Clarifying a Clinical Ethics Service's Value, the Visible and the Hidden

Area of Science:

• Healthcare Management
• Bioethics
• Health Services Research

Background:

• Clinical ethics services (CES) face increasing pressure to quantify their value.
• Articulating the impact of clinical ethics work to hospital administrators presents significant challenges.
• The nature of clinical ethics practice, often systems-level and process-oriented, obscures direct attribution of benefits.

Purpose of the Study:

• To define the difficulties CES encounter in demonstrating their institutional value.
• To elucidate the multifaceted, often hidden, value added by CES.
• To suggest methods for conveying CES value beyond simplistic or reductionistic metrics.

Main Methods:

• Analysis of presentations from the Cleveland Clinic Un-Conference (August 2018).
• Review of challenges in articulating the value of clinical ethics work.
• Exploration of the systems-level and process-oriented nature of clinical ethics practice.

Main Results:

• The field of clinical ethics may be experiencing a crisis due to the demand for explicit value metrics.
• Metrics alone may not fully capture the scope and impact of clinical ethics consultations.
• The benefits of CES are often hidden, making them difficult to attribute and convey.

Conclusions:

• Demonstrating the value of CES requires acknowledging both overt and hidden contributions.
• Effective communication of CES value must avoid oversimplification and reductionism.
• Developing comprehensive methods to showcase CES integration and positive effects across the institution is crucial.