Disparities in Health Care: Is Ethics Part of the Problem

Examination of ethics is uncritically influenced by dominant cultural perspectives and the need for health care ethics to be open to multicultural inluences of right and just delivery of health care

Comprehensive Quality Assessment in Clinical Ethics.

Scholars and professional organizations in bioethics describe various approaches to quality assessment in clinical ethics. Although much of this work represents significant contributions to the literature, it is not clear that there is a robust and shared understanding of what constitutes quality in clinical ethics, what activities should be measured when tracking clinical ethics work, and what metrics should be used when measuring those activities. Further, even the most robust quality assessment efforts to date are idiosyncratic, in that they represent evaluation of single activities or domains of clinical ethics activities, or a range of activities at a single hospital or healthcare system. Countering this trend, iin this article we propose a framework for moving beyond our current ways of understanding clinical ethics quality, toward comprehensive quality assessment. We first describe a way to conceptualize quality assessment as a process of measuring disparate, isolated work activities; then, we describe quality assessment in terms of tracking interconnected work activities holistically, across different levels of assessment. We conclude by inviting future efforts in quality improvement to adopt a comprehensive approach to quality assessment into their improvement practices, and offer recommendations for how the field might move in this direction

Deplantation of the Placenta in Maternal-Fetal Vital Conflicts

In this essay, some of the signatories to Medical Intervention in Cases of Maternal-Fetal Vital Conflicts: A Statement of Consensus respond to The Placenta as an Organ of the Fetus: A Response to the Statement of Consensus on Maternal-Fetal Conflict, both recently published in this journal. The response examines Bringman and Shabanowitz\u27s claims and assumptions about the morally relevant pathologic condition in some cases of peripartum cardiomyopathy complicated by a subsequent pregnancy, the moral status of a normally functioning placenta, and the use of the principle of double effect in these cases. The signatories\u27 response sets out to demonstrate how Bringman and Shabanowitz do not engage the essential points of the statement of consensus and how their argument is premised on false assumptions

Medical Intervention in Cases of Maternal-Fetal Vital Conflicts

This statement articulates a consensus of participants in a colloquium organized and sponsored by Ascension Health. The purpose was to consider what, if any, clinical interventions would be consistent with the Catholic moral tradition in the event that a woman\u27s life is threatened because her body is unable to adapt to the changes associated with pregnancy because of a preexisting pathology. An example is peripartum cardiomyopathy in pregnancy. The consensus is offered for evaluating the morality of medical interventions in such cases and as the basis for developing clinical guidelines consistent with Catholic teaching and the standard of care. The colloquium participants agree that induction before viability to eliminate a grave and present danger posed by a life-threatening condition resulting from the interaction of a normally functioning placenta with diseased organs of the mother can be consistent with Catholic Church teaching and the moral tradition