Consultation

Consultation Image

Clinical ethics focuses on decision-making in the health care setting, where patients, families and health professionals often face difficult decisions about medical treatments and patient care. These decisions may involve moral values, religious beliefs, or professional duties and guidelines. Clinical ethics offers ways to identify and weigh the values at stake so that the individuals responsible for decisions can make good choices. Ethical questions and concerns arise when the right thing to do is not clear, or when disagreement exists about what is best for a patient.

Ethics Consultation Service

Ethics consultants provide guidance on challenging issues such as ethical dilemmas in end-of-life care, the application of advanced directives, and surrogate decision-making. Consultations may be requested by patients, family members of the patient, or any individual involved in the patient's care.

What should be done when there is a clinical ethics problem?

Health care providers should rely upon their own experience, knowledge, and consultation with colleagues.  The first step is to clarify all participants’ understanding of the problem.  Frequently situations that appear to be ethical problems are actually communication failures.  First, assure clear communication.  Chaplains and social workers are frequently helpful in ensuring clear communication.

After consultation with key persons involved in the care of the patient, when it is determined that there may be an ethics problem that clear communication cannot resolve, the Ethics Committee Consultation Service should be called.  Any person involved with the care of a patient can ask for an ethics consultation (e.g., physician, nurse, other care provider, patient, family)

Examples of clinical ethics problems include:

  • There is disagreement between the patient, loved ones, and/or care providers about “what is in the patient’s best interest.”
  • Should life-sustaining treatments be started or stopped?
  • Who should serve as a patient’s surrogate decision-maker?
  • How should an advance directive be applied in a particular circumstance?
  • What will happen in an ethics consultation?

One or more members of the Ethics Committee will respond to a request for ethics assistance.  They are trained to deal with ethically, legally, emotionally, and spiritually sensitive situations with both compassion and fairness.  The consultant(s) may review the medical record, discuss concerns with the attending physician and other key care providers, convene a family conference, offer a recommendation, and/or write a note in the medical record.

Ethics Consultants will help those involved in the difficult situation:

  • Identify specific ethical issues in the care of the particular patient;
  • Carefully discuss and analyze the ethical issues with all parties;
  • Recommend an ethical resolution to the problem.

Ethics Consultation is an advisory service.  Patients, decision-makers, and health care providers remain responsible for choices that must be made.  There is no charge for Ethics Consultation.