Clinical Ethics Consultations in the Opinion of Polish Physicians

Clinical Ethics Consultations (CEC) are an important tool for physicians in solving difficult cases. They are extremely common in North America and to a lesser extent also present in Europe. However, there is little data on this practice in Poland. We present results of a survey of 521 physicians practising in Poland concerning their opinion on CECs and related practices. We analysed the data looking at such issues as CECs’ perceived availability, use of CECs, and perceived usefulness of such support. Physicians in our study generally encounter hard ethics cases, even—surprisingly—those who do not work in hospitals. Most physicians have no CEC access, and those that do still do not employ CECs. However, physicians perceive this form of support as useful—even more so among actual users of CECs. We compared these findings with similar studies from other European countries and the North America. We point out peculiarities of our results as compared to those in other countries, with some possible explanations. We hope the results may encourage regulatory debate on the need to formally introduce CECs into the Polish healthcare system.

Cracking the Case, and Cases to Consider

This concluding chapter deals with the nature and usefulness of ethical cases, and it opens with a prompt to readers to describe a moral problem relevant to their lives. It is argued that the most helpful ethical cases are the ones closest to home, which we have experienced or conceivably could experience. In the first section of this chapter, readers are taught to interrogate case presentations for their assumptions and biases, and some measures of effective ethics cases are offered. In the final section, 12 wide-ranging, contemporary cases are presented, along with prompts for how to explore them further. These are nonprescription use of Adderall; self-driving cars; vaccine refusal; arming school teachers; businesses that provide services selectively; paying student-athletes; cows and global warming; the effects of social media; choosing the sex of one’s children; age as a screen for expensive therapies; buying and selling organ; and divisive monuments.

“Hooked up to that damn machine”: Working with metaphors in clinical ethics cases

The frequent use of metaphors in health care communication in general and clinical ethics cases in particular calls for a more mindful and competent use of figurative speech. Metaphors are powerful tools that enable different ways of thinking about complex issues in health care. However, depending on how and in which context they are used, they can also be harmful and undermine medical decision-making. Given this contingent nature of metaphors, this article discusses two approaches that suggest how medical health care professionals may systematically and imaginatively work with metaphors. The first approach is informed by a model developed by cognitive scientists George Lakoff and Mark Turner. The second approach is a close reading and thus a text-immanent, hermeneutical strategy. Using the double perspective of an ethics consultant and a researcher in literature studies, we take a case from Richard M Zaner in which a metaphor is central to the clinical-ethical problem. The article shows that the approaches, which focus on creativity and the intersections of form and content, may be helpful tools in clinical ethics, enabling a competent and mindful working with metaphors in complex cases as well as supporting the consultant’s thoughts processes.