciences). As a clinician, a teacher, and a researcher, Finder is interested in exploring the complexity and implications of moral experiences as actualized in health care contexts. This includes the entire spectrum of the health care arena, from patient care to clinical and basic sciences research. Mark J. Bliton, Ph.D., is the Director of Medical Bioethics at Kaiser Permanente Los Angeles Medical Center in Los Angeles, CA. He serves as a member of the Kaiser Permanente Southern California Regional Committee on Bioethics as well as the Co-chair for the Los Angeles Medical Center Committee on Bioethics. In his capacity as Director of Medical Bioethics, he organizes and leads ongoing clinical ethics education for staff and provides individual clinical ethics consultations. He plays an ongoing role in leadership for Los Angeles Medical Center's innovative Beneficial Care program (which he helped conceptualize, design, and implement). Bliton spent the first 20 years of his career at Vanderbilt University Medical Center in Nashville, TN, as a faculty member in the Center for Clinical and Research Ethics and one of VUMC's Clinical Ethics Consultants; he also held academic appointments in the Department of Medicine (School of Medicine), the Department of Obstetrics and Gynecology (School of Medicine), and the Department of Philosophy (College of Arts & Sciences). His work is premised on the crucial need to pay careful attention to the actual details and moral experiences associated with clinical interactions and decision making. With that as a fundamental orientation, the focus of his academic work has been primarily directed toward the experience of responsibility in clinical ethics consultation and the diversity among methods for ethics consultation practice. He also has spent considerable time exploring ethical issues at the frontlines of the dynamic and rapidly changing environments of health care, including especially the ethical and social values expressed in innovative approaches in surgery, for example, maternal-fetal surgery for spina bifida and deep brain stimulation for Parkinson's disease.

Introduction; Bliton & Finder.- Case Scenario; Finder.- Critical commentary on scenario; Armstrong, Frolic & Rubin, Hynds, Rosell & Johnson, Tarzian, Tsai.- Method; Agich, Aulisio, Hurst, Rasmussen.- Critical commentary on method; Bishop, Molewijk, Reiter-Theil.- Conclusion - Bliton & Finder.