In the fall of 1970 Philip Tumulty, a Johns Hopkins’ internist, gave a lecture to the 3rd year medical school class at Johns Hopkins. His lecture was published in the same year in the New England Journal of Medicine under the title of “What is a clinician, and what does he do?” (Tumulty PA. What is a clinician and what does he do? N Engl J Med. 1970 Jul 2;283(1):20-4.) In this classic piece, this eminent physician of his era claimed that the primary role of the clinician is to “manage a sick person with the purpose of alleviating the total effect of his illness”. 

This paper, probably better than any other paper I have ever read gets to the essence of what a patient needs from an expert clinical caregiver; it lays out eloquently and robustly the characteristics of a good clinician and what is involved in excellent clinical care of patients. As Tumulty says, it is not a diseased body organ that shows up for physical diagnosis and treatment; rather, it is an anxious, fearful, wondering person concerned about her personal life, including her family, work, friends as well as her hopes and dreams. This means the clinician must be a thoughtful and systematic fact finder, a careful listener, a keen analyst of the facts and a prudent planner regarding which tests and treatment options make the most sense for this particular patient. Moreover, Tumulty rightly assumes that these skills should be embodied in the clinician as natural traits that the clinician genuinely enjoys performing. 

The Alden March Bioethics Institute offers a Master of Science in Bioethics, a Doctorate of Professional Studies in Bioethics, and Graduate Certificates in Clinical Ethics and Clinical Ethics Consultation. For more information on AMBI's online graduate programs, please visit our website.

Those involved in healthcare ethics consultation professionalism efforts face many challenges. Many – particularly academics involved in bioethics education – have been working on the notion that those who offer clinical ethics consultation services as individuals be appropriately credentialed, certified, or accredited in someway.

In re-reading an article by Diane Hoffmann, Anita Tarzian, and Anne O’Neil which appeared in the Journal of Law, Medicine & Ethics in 2000, one striking challenge is readily apparent: ethics committee members – with little or no formal training in clinical ethics, little or no actual consultation experience, some with not much more than a sufficient interest in biomedical ethics issues and a willingness to serve – already feel competent to participate in offering consultation services. Moreover, from the Hoffmann-Tarzian-O’Neill data set, ethics committee members who self-report that they are competent to participate in clinical ethics consultation – and in hospitals which average only three consultations per year – believe that they are meeting their obligations to patients, families, staff, and institutions reasonably well.

The Alden March Bioethics Institute offers a Master of Science in Bioethics, a Doctorate of Professional Studies in Bioethics, and Graduate Certificates in Clinical Ethics and Clinical Ethics Consultation. For more information on AMBI's online graduate programs, please visit our website.