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Bioethics fancies itself as the field that offers reasoned and reasonable justification for medical advancements in science; clinical ethicists offer reasoned and reasonable reflection on the deployment of those technologies at the patient's bedside. The latter now hope to ensconce in policy and procedure, as well as in new institutions, a set of skills to facilitate between the patient and the health care team, a skill-set that all clinical ethicists should deploy in order to keep medical practitioners on the straight and narrow. All the while, the field also wants to suggest that it does not offer moral expertise. Health Care Ethics Consultation appears only to have a set of goals, but no a clear set of goods that it promotes, unlike the practices of medicine or nursing. The goals articulated by clinical ethics consultants are in some way related to the goods of medical care. Ultimately, however, the highest goods are the goods of efficiency and effectiveness. The clinical ethicist then is a bureaucratic manager, guiding a process toward unknown and interchangeable ends and goods. For Health Care Ethics Consultants, the supreme good is efficiency and effectiveness of the process, the intermediary goals, not the goods, of a valued practice.

DOI: 10.1007/978-94-007-2244-6_9

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