JHAH Ethics Consultation

What is an ethics consultation?

The Ethics Consultation Service and Ethics Committee support patients, families and caregivers as they work together to find solutions to ethical questions regarding patient care. 

An ethics consultation helps people in healthcare, and patients and their family members answer the question "what is the right thing to do?" in a caring and supportive environment. It can offer recommendations that healthcare providers and the patient (or the patient’s family) may use in their decision-making, while retaining the authority and responsibility to make their own decisions. 

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

Who can request a consultation?

Anyone involved with a patient can ask for an ethics consultation, from the patients themselves, their families, the attending physician, and healthcare team members, to healthcare managers and administrators. 

What type of cases qualify for a consultation?

A few examples of cases that qualify for an ethics consultation include:

• Uncertainty as to who should make healthcare decisions or how to make those decisions for patients too sick to speak for themselves.
• Conflict arising between values or religious beliefs and a recommended course of treatment.
• Disagreement over whether starting, continuing, or ending treatment, such as breathing tubes or feeding tubes, is the right thing to do. 
• Moral distress about a health care decision. 
• A complex medical situation that also raises ethical concerns.
• Conflict arising between the autonomy of the patient and treatment provided by healthcare staff.
• Addressing uncertainty as to who should make treatment decisions for a patient who is incapable of participating in the treatment decision-making process for themselves.

How do I ask for an ethics consultation, and what happens when I do?

A patient or their appropriate decision-maker can place a request for an ethics consultation with any member of the healthcare team caring for the patient. The team member will then contact the Ethics Consultation Service or the Medical Ethics Committee.

• A patient/family member can send a direct e-mail
• The ethics consultant/committee will contact the relevant parties and assess the situation with those involved.
• If appropriate, the ethics consultant/committee will facilitate a discussion among the people involved to help clarify values and reach a consensus on an ethical care plan.

How long does the process take?

Depending on the urgency and the acuity of the situation, the process from start to finish for an ethics consultation could take a few hours (for some patient treatment questions) or a few days or even 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 as well.