Clinical bioethics is big business. There are now
hundreds of people who “do” bioethics in community
and university hospitals, nursing homes, rehabilitation
and home care settings, and some (though quite a few less)
who play the role of clinical ethics consultant to transplant
teams, managed care companies, and genetic testing firms.
Still, there is as much speculation about what clinically
active bioethicists actually do as there was ten years
ago. Various commentators have pondered the need for training
standards, credentials, “certification” exams,
and malpractice insurance for ethicists engaged in clinical
consultation. Much of the discussion seems to accept an
implicit presumption that all clinical ethics consultation
practices look pretty much alike. But is this accurate?
What do clinical ethicists do, how and where do they do
it, and what kind of clinical ethics is useful in the hospital
and in other settings?