Accessing an Ethics Consultation

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What is an ethics consultation?

An ethics consultation is a service available in most Canadian hospitals and health service organizations. Its purpose is to provide support to patients, continuing care residents/clients, families, health professionals and health administrators who are facing difficult ethical questions regarding the care of a patient or client.

In most organizations, the ethics consultation service does not make decisions for others. Instead, it facilitates a process with the relevant people involved to help clarify the nature of the ethical issue arising in the care of a patient or resident, explore ethically acceptable alternatives, and identify a path forward. In other words, an ethics consultation is designed to help people in healthcare to answer the question "what is the right thing to do?" in a caring and supportive environment. Patients, family members and health care providers retain the authority and responsibility to make their own decisions.

In the process, an ethics consultation can help to ensure that varying perspectives are aired and that dialogue to address the issue is respectful, inclusive and confidential.

Who can request a consult?

In most Canadian health care organizations, anyone involved with a patient or client can ask for an ethics consult - from patients themselves, their families, the attending physician, other members of the health care team - to health care managers/administrators. 

Timelines

Typically, an ethics consultation service is able to respond quickly to a request for support. Depending on the urgency and the acuity of the situation, the process from start to finish for an ethics consultation could be in hours (for some patient treatment questions) or days/weeks (for more complex, less urgent issues). 

The subject of ethics consultations are also not necessarily limited to current issues and decisions. Much can be learned by reviewing past situations. Similarly, it is a good idea to explicitly think and talk about the ethical aspects of future opportunities and challenges.

Who “does” ethics consultations?

A growing number of health care organizations in Canada have clinical ethicists/bioethicists on staff who facilitate ethics consultations. In other cases, an organization may rely on members of its clinical ethics committee, usually composed of care providers with additional training in ethics. Other health care organizations utilize personnel from affiliated academic institutions (e.g., in the philosophy or religious studies department) to provide the service. 

How do you access an ethics consultation?

In many cases, ethics consultations can be accessed by contacting the ethicist on staff or the chair of the organization's clinical ethics committee. Often, this person can be accessed through the hospital or healthcare organization's switchboard.