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Framework for evaluation research on clinical ethical case interventions: the role of ethics consultants
  1. Joschka Haltaufderheide1,
  2. Stephan Nadolny2,3,
  3. Jochen Vollmann1,
  4. Jan Schildmann2
  1. 1Institute for Medical Ethics and History of Medicine, Ruhr University, Bochum, Germany
  2. 2Institute for History and Ethics of Medicine, Interdisciplinary Center for Health Sciences, Martin Luther University, Halle-Wittenberg, Germany
  3. 3Nursing Science Staff Unit, Franziskus Hospital Harderberg, Niels-Stensen-Kliniken, Germany
  1. Correspondence to Dr Joschka Haltaufderheide, Institute for Medical Ethics and History of Medicine, Ruhr University Bochum, Bochum 44799, Germany; joschka.haltaufderheide{at}


Evaluation of clinical ethical case consultations has been discussed as an important research task in recent decades. A rigid framework of evaluation is essential to improve quality of consultations and, thus, quality of patient care. Different approaches to evaluate those services appropriately and to determine adequate empirical endpoints have been proposed. A key challenge is to provide an answer to the question as to which empirical endpoints—and for what reasons—should be considered when evaluating the quality of a service. In this paper, we argue for an approach that adopts the role of ethics consultants as its point of departure. In a first step, we describe empirical and ethical characteristics of evaluating clinical ethical case. We show that the mode of action and the explicit normative character of the interventions constitute two characteristics which pose challenges to the selection of appropriate quality criteria and require special attention. In a second step, we outline the way in which an analysis of the role of ethics consultants in the context of a clinical ethical case consultation services can account for the existing challenges by linking empirically measurable endpoints with normative theory. Finally, we discuss practical implications of our model for evaluation research.

  • clinical ethics
  • ethics committees/consultation
  • quality of healthcare

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  • Contributors JH and JS conceived of the presented Idea. JH, JS and SN developed the first outline of the theory. JV contributed to theory development. JH wrote the manuscript with support from JS. All authors discussed the results, contributed to and approved the final version of the manuscript.

  • Funding This paper contains results obtained within the BMBF-funded research project 'Systematische Übersichtsarbeit zur Effektivität von ethischer Einzelfallberatung bei Erwachsenen Patienten in der letzten Lebensphase' (A Systematic Review of the Effectiveness of Ethical Individual Case Consultation in Adult Patients in the Last Phase of Life) (FK: 01KG1404).

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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