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.

Respecting Choices® and advance directives in a diverse community.

Background: Respecting Choices® is a program designed and verified to improve advance care planning, yet it has not been tested in racially/ethnically diverse communities. Research has shown racial/ethnic minorities are less likely to have advance directives (ADs).

Objective: To determine whether Respecting Choices® would improve AD prevalence and utilization in a racially and ethnically diverse community.

Catholic identity and charity care in the era of health reform.

Catholic healthcare institutions live amidst tension between three intersecting primary values, namely, a commitment of service to the poor and vulnerable, promoting the common good for all, and financially sustainability. Within this tension, the question sometimes arises as to whether it is ever justifiable, i.e.

Moral distress: inability to act or discomfort with moral subjectivity?

Amidst the wealth of literature on the topic of moral distress in nursing, a single citation is ubiquitous, Andrew Jameton's 1984 book Nursing practice. The definition Jameton formulated reads '..

Honoring experience in moral discourse.

This essay seeks to address the role of human experience in moral discourse. The authors propose that it is precisely through incorporating a collective experience of what it means to be human in moral discourse that we come to understand the relevance of moral norms in ethical decision-making. We conclude by offering a number of recommendations for ethics committees and hospital administrators.