Charting the Future: Credentialing, Privileging, Quality, And Evaluation in Clinical Ethics Consultation‪.‬

Clinical ethics consultation has become an important resource, but unlike other health care disciplines, it has no accreditation or accepted curriculum for training programs, no standards for practice, and no way to measure effectiveness. The Clinical Ethics Credentialing Project was launched to pilot-test approaches to train, credential, privilege, and evaluate consultants. When difficult decisions must be made about health care, clinical ethics consultation provides an additional resource and a conduit for complex communication among patients, their families (including relatives, significant others, close friends, and appointed surrogates), and the care team. CE consultants address some of the most divisive and contentious issues in American society. While other disciplines, such as chaplaincy and palliative medicine, have developed training standards (1) and become viable, funded disciplines within the medical center, clinical ethics consultation (CEC) has yet to mature. Although there are stipulated competencies for consultants, (2) there is no agreement on (1) standards for practice (outside of the Veterans Administration system), (3) (2) qualifications for practitioners, (4) or (3) valid and reliable measures to rate the quality and effectiveness of the CEC process. (5) There is neither accreditation for training programs nor an accepted curriculum for what such programs should teach. Finally, there has been no agreement that these clinicians must be credentialed and privileged in order to practice, in contrast to what is required for all other health care professionals.