The purpose of this series is to illustrate how clinical ethicists analyze, process, and address complex cases. The primary author of each essay should be a clinical ethicist (individual, team, or committee model) who was involved in the case while performing the clinical ethicist’s role. Essays may have multiple authors, including those who were involved in the process but not serving as clinical ethicists. Someone who works exclusively in an academic (non-clinical) setting would not be appropriate as a primary author, nor would a clinician who did not serve as a clinical ethicist in their role in the case. Academics, clinicians, or community members who were not involved as clinical ethicists could be appropriate co-authors, however. Fellows who participate in clinical ethics consultations may submit as primary author or as a co-author, depending on their role in the case.

Cases should present ethical complexities for which there is no single appropriate response. Essays should fairly and sensitively discuss positions from involved parties (patients, families, nurses, physicians, social workers, spiritual care, etc.) and recognize differences in perspectives that are difficult to reconcile (a tension between two providers, for example). Case presentations may also address system-level issues (a tension between an ethical and legal perspective, for example).

Unlike an academic journal, Hastings Bioethics Forum is aimed at a broad audience, with a substantial readership that includes journalists, and the general public. Consequently, there is a special interest in cases that relate to topics that are of current media interest. This is not a necessary quality for submissions, but it may increase the odds of having the case shared on social media, thus increasing the reach of the case narrative.

Writing Style and Requirements

Each section of the essay should be understandable and compelling to a broad audience. Any technical terms, abbreviations, or acronyms should be clearly explained. Think of cases that might spark a conversation among people who are not health care professionals or scholars. The writing style should also be for a lay audience, similar to other essays posted on Hastings Bioethics Forum.

Each essay must be 750 – 1100 words and must be structured under the following headings:

• Case Narrative: Describe the main components of the case that led to consulting the clinical ethicist(s) with clear identification of the ethical conundrum
• Ethical Analysis and Process: Analyze the ethical conundrum using any appropriate disciplinary lens(es), integrating careful discussion of the steps taken by the clinical ethicist or clinical ethics team in the course of their work during (and perhaps after) the case
• The Decision and Lingering Questions: What the clinical ethics team recommended, and why. Acknowledge any remaining ethical concerns or questions related to the case or process.

All cases must be strictly deidentified, such that the patient, family, or other involved party could read the case and not necessarily know that the case was theirs. This may require certain modifications to the case, such as the patient’s age and sex, as well as omission of certain identifying details. If the case concerns a particularly rare medical condition that is central to this kind of discussion, then it may not be an appropriate case for this series. Upon submission, all authors will have to testify that the piece is sufficiently deidentified. A consent form is available for any authors who wish to keep their case identifiable with the explicit permission of those who could be identified (such as the patient). If the authors wish to receive consent for such a case, the signed consent must be submitted within 2 weeks of acceptance of the essay for Hastings Bioethics Forum.

Essays should have appropriate references with embedded links as possible, following Hastings Bioethics Forum guidelines.

Decision and Posting

The editorial team of the Clinical Ethics Case Studies will work closely with Susan Gilbert, editor of Hastings Bioethics Forum and communications director of The Hastings Center, and they may send anonymized essays to expert readers for additional review. Essays will be chosen based on the following criteria (in no particular order):

• Writing is clear and matches guidelines for series.
• Author(s) demonstrate expertise related to clinical ethics.
• Case is compelling, timely, and properly deidentified.
• Analysis of the case is robust, precise, and easy to follow for a broad audience.
• Writing demonstrates fairness, equity, thoughtfulness, and humility in description and discussion of the case.

Authors will be informed within 4-6 weeks of submission whether their essay has been accepted, invited for revision and resubmission, or rejected. The posting date of an accepted essay will depend on a host of factors, including the topics of other essays, whether further revisions are necessary, and space. Any questions can be sent to Susan Gilbert (gilberts@thehastingscenter.org) or members of the editorial team:

Gina Campelia, PhD, HEC-C (gdcamp@uw.edu)

Thomas Cunningham, PhD, MA, MS, HEC-C (Thomas.V.Cunningham@kp.org)

Laura Guidry-Grimes, PhD, HEC-C (GuidryL@ccf.org)

Adira Hulkower, JD, HEC-C (ahulkowe@montefiore.org)

Debjani Mukherjee, PhD, HEC-C (dem9199@med.cornell.edu)

Devan Stahl, PhD, HEC-C (Devan_Stahl@baylor.edu)