Perspect Biol Med. 2020;63(3):570-588. doi: 10.1353/pbm.2020.0048.
With the Healthcare Ethics Consultant Certification (HEC-C) offered through the American Society for Bioethics and Humanities (ASBH), the practice of clinical ethics has taken a decisive step into professionalization. But without an unambiguous sense of what clinical ethicists can contribute to the clinical environment, it is unclear what the HEC-C ensures clinical ethicists can do. Though the ASBH enumerates a set of core competencies, many disagree over what role those competencies empower ethicists to serve. Two recent publications are notable for advocating conflicting positions on the question of ethicists' competence: "Ethics Expertise: What It Is, How to Get It, and What to Do with It" by Christopher Meyers (2018) and Rethinking Health Care Ethics by Stephen Scher and Kasia Kozlowska (2018). In response to Scher and Kozlowska's argument that the primary role of ethicists is to create space to engage clinician's moral intuitions, this analysis follows Meyers in contending that ethicists can also contribute a kind of moral expertise. However, acquiring moral expertise is no easy task, and it is unlikely to be substantiated by a certification exam. This analysis draws on research from the psychology of expertise to outline the sort of training needed to cultivate and enhance moral expertise.
通过美国生物伦理学和人文学会 (ASBH) 提供的医疗保健伦理顾问认证 (HEC-C),临床伦理实践已经迈出了决定性的专业化步伐。但是,如果没有明确的临床伦理学家可以为临床环境做出贡献的意识,那么就不清楚 HEC-C 可以确保临床伦理学家能够做什么。尽管 ASBH 列举了一套核心能力,但许多人对这些能力赋予伦理学家的角色存在分歧。最近的两份出版物值得注意,它们在伦理学家能力的问题上提出了相互矛盾的立场:克里斯托弗·迈耶斯 (Christopher Meyers) 的《伦理专家:是什么,如何获得,以及如何利用它》(2018 年)和斯蒂芬·舍尔 (Stephen Scher) 和卡西亚·科佐洛夫斯卡 (Kasia Kozlowska) 的《重新思考医疗保健伦理》(2018 年)。针对舍尔和科佐洛夫斯卡的论点,即伦理学家的主要角色是创造空间来参与临床医生的道德直觉,本分析赞同迈耶斯的观点,即伦理学家也可以做出一种道德专长。然而,获得道德专长并非易事,而且不太可能通过认证考试来证明。本分析借鉴了专长心理学的研究成果,概述了培养和增强道德专长所需的培训类型。