What Can I Expect from a Clinical Ethics Consultation?
How Can an Ethics Consultation Be Helpful?
Who May Request an Ethics Consultation?
How Do I Request an Ethics Consultation?
Are there issues beyond the scope of the Ethics Consultation Service?
What Can I Expect from a Clinical Ethics Consultation?When you call for an ethics consultation, you can expect to talk with someone committed to providing you with support, understanding and assistance as you, your family, and your healthcare team work through challenging questions. You can expect to be treated with dignity and respect. You can also expect compassion, confidentiality and transparency as we respond to your particular needs.
Because each patient’s situation is unique, the steps in the process will vary. Some situations are resolved quickly and simply by facilitating communication or providing valuable information; but other situations may be more involved and could require one or more organized meetings with the patient, the patient's family, and/or the healthcare team.
Weighing the benefits and burdens of treatment from the perspective of patients can yield very different results than a physician’s perspective of treatment benefits and burdens. Identifying which treatment is right for each patient is made more complex given the multitude of choices and technological advances available to clinicians and patients. Conflict can arise when
- disagreement exists about the values, wishes, goals, hopes, and fears of the patient, and what the patient would want for himself/herself in this situation;
- values differ between stakeholders (patients, families, physicians, and staff) (i.e., a preference for a greater quality of life, even if it means fewer days versus living more days even though the quality of those days is diminished);
- communication has been unclear or strained between stakeholders;
- complicated decisions divide the health care team and family during the severe stress of critical illness.
Clinical Ethicists help stakeholders clarify and resolve ethical issues that can often be at the root of medical decision-making conflicts or confusion. This process can involve reviewing the patient’s medical record, meeting with the patient and family and facilitating discussions with physicians, nurses, and other caregivers. A summary of the consultation is recorded in the patient’s chart.
The Ethics Consultation team does not make decisions or tell patients, families, and physicians what to do; we make recommendations and suggestions. The decision-making authority rests with the physicians, patients, and families.
How Can an Ethics Consultation Be Helpful?Below are examples of situations in which an ethics consultation can be helpful:
- Discerning how to respect patient preferences regarding treatment decisions when the patient is too sick to speak for himself/herself
- Addressing uncertainty as to who should make treatment decisions for the patient who is unable to participate in making treatment decisions for himself/herself
- Resolving disagreement over whether starting, continuing, or ending treatment, such as breathing tubes or feeding tubes, is the right thing to do
- Facilitating discussion when there are differences of opinion between physicians and patients (or their family members) about appropriateness of treatments
- Providing support to a patient or family member making decisions about the types of treatment the patient would or would not be willing to endure
- Helping patients, families, physicians, and staff discern the role of personal values, religious, and cultural traditions in ethical decision making
- Alleviating moral distress about treatment decisions that appear not to be in the patient’s best interest
Who May Request an Ethics Consultation?
Any person may request an ethics consultation at any time.
People often tell the Ethics Consultation Service they wish they had requested a consultation sooner. If you think a consultation might be helpful, or just have a question about consultations, feel free to call and ask. The Ethics Consultation Service is available to patients and customers of Spectrum Health and their families, as well as physicians and staff who work in Spectrum Health hospitals and medical group locations. There is no charge for an ethics consultation.
How Do I Request an Ethics Consultation?Patients and their family members
Patients and their family members may request an ethics consultation by either of the following channels:
- Ask the patient’s bedside nurse to place an ethics consultation request; or
- Contact the hospital operator at 616.391.1311 and request an ethics consultation.
Physicians and Staff
The clinical ethicist on-call can be reached through Perfect Serve by following these simple steps:
- Log in to InSite
- Hover the cursor over Clinical Connections and select PerfectServe.
- Select the BW Butterworth tile.
- Click on All Other Departments.
- Type ethics in the search box, and press Enter.
- Select either Ethics BL BW or Pediatric Ethics HDVCH.
- The name of the on-call Clinical Ethicist will appear. Click Next.
- Complete the required fields* and press Send.
The on-call clinical ethicist will return your call within 15 minutes.
Are there issues beyond the scope of the Ethics Consultation Service?Yes. There are value-laden issues that are best addressed by other resources. For example
- General complaints should be addressed with the nurse supervisor or Patient Relations
- Financial questions should be addressed by the Finance Department
- Requests for legal advice should be addressed by patients’ personal attorneys
- Requests for spiritual advice or support should be referred to Pastoral Care or the patient’s own spiritual leader
- Requests for medical opinions should be addressed by physicians