Policy Development and Review

Ethics Nova Scotia Health provides support to the development and review of health and organizational policies that have significant ethics dimensions. In the health domain, policies provide concrete direction as to how large health organizations, such as Nova Scotia Health, manage the crucially important, social goods of health and health care. Policies direct how health care providers, staff and patients/families interact; how patients are cared for; and how, and to whom, limited health resources are delivered. The application of an 'ethics lens', and the critical appraisal that such an analysis provides, have the capacity to add-value to the development and review of policies within health organizations. Additionally, the demonstration of the existence of a credible process for performing ethics reviews of policies is required for a health organization to be formally accredited by Accredication Canada.

The Ethics Leads Group is responsible for the organization and delivery of ethics support for the development and review of health policies within Nova Scotia Health. By doing so, Ethics Nova Scotia Health assists in building an internal capacity for policy development and health policy analysis within the health authority. In some circumstances, a health care ethics consultant who is a member of the Ethics Collaborations Team of the Dalhousie Department of Bioethics or another member of the Ethics Leads Group or Zone Ethics Committee member becomes an active, direct participant in the policy development working group that has been tasked to write a health policy or revise an existing policy. Such working groups consist of relevant administrators, topic/subject-area experts/specialists, participants from key, affected stakeholder groups and relevant resource persons.

In its engagement with policy development and review, Ethics NSHA pays particular attention to the identification of, and inclusion of members from, historically marginalized and otherwise disadvantaged social groups that are expected to be directly affected by policy development outcomes. This ensures that the perspectives and interests of these stakeholders are meaningfully included in policy development and review processes.

The processes for: 1) ethics review of health policies under development or revision by another Nova Scotia Health entity (e.g. a policy development working group, a policy revision working group, program, committee or individuals(s)), and 2) direct engagement of Ethics Nova Scotia Health in the development or revision of a health policy are described in detail, in NSHEN's policy manual (Ethics and Health Policy: The nuts and bolts) and in the Ethics Nova Scotia Health Standard Operating Procedures.

The comprehensive policy manual by teh Ethics Collaboration Teams of the Dalhousie Department of Bioethics. It focuses on providing practical assistance to members of teh Ethics Leads Group and Zone Ethics Committees in the performance of their policy work, i.e., the development and review of Nova Scotia Health policies that have significant ethics dimensions.

As proactive components of its policy work, Ethics Nova Scotia Health:

  • Provides leadership to the collaborative development of targeted, ethics-informed, decision- and recommendation-making frameworks, the use of which enhances accountability and provides legitimacy to the outcomes of policy-related decisions.  
  • Identifies specific needs for the development of health policies with ethics dimensions.

Sample NSHA Health and Organizational Policies with Ethics Elements

  • Decision Making about Potentially Life-sustaining Treatment Policy
  • Consent to Treatment Policy
  • Organ and Tissue Donation After Cardiocirculatory Death Policy
  • Personal Directives Policy
  • Disclosure of Adverse Patient Safety Events and Harm
  • Conflict of Interest Policy
  • Palliative Sedation Policy
  • Use of Seclusion on Mental Health Inpatient Services