Sociology

1. The Impact of Clinical Ethics on Quality of Care and Organizational Communication
Clinical ethics consultants help medical practitioners choose the best course of action in situations wherein treatment is contentious, risky or has disagreeable consequences. Medical decisions do not fall solely on the hands of physicians the interests and values of patients and their relatives should be accommodated as well. Health care ethics professionals serve as the bridge that coalesces the interests of all parties involved in health care delivery while balancing the rights of patients with legal liability and moral obligations of health care providers, which often run afoul of each other.  Understanding and communicating to affected parties the legal and moral implications of medical decisions ensure that health care is delivered in good faith without hurting the interests of any party. It will also guarantee that patients could fully exercise their right to choose or  refuse treatment without undermining the role of health care providers. By walking physicians, patients and their relatives through the moral and legal implications of their decisions, ethics consultants open the door for communication and compromises, making sure that health care decisions are not solely born of the interests of one party.

2. Skill Requirements for Clinical Ethics Consultants
The prevalence of malpractice lawsuits and legal actions related to ANH cessation suggests that many physicians and hospital operators lack practical understanding of clinical ethics. A certification for medical practice does not necessarily guarantee the ability to address the complex issues facing clinical ethics consultants. Just like other fields of allied health services, clinical ethics has become a specialized one amid the changing legal environment and growing consumer empowerment and regulatory oversight of health care providers. Clinical ethics consultant is now a recognized profession in terms of prestige, salary scale and educational requirements, suggesting that physicians alone cannot address the complex ethical dilemma of the modern time (Klugman).

Communication, interpersonal and conflict resolution skills are critical to the job of clinical ethics consultants. Since the goal of clinical ethics is to facilitate compliance with the most evident moral, legal and social laws or norms from diverse perspectives, consultants have to reach out to the parties involved and widen their perspective on contentious medical decisions under consideration.  Conflict resolution and interpersonal skills are important in dealing with patients who are unreasonably hesitant to undergo treatment or with physicians having ethical disagreement with their patients (Sontag).  These skills complement consultants knowledge of clinical, legal, social and psychological facets of ethical dilemma.

3. The Ethical Dilemma on ANH Cessation The Terri Schiavo Case
Following the line of reasoning entailed by the responsibilities of a clinical ethics consultant, I believe that the withdrawal of feeding tube of Terri Schiavo is ethically acceptable. It has been proven in court that Terri wanted to die rather than live off  ANH. Since the right to die is recognized in some states, the removal of Terris feeding tube cannot be compared to homicide or medical negligence. It is unethical and sometimes illegal for a clinical ethics consultant to override the wish of a terminally-ill patient to refuse artificial nourishment. Moralists may think otherwise, but such act is clearly beyond the duties of this profession.

4. Justifying ANH Cessation
Case4 entails close examination of medical law. If the state where the hospital is located recognizes the right of terminally-ill patients to refuse ANH, a clinical ethicist must not override the patients decision. However, it doesnt necessarily prevent conservative ethics consultants from encouraging Marys relatives to prolong artificial feeding if there is no imminent legal actions that may result thereof.  If there is no living will ordering the ANH cessation,  ethics consultants should explain to Marys relatives the legal obstacles and moral objections to their proposal.

This case should be approached in the same way as recommended in the preceding case of Terri
Schiavo. I must reiterate that the role of a clinical ethics consultant is to walk patients, relatives and doctors through the ethical, legal and medical implications of their opposing decisions so as to bring them to a consensus, which may or may not please conservative moralists. Advocating religious beliefs or specific moral tenet, though important in the intervention endeavors of ethics consultants and committees, is not necessarily the ultimate goal of the profession.