Bioethics Mediation & the End of Clinical Ethics as We Know It

“Bioethics mediation” entered the collective clinical ethics vernacular through a widely read treatise of the same name by Nancy Dubler and Carol Liebman, now in its second edition. In Bioethics Mediation, Dubler and Liebman articulated a new vision for how clinical ethics consultations could be conducted that would offer stakeholders in a bedside conflict a way to craft a shared resolution to a seemingly intractable ethical impasse. They argued that a mediated resolution to a bioethics conflict, as in legal mediation, would avoid the pitfalls of the win-lose verdicts conventionally leveled by ethics committees or consultants in tough, recalcitrant cases. While the field of clinical ethics was quick to acknowledge the value of mediation as one skill in a large arsenal of clinical ethics tools, bioethics mediation has not been widely adopted as the central method of clinical ethics consultation, a fact lamented by its supporters. Verdict-based consultation is still the predominant approach to bedside conflicts that are addressed by ethics consult services (ECS). In this Article, I will not only argue that bioethics mediation is a superior approach for resolving ethics conflicts, but I will also defend the controversial position that it is the only ethically justifi-