The chiaroscuro of accountability in the second edition of the Core Competencies for Healthcare Ethics Consultation.

"Chiaroscuro" is a art technique that makes use of light and shade to suggest depth and solidity on a flat surface. I argue that the standards regarding accountability in the second edition of the Core Competencies for Healthcare Ethics Consultation (CC2), are chiaroscuro, because, despite the offered lists of competencies, it is very difficult to imagine how consultants might be held accountable to such standards. It is not clear to which of the many suggested standards a consultant should be held accountable, and even if one stipulates that only the tabulated competencies are meant as standards, the vague wording makes it hard to know how a consultant might fail to meet the standards or perform excellently. In addition, because terms such as "ethics" and "ethical" are not defined in the document, we are left with no way to determine whether consultants have made appropriate recommendations.The document is useful as a point of discussion, but not yet ready to serve as a tool for holding practitioners accountable.