Hidden Dimensions in Clinical Ethics Consultation

Journal of Bioethical Inquiry

Abstract

Clinical Ethics Consultation addresses ethical questions, conflicts, and dilemmas in healthcare. This article argues that there are ethical dimensions in Clinical Ethics Consultation that are difficult to identify and need to be addressed additionally in Clinical Ethics Consultation models. Despite the diverse models and instruments developed across different regions, existing approaches often do not explicitly address these dimensions. The article illustrates the following critical hidden dimensions: issues of power and knowledge, pointing to structural and epistemic injustices, as well as further epistemic issues of implicit biases and subjectivity, intersectional discrimination, and limited participation of patients and their relatives. We argue that improving practice requires greater awareness of these hidden dimensions, consultant self-reflexivity, epistemic humility, and the implementation of specific strategies to mitigate power imbalances, thereby better fulfilling the goal of Clinical Ethics Consultation to support nuanced ethical decision-making.

Authors 4

1. Anna‐Henrikje Seidlein corresponding

   Universitätsmedizin Greifswald · Universität Greifswald

   Affiliation as printed

   Institute of Ethics and History of Medicine, University Medicine Greifswald, Ellernholz-Str. 1-2, 17487, Greifswald, Germany. anna-Henrikje.Seidlein@med.uni-greifswald.de

2. Marie-Christine Fritzsche

   Technical University of Munich

   Affiliation as printed

   Department of Science, Technology and Society (STS), School of Social Sciences and Technology, Technical University of Munich, Munich, Germany

   Institute of History and Ethics in Medicine, TUM School of Medicine and Health, Technical University of Munich, Munich, Germany

3. Rouven Porz

   University of Bern · University Hospital of Bern

   Affiliation as printed

   Medical Ethics and Continuing Medical Education, Insel Gruppe Inselspital, University Hospital of Bern, 3010, Bern, Switzerland

4. Helen Kohlen Aachen Clinic of Palliative Medicine

   Universitätsklinikum Aachen · RWTH Aachen University

   Affiliation as printed

   Clinic of Palliative Medicine, University Hospital/RWTH Aachen, Pauwelsstr. 30, 52074, Aachen, Germany