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What is an ethics consultation?

Health care delivery can be very complex, not only because of the increasing use of technology, but also because of the different values held by diverse populations. Individuals have a right to autonomy, which means they have a right to make their own decisions, once they are fully informed and are able to understand the risks and benefits of their decision. Sometimes an individual's values are in conflict with other people involved in their care, so an ethics consultation may be helpful before any final decisions are made.

An ethics consultation may be done by an individual, a team or an entire ethics committee. They will not only help patients and their families, but they will also help health care providers or those designated as surrogate decision makers when faced with a difficult decision.

 

Katrina Bramstedt, PhD
Health Education

An ethics consultation is performed by a medical ethicist when there is a medical ethics dilemma that needs resolution. Common consultation requests are: Should this patient have a  DNR Order (Do Not Resuscitate) or be full code (perform resuscitation)?  Should this patient get a feeding tube? A tracheostomy? Is this patient a good candidate for an organ transplant?  Is it ethically permissible to withdrawal life support on this patient?  This patient has no friends or family; who should function as surrogate decision-maker?  The patient is refusing treatment, what should we do?  The patient's family is demanding futile interventions, what should we do?

During the consultation, the medical ethicist interviews the patient, family and medical team; reviews the medical chart, living will, and relevant bioethics and medical literature; and makes a series of recommendations in a formal chart note in the patient's medical record. The recommendations outline the ethically permissible and impermissible options available to resolve or mediate the dilemma. Sometimes the ethicist will offer suggestions that also include second opinions from specialists, hospital transfers, and behavior contracts for non-compliant patients, and education (e.g., journal articles).

Anyone can request an ethics consult: the patient, the family, or the medical team. To learn more, see www.AskTheEthicist.com or read the book, Finding Your Way: A Medical Ethics Handbook for Patients and Families.

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Important: This content reflects information from various individuals and organizations and may offer alternative or opposing points of view. It should not be used for medical advice, diagnosis or treatment. As always, you should consult with your healthcare provider about your specific health needs.