Ruchika Mishra

As clinical ethics continues to professionalize, there is growing demand for trained clinical ethicists and expansion of clinical ethics fellowship programs. While existing discussions of professionalization have largely focused on competencies in knowledge, skills, and professional attributes, comparatively little attention has been paid to professional identity formation among clinical ethicists. Professional identity formation - the integration of a profession’s values, skills, knowledge, and behaviors into an individual’s sense of self - is widely recognized as essential for sustainable and meaningful professional practice in health care. This paper explores the role of clinical ethics fellowship training programs in fostering professional identity formation among trainees. Drawing on established literature in medical education and the author’s experience leading a long-standing clinical ethics fellowship within a large health system, the paper highlights three core elements of professional identity formation that should be embedded in clinical ethics fellowship training: experiential learning, reflection, and effective mentoring and professional socialization. Integrating these elements can help trainees internalize the role of the clinical ethicist, promote resilience and well-being, and support long term commitment to the field of clinical ethics.

This symposium collection of twelve narratives from individuals who experienced clinical ethics consultations provides perspectives from a group that has not been adequately explored in the bioethics literature. The authors represent a variety of stakeholders who received ethics consultations: healthcare providers and family members. This commentary will focus on three themes addressed in the different narrative accounts: the reasons for requesting an ethics consultation; the expectations of the narrators from the consultation; and the conclusions the authors drew from their experience of the ethics consultation.

This paper attempts to explore the idea of mind on the basis of René Descartes and Gilbert Ryle’s vision. Descartes, a 17thcentury philosopher, developed a dualistic theory that posits the mind and body as distinct entities. According to him, the mind is an immaterial, non- extended entity with consciousness and rational thought, while the body is a material substance subject to physical laws. In contrast, 20th-century philosopher Ryle rejected the idea of a separate mental realm and argued for the unity of mind and body. He criticized Cartesian dualism, proposing that mental states and mental processes are not separate from bodily behavior but are intricately intertwined with it. This comparative analysis delves into Descartes’s arguments for dualism, including the interaction between mind and body through the pineal gland and his ideas on the mind’s independence from the body. On the other hand, Ryle’s critique of dualism is examined, with a focus on his concept of “category mistake” and his advocacy for behaviorism, which prioritizes observable behavior over unobservable mental states. By exploring these two contrasting perspectives, this paper aims to comprehensively understand the historical development and implications of the notion of mind. It highlights the influence of Descartes’s dualistic framework on philosophical discourse and Ryle’s efforts to challenge it, emphasizing the importance of considering the relationship between mind, body, and behavior in understanding human cognition and experience.

On October 5, 2015, Governor Jerry Brown approved bill ABX2 15, the End of Life Option Act, making California the fifth state in the country to allow physician-assisted dying. The law was modeled after Oregon's 1997 Death with Dignity Act. When the legislative special session ended on March 10, 2016, California health care providers had only ninety days to respond to the state mandate before the law would take effect, on June 9, 2016. Experience with the law so far suggests several challenges with implementation.