Ethics consultation is supported by the services of a full-time ethicist. When Dr. Mullen is consulted, an initial triage discussion takes place and multi-disciplinary clinical ethics patient meetings are organized as needed. In this way, all of the pertinent expertise such as health care providers, faith, cultural and community supports, can be drawn upon to help move decisions forward.
This approach differs from traditional ethics consultations and clinical ethics committees in that it is highly flexible in providing the precise expertise required to achieve the best answers and provide support to patients, families and the health care team. It is also an inclusive and transparent process.
Inpatient and outpatient care
Any person directly involved in a patient’s care can request an ethics consultation, including patients and family, nurses, physicians, social workers and other health care professionals. The ethicist meets with the person(s) making the request and usually ascertains at this stage whether the concern is an ethics question. The patient chart and relevant literature are reviewed and discussions planned. Any consultation, discussion and recommendations are documented in the patient’s record.
The ethicist is available for ongoing reflection and assistance in decision-making and provides support to patients, families and the CHEO team.
High frequency clinical consultation areas include informed decisions, best interests, substitute decisions, end of life care, cultural difference, privacy and limits.