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Ethics rounds in clinical ethics have already taken hold in multiple
venues. There are “sit-down rounds,” which usually consist of
a bioethicist setting a specific, prescheduled time aside for residents
and/or others to bring a case or two for discussion with the
bioethicist. Another kind of rounds that occurs on an ad hoc or infrequent
basis is to have either a staff or outside bioethicist give hospital-wide
and/or departmental “grand rounds.” Grand rounds is a
traditional educational format in medicine and adding bioethics to the
topics covered in grand rounds is an important means of elevating ethical
awareness within a department or throughout a healthcare organization.
Newer is the rounding practice of adding a bioethicist to other
established rounding processes, such as case management and utilization
review rounds. All of these kinds of ethics rounds are important
opportunities to elevate the level of moral discourse within a healthcare
setting and are becoming part and parcel of any full-service hospital
bioethics program.Some of the content of
this paper was delivered by DeRenzo in her talk, “Having a
Bioethicist Round Weekly in the Intensive Care Unit: Benefits to Patients
and Staff of Upstream Preventive Ethics versus Conflicted Downstream
Consultations,” presented at the Second International Conference on
Clinical Ethics Consultation, Basel, Switzerland, March 2005.
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