Assistance with Ethical Challenges in Patient Care
Situations appropriate for an ethical consultation:
Disagreement regarding appropriate care choices of a patient and their family, designated health care representatives, involved staff of various disciplines, and physicians.
- Questions on applying hospital policies and procedures.
- End of life questions on how aggressively to treat a patient with poor prognosis.
- Conflicts of value in determining the best course of treatment for incapacitated patient.
- Perceived failure of a health care representative to act in accordance with a patient's expressed wishes or best interest.
- Interest in exploring ethical issues of a case with an interdisciplinary team.
- When there is frustration or concern regarding a complicated patient situation.
Options for those who need ethical assistance:
It is best that staff working closely with the situation be fully involved in resolving ethical challenges. Possible routes to resolving an ethical issue are:
- Discuss concerns with co-workers involved in the case, such as physicians, nurses, chaplain, respiratory therapists, physical/occupational therapists, care management, patient and family members
- Arrange a timely patient care conference of the main disciplines who are involved or may be included in the discussion of the issue as perceived from each team member's perspective
- Identify key issues with the primary care coordinator and manager of the unit to help determine what direction to take with the case.
- If the case remains conflicted and unresolved, contact either a co-chair of the Bioethics Committee, or executive secretary of the hospital, to convene a meeting to consider various options or possible solutions for the case. The conclusions of the committee are advisory in nature, and attempts are made to clarify issues, to encourage clear and consistent communication between staff and the patient and family, and to consider how various options may affect the outcome of the case.
- Determine if Risk Management, Compliance Officer, Executive Office, or Human Resources need to be contacted.
Goals of the Bioethics Committee Consultation:
· Respect all persons
· Clarify issues
· Apply pertinent policies
· Promote reflection and open discussion of issues
· Enhance communication
· Facilitate decision making
· Provide debriefing support to staff
· Avert crises
· Manage resources
· Promote resolution
To contact members of the Bioethics Committee to set up a case consultation, please call either Co-chair Brenda Yoder, 726-4478 or Kathy Mirabile, 726-2104.