Who is a real bioethicist?

Michael Cook
18 Mar 2011
Reproduced with Permission

Should you have recognised credentials to practice as a clinical bioethicist? According to an article in the Stanford Medical Magazine, there is interest in setting up a clinical ethics certification process. The American Society for Bioethics and Humanities is currently working on defining the core competencies which will be needed for hospitals which offer clinical bioethics consultations. "In some hospitals, there may not be an individual who possesses the full skill set, but there should be a committee or group that collectively has all of the skills," says David Magnus, director of Stanford's Center for Biomedical Ethics.

However, leading figures in bioethics have serious reservations - because no one quite knows what bioethics is. "Certification in medicine itself is a very complex and expensive business," says Albert Jonsen, one of the early bioethicists and author of The Birth of Bioethics. "I think the world of bioethics may be too small to support that at the present time. And given the diversity of theoretical and practical approaches, it's hard to figure out how to give a standard examination."

In the United States between 2,000 and 6,000 people "do" bioethics in some fashion. But the field is bedevilled by uncertainty about its foundations.

"Bioethics is a field that is always evolving because it exists in relation to newly emerging moral questions in society," says Stanford bioethicist Laura Roberts. "The field itself struggles - we are always trying to make sense of things and to understand and resolve complex issues in ways that rely on more than mere intuition."

This extends to the curricula in university courses in bioethics, as well. There is no agreement on how much philosophy, law, theology, sociology, anthropology or other disciplines should be included.

Enforcing accreditation would be possible if the Joint Commission, the body which accredits all hospitals, demanded it. At the moment it stipulates that hospitals should have the ability to provide clinical ethics consultations, but hasn't specified the level of expertise. And at the moment, it has no plans to do so. - Stanford Medical Magazine, Spring 2011