Complex Ethics Consultations: Volume 1
Cases that Haunt Us

The book contains 28 cases written by clinical ethicists that explore emotional and humanistic aspects of difficult consultations.

Paul J. Ford (Edited by), Denise M. Dudzinski (Edited by)

9781009400954, Cambridge University Press

Paperback / softback, published 5 June 2025

281 pages
23.3 x 15.4 x 1.5 cm, 0.44 kg

'This volume provides a distinct and rare look at the inner workings of ethics consultation. The new edition probes more deeply yet, and a series of commentators revisits the original cases by posing questions or offering observations that invite greater reflexivity and deeper insights. The commentators are compassionate but unflinching, pushing the reader into deeper and more troubling waters than before. This is an invaluable resource for both the novice practitioner and the experienced ethicist, suitable for quiet introspection or lively classroom/boardroom discussion. It sparks the sort of intergenerational and cross-cultural conversations that our field now knows are long overdue.' Ann M. Heesters, Senior Director, Department of Clinical and Organizational Ethics, UHN Education Investigator II, TIER (The Institute for Education Research); Assistant Professor, Dalla Lana School of Public Health; Research Adjunct Professor, Michener Institute of Education; Wilson Centre Scholar; Member, Joint Centre for Bioethics, University of Toronto

Clinical ethics consultants navigate dilemmas across patient care, public health, and healthcare policy. Issues span from the beginning to the end of life, complex discharges, employment of novel technologies, and visitation restrictions. The second edition relays the narratives of fraught, complex consultations through richly detailed cases. Authors explore the ethical reasoning, professional issues, and emotional aspects of these impossibly difficult scenarios. Describing the affective aspects of ethics consultations, authors highlight the lasting effects of these cases on their practices. They candidly reflect on evolving professional practice as well as contemporary concerns and innovations while attending to equity and inclusivity. Featuring many new chapters, cases are grouped together by theme to aid teaching, discussion, and professional growth. The book is intended for clinicians, bioethicists, and ethics committee members with an interest in the choices made in real-life medical dilemmas as well as the emotional cost to those working to improve the situations.

Introduction: live and learn: courage, honesty, and vulnerability
Part I. Starting at the Beginning: Prenatal and Neonatal Issues: 1. Quality of life – and of ethics consultation – in the NICU Robert C. Macauley and Robert R. Orr
2. When a baby dies in pain Thomas R. McCormick and David Woodrum
3. But how can we choose? Richard M. Zaner
4. Maternal-fetal surgery and the “profoundest questions in ethics” Mark J. Bliton
Commentary 1. Reflections on Part I Lucia D. Wocial
Part II. The Most Vulnerable of Us: Pediatrics: 5. She was the life of the party Douglas S. Diekema
6. The sound of chains Jeffrey Spike
7. Susie's voice Rosa Lynn Pinkus, Stella L. Smetanka, and Nathan A. Kottkamp
8. Access to an infant's family: lingering effects of not talking with parents D. Micah Hester
Commentary 2. Reflections on Part II Nneka Sederstrom
Part III. Diversity of Desires and Limits of Liberty: Psychiatric and Psychological Issues: 9. Helping staff help a “hateful” patient: The case of TJ Joy Skeel and Kristi Williams
10. Ulysses contract Barbara Daly and Cynthia Griggins
11. Misjudging needs Paul J. Ford
12. When the patient refuses to eat Debra Craig and Gerald R. Winslow
Commentary 3. Reflections on Part III Maya Scott
Part IV. Withholding Therapy with a Twist: 13. Listening to the husband Ellen W. Bernal
14. You're the ethicist
I'm just the surgeon Joseph P. DeMarco and Paul J. Ford
15. Haunted by a good outcome: the case of Sister Jane George J. Agich
16. Is a broken jaw a terminal condition Stuart G. Finder
Commentary 4. Reflections on Part IV Crystal Brown
Part V. The Unspeakable/Unassailable: Religious and Cultural Beliefs: 17. Adolescent pregnancy, confidentiality, and culture Donald Brunquell
18. 'Tanya, the one with Jonathan's kidney': a living unrelated donor case of church associates Tarris D. Rosell
19. Futility, Islam, and death Kathryn L. Weise
20. Suffering as God's will Kathrin Ohnsorge and Paul J. Ford
Commentary 5: Reflections on Part V: The Unspeakable/ Unassailable: Religious and Cultural Beliefs Mahwish Ahmad
Part VI. Human Guinea Pigs and Miracles: Clinical Innovations and Unorthodox Treatment: 21. Amputate my arm, please. I don't want it anymore Denise M. Dudzinski
22. Feuding surrogates, herbal therapies, and a dying patient Alissa Hurwitz Swota
23. One way out: destination therapy by default Alice Chang and Denise M. Dudzinski
24. Altruistic organ donation: Credible? Acceptable? Ronald B. Miller
Commentary 6: Reflections on Part VI: Human Guinea Pigs and Miracles: Clinical Innovations and Unorthodox Treatment Kaarkuzhali B. Krishnamurthy
Part VII. The Big Picture: Organizational Issues: 25. It's not my responsibility Mary Beth Foglia and Robert A. Pearlman
26. Intra-operative exposure to sporadic Creutzfeldt-Jakob disease: to disclose or not to disclose Joel Potash
27. Why do we have to discharge this patient? Sarah E. Shannon
28. Who's that sleeping in my bed? An institutional response to an organizational ethics problem Daryl Pullman, Rick Singleton, and Janet Templeton
Commentary 7: Reflections on Part VII Ruchika Mishra
Conclusions, educational activities, and references Denise M. Dudzinski and Paul J. Ford
Index.

Subject Areas: Bio-ethics [PSAD]