title: Reasoning Backwards by Design: Commentary on "Moral Reasoning among HEC Members".
abstract: Empirical assessment of the practice of clinical ethics is made difficult by the limited standardization of settings, structures, processes, roles, and training for ethics consultation, as well as by whether individual ethics consultants or hospital ethics committees (HECs) provide consultation. Efforts to study the relationship between theory and practice in the work of HECs likewise require the spelling out of assumptions and definition of key variables, based in knowledge of the core concepts of clinical ethics and logistics of clinical consultation. The survey of HEC members reported by Wasserman and colleagues illustrates the difficulty of such research and calls attention to need for studies of real-time, complex decision making to inform conclusions about how theory affects practice.
authors.affiliation: Baylor College of Medicine, 1 Baylor Plaza, Ste 310D, Houston, Texas 77030 USA Ashley.stephens@bcm.edu.
authors.forename: Ashley L
authors.initials: AL
authors.lastname: Stephens
authors.affiliation: Vanderbilt University Medical Center, Center for Biomedical Ethics and Society, 2525 West End Ave., Ste 400, Nashville, Tennessee 37203 USA. Elizabeth.heitman@vanderbilt.edu.
authors.forename: Elizabeth
authors.initials: E
authors.lastname: Heitman
mesh_terms: D026688:Bioethical Issues; D003657:Decision Making / Q000941:ethics*; D004500:Education, Graduate; D026822:Ethicists; D028741:Ethics Committees, Clinical; D033061:Ethics Consultation; D026690:Ethics, Clinical / Q000193:education*; D006801:Humans; D019545:Intuition; D009014:Morals; D011340:Problem Solving / Q000941:ethics*