Abstract
In “What the HEC-C? An Analysis of the Healthcare Ethics Consultant-Certified (HEC-C) Program: One Year In,” Horner et al. provide an overview of the new HEC-C examination and note many opportunities for improvement. Their contributions, and those of the Open Peer Comment (OPC) authors, will help the HEC Certification Commission improve the certification process. Horner and the authors of the OPC’s are grappling with the question, “what is the HEC-C exam trying to achieve?” Their answers determine whether they believe the American Society for Bioethics & Humanity’s (ASBH’s) nascent exam has potential. Horner et al. believe the HEC-C’s “goal [of HEC-C] is modest: to set an entry-level foundation for minimum experience, knowledge, and skill for clinical ethics consultation as a first step toward greater standardization and evaluation in the field.” Most OPC authors agree that qualifying for and passing an exam does not adequately attest to the full spectrum of an ethics consultant’s competencies. For example, a multiple-choice exam cannot effectively assess interpersonal, conflict resolution, and facilitation skills. Those skills must be evaluated by peers, colleagues, and ethics service chiefs. In fact, I do not know anyone who thinks successful completion of 400 hours of diverse HEC activities and one exam is sufficient. I agree with Horner et al. that “the HEC-C exam should not [emphasis added] be seen as an indication that a candidate has achieved a high level of proficiency in clinical ethics consultation.” Ultimately, the exam is one small part of the broader goal to ensure HECs are well qualified. It is the first step.