Hidden Dimensions in Clinical Ethics Consultation

Clinical Ethics Consultation addresses ethical questions, conflicts, and dilemmas in healthcare. This article argues that there are ethical dimensions in Clinical Ethics Consultation that are difficult to identify and need to be addressed additionally in Clinical Ethics Consultation models. Despite the diverse models and instruments developed across different regions, existing approaches often do not explicitly address these dimensions. The article illustrates the following critical hidden dimensions: issues of power and knowledge, pointing to structural and epistemic injustices, as well as further epistemic issues of implicit biases and subjectivity, intersectional discrimination, and limited participation of patients and their relatives. We argue that improving practice requires greater awareness of these hidden dimensions, consultant self-reflexivity, epistemic humility, and the implementation of specific strategies to mitigate power imbalances, thereby better fulfilling the goal of Clinical Ethics Consultation to support nuanced ethical decision-making.