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In Reply

Key Words: Letter

It is unfortunate that Dr. Williams and Ms. Skeel have misinterpreted the intent of our series entitled "Clinical Ethics: An Important Role for the Consultation-Liaison Psychiatrist." I did not mean to imply that clinical ethics is exclusively the role for the C-L psychiatrist. The intent of the series of articles was to make our colleagues aware that they have certain basic skills that make them particularly well suited to play this role, given the additional training that is required to do so.

My observation that it would be easier to train a C-L psychiatrist in medical ethics and the law than to train nonclinicians (laymen) in clinical medicine and/or psychiatry was not intended to imply that "most ethicists are laypersons." I do believe, however, that professional medical training is essential to do this job effectively.

It was also not my intent to suggest that C-L psychiatrists entering the field of clinical ethics would obviate the need for nonpsychiatric clinical ethicists; rather it was that our training and skills could help us to play this role exceedingly well, were we to acquire the additional knowledge required to function effectively as such.

Dr. Williams and Ms. Skeel's letter states, "There is minimal discussion about collaboration between clinical ethicists and C-L psychiatrists." This does not reflect our lack of awareness of the value of such collaboration. It was just not the intent of this series of articles to cover the entire topic of clinical ethics. Our own institution maintains such collaborative relationships and finds them to be most helpful. As I state in the conclusion of my article, it was my hope that this symposium would motivate more of our colleagues in C-L psychiatry to play a larger role in this important new aspect of medical practice.

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