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141. The National Catholic Bioethics Quarterly: Volume > 18 > Issue: 1
Greg Schleppenbach Washington Insider
142. The National Catholic Bioethics Quarterly: Volume > 18 > Issue: 1
Courtenay R. Bruce, Jocelyn Lapointe, Peter Koch, Katarina Lee, Savitri Fedson Building a Vibrant Clinical Ethics Consultation Service
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The authors work in a variety of clinical ethics consultation services (CECSs) that employ a range of methods and approaches. This article discusses the approach to ethics consultation at the Center for Medical Ethics and Health Policy at Baylor College of Medicine and describes the development and transformation of the authors’ CECSs. It discusses how one CECS shifted from a nascent program with only fifty consultations a year to a vibrant, heavily staffed service with five hundred ethics consultations a year.
143. The National Catholic Bioethics Quarterly: Volume > 18 > Issue: 1
Jason Lesandrini, Alan Muster Practical Steps for Integrating an Ethics Program
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The field of health care ethics continues to grow as the ethics structures in health care organizations become well established. While the literature is saturated with reports on clinical ethics consultation services, very little is known about the development and success of ethics programs. The following describes the development and growth of an ethics program at the largest health care provider in Georgia. With a focus on nine key components of an ethics program, the paper reviews what one system did on its path to a flourishing program and what others can learn from it.
144. The National Catholic Bioethics Quarterly: Volume > 18 > Issue: 1
Mary E. Homan Factors Associated with the Timing and Patient Outcomes of Clinical Ethics Consultation in a Catholic Health Care System
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Little is known about how certain patient characteristics can affect the timing of an ethics consultation, which has been hypothesized to affect patient length of stay. This study assessed how specific patient characteristics affect the timing of an ethics consultation, namely, age (over 65 years), race, Medicaid status, the presence of a living will, the presence of a health care proxy, and the absence of decisional capacity. Moving beyond the typical case-series evaluation of an ethics consultation service, this study used an innovative approach to model how predisposing, enabling, and need factors affect health behavior and subsequently affect health outcomes for patients who received an ethics consultation at a Catholic health care system in Oklahoma.
145. The National Catholic Bioethics Quarterly: Volume > 18 > Issue: 1
Matthew R. Kenney A System Approach to Proactive Ethics Integration
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Although ethics consultation services often engage in some of the most complex and delicate clinical situations, little is known about the qual­ity of these services or their effect on patient care and patient and provider satisfaction. There is still significant work to be done in the areas of training, credentialing, and standardization. This article articulates the essential “build­ing blocks” of the Proactive Ethics Integration model developed at Ascension as well as the lessons we have learned along the way.
146. The National Catholic Bioethics Quarterly: Volume > 18 > Issue: 1
Nicholas J. Kockler, Kevin M. Dirksen Integrating Ethics Services in a Catholic Health System in Oregon
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At Providence St. Joseph Health in Oregon, many factors contribute to the integration and success of the ethics services. There are three principal lenses through which one can understand the distinct way in which the ethics services are operationalized and integrated: the theological foundations of ethics as a service, the institutional ecology, and the professionalization of the field of health care ethics. The authors review key realities that have shaped their work through these three lenses and then describe the activities of the Providence Center for Health Care Ethics regarding its strategic objectives and clinical and administrative integration.
147. The National Catholic Bioethics Quarterly: Volume > 18 > Issue: 1
Pope Francis The Limitations of Our Mortality: Message to the European Regional Meeting of the World Medical Association, November 7, 2017
148. The National Catholic Bioethics Quarterly: Volume > 18 > Issue: 1
John S. Sullivan Medicine
149. The National Catholic Bioethics Quarterly: Volume > 18 > Issue: 1
Christopher Kaczor Philosophy and Theology
150. The National Catholic Bioethics Quarterly: Volume > 18 > Issue: 1
David A. Prentice Science
151. The National Catholic Bioethics Quarterly: Volume > 18 > Issue: 1
Karen Pavic-Zabinski Ethics by Committee: A Textbook on Consultation, Organization, and Education for Hospital Ethics Committees
152. The National Catholic Bioethics Quarterly: Volume > 18 > Issue: 1
Kelly Stuart Handbook for Health Care Ethics Committees
153. The National Catholic Bioethics Quarterly: Volume > 18 > Issue: 1
Ashley L. Stephens A Practical Guide to Developing and Sustaining a Clinical Ethics Consultation Service
154. The National Catholic Bioethics Quarterly: Volume > 18 > Issue: 1
Steven J. Squires Striving for Excellence in Ethics: A Resource for the Catholic Health Ministry
155. The National Catholic Bioethics Quarterly: Volume > 18 > Issue: 1
Jenny Heyl Core Competencies for Healthcare Ethics Consultation
156. The National Catholic Bioethics Quarterly: Volume > 18 > Issue: 2
Charles C. Camosy Defending against Formally Innocent Material Mortal Threats: A Response to Joshua Evans
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In the Summer 2017 NCBQ, Joshua Evans strongly criticized arguments made by Charles Camosy about the possibility of a prenatal child being a material mortal threat to her mother. Here Camosy demonstrates that the formal/material debate remains open for non-dissenting Catholic moral theologians. He also shows that his reference to just-war theory is used to discuss innocence; it is not evidence of a particular methodology. Despite Evans’s claim to the contrary, Camosy notes multiple examples where he affirms the uniqueness of pregnancy and the special duty of parents to children. He argues for full deference to the magisterium in matters where doctrine has been defined and urges solid theological grounding for teachings on abortion when the mother’s life is at risk, especially given the profound personal and political issues at stake.
157. The National Catholic Bioethics Quarterly: Volume > 18 > Issue: 2
Edward J. Furton In This Issue
158. The National Catholic Bioethics Quarterly: Volume > 18 > Issue: 2
William L. Saunders Washington Insider
159. The National Catholic Bioethics Quarterly: Volume > 18 > Issue: 2
Christopher M. Reilly Medical Professionals as Agents of Eugenics: Abortion Counseling for Down Syndrome
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Eugenic thinking divides people into groups according to real or perceived genetic traits, identifies some groups as unwanted, and then promotes the elimination of the unwanted groups. Some American medical professionals are pursuing a eugenic agenda that pressures and misleads parents to abort unborn children with Down syndrome. These counselors have a strong, unwar­ranted bias that influences parents’ decisions significantly. The use of prenatal genetic testing and in vitro fertilization increases the number of deaths of unborn children with Down syndrome. The widespread practice of identifying and aborting children with Down syndrome is properly called eugenics.
160. The National Catholic Bioethics Quarterly: Volume > 18 > Issue: 2
Deacon Gregory Webster Financial Toxicity: Treatment Expense and Extraordinary Means
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The financial toxicity of biotherapeutic treatments is examined. Kymriah, a new gene therapy, has a list price of $475,000 per treatment; Yescarta, from Kite Pharma, costs $373,000 per treatment. Such costs are a significant burden on patients, patients’ families, payers, health care systems, and communities. Studies have shown that financial toxicity—the effect of excessive treatment cost—diminishes patients’ quality of life, compliance, and survival. Some pharmaceutical companies promote outcomes-based pricing and other strategies to offset financial toxicity, but these approaches have not been shown to reduce burdens. Catholic teaching holds that the benefits of treatment should outweigh its burdens, and that burdensome treatments are not obligatory. The financial toxicity of treatments should be included in the ethical assessment of burdens on the patient.