Lanphier Elizabeth, Anani Uchenna E
Cincinnati Children's Hospital Medical Center.
University of Cincinnati College of Medicine.
Am J Bioeth. 2022 May;22(5):45-57. doi: 10.1080/15265161.2021.1887963. Epub 2021 Mar 8.
We argue for the addition of trauma informed awareness, training, and skill in clinical ethics consultation by proposing a novel framework for Trauma Informed Ethics Consultation (TIEC). This approach expands on the American Society for Bioethics and Humanities (ASBH) framework for, and key insights from feminist approaches to, ethics consultation, and the literature on trauma informed care (TIC). TIEC keeps ethics consultation in line with the provision of TIC in other clinical settings. Most crucially, TIEC (like TIC) is systematically sensitive to culture, history, difference, power, social exclusion, oppression, and marginalization. By engaging a neonatal intensive care ethics consult example, we define our TIEC approach and illustrate its application. Through TIEC we argue it is the role of ethics consultants to not only hold open moral spaces, but to furnish them in morally habitable ways for all stakeholders involved in the ethics consultation process, including patients, surrogates, and practitioners.
我们通过提出一种创伤知情伦理咨询(TIEC)的新颖框架,主张在临床伦理咨询中增加创伤知情意识、培训和技能。这种方法扩展了美国生物伦理与人文学会(ASBH)的伦理咨询框架、女性主义伦理咨询方法的关键见解以及创伤知情护理(TIC)的相关文献。TIEC使伦理咨询与其他临床环境中TIC的提供保持一致。最关键的是,TIEC(与TIC一样)对文化、历史、差异、权力、社会排斥、压迫和边缘化具有系统性的敏感性。通过一个新生儿重症监护伦理咨询的例子,我们定义了我们的TIEC方法并说明其应用。通过TIEC,我们认为伦理咨询师的作用不仅是保持开放的道德空间,而且要以道德上适宜居住的方式为参与伦理咨询过程的所有利益相关者提供这些空间,包括患者、代理人和从业者。