Clinical Ethics Consultation

Every day in NSHA clinical care settings, patients, family members and attending health care providers are required to make challenging decisions, and, in some circumstances, the outcomes of these decisions are life-altering. Often, in complex clinical circumstances, more than one ethical principle and/or value is relevant (at play), and the concurrent application of these principles/values may lead to the emergence of competing obligations that need to carefully balanced by the relevant decision makers.  

Any member of the NSHA community may request a clinical ethics consultation (CEC) – patients, family members, health care providers, staff members, students and volunteers. CECs are performed when there are substantial ethics elements to direct-care, clinical circumstances. When the matter/issue is urgent, Ethics NSHA responds within two regular working days. Requests made over the weekend or on holidays are addressed on the first, regular working day after the weekend or holiday. Typically, it is best to request CECs sooner rather than later in the development of complex, clinical circumstances where significant conflict has emerged or is emerging. Although the performance of a CEC often supports and facilitates decision making in clinical circumstances with ethics dimensions, Ethics NSHA consultants do not make clinical decisions – the final responsibility for making an ideally-shared, heath care and treatment decision lies with the patient, substitute decision maker(s) (as appropriate) and the most responsible health care provider.

Many CEC requests can be effectively and efficiently addressed with a telephone conversation (teleconsultation) or by an in-person meeting of the requestor and an Ethics NSHA consultant. Other requests require one of more meetings of a larger group consisting of the core stakeholders in the clinical circumstances, i.e., typically, the patient, family and key members of the attending health care team.