From Wise Counselors to Clinical Ethicists: Historical Milestones and Their Impact on Professional Identity Formation.

Abstract

This paper explores how historical bioethics milestones have shaped the professional identity of clinical ethicists, discussing both the benefits and challenges of professionalizing the role of the clinical ethicist by comparing how a “wise counselor,” an ethics consultant, and a clinical ethicist provide healthcare ethics guidance. I examine the evolution of clinical ethics as a sub-category of bioethics, tracing its origins and key milestones in its development toward professionalization. These include the American Society for Bioethics and Humanities’ (ASBH) Core Competencies for Health Care Ethics Consultation reports, ASBH’s Code of Ethics and Professional Responsibilities for Healthcare Ethics Consultants, Fox et al.’s national surveys of healthcare ethics consultation in the United States, and the emergence of the Healthcare Ethics Consultant Certification (HEC-C) program. Practicing as a clinical ethicist requires mastery of a wide scope of knowledge, skills, and attitudes reflected in each stage of the field’s development. Reflecting on this history may yield clues for how clinical ethicists position themselves for the next phase of the field’s evolution.