What is an “ethical decision”?
“Ethics” examines our basic moral values, helping us understand what we should or should not do. Often values can conflict with one another. For example, most people value telling the truth. They also value acting in a way that will not harm other people. But what if telling someone the truth about their medical condition could cause them harm? Any time that two or more moral values conflict; an ethical decision must be made.
Labrador -Grenfell Health offers an Ethics Review Service for patients, families and staff. It is available to anyone who needs help in making difficult ethical decisions about patient care.
How can an ethics review help me?
An ethics review is an opportunity to discuss an ethical issue and decision you must make. You will meet with others familiar with your situation, and who have experience dealing with the kind of decision you must make. Those involved in the Ethics Review will not tell you what to do, but they will help you understand and resolve your conflicting values and feelings.
An Ethics Review is not intended to address personal problems between patients and staff, between family members, or between staff members. Other avenues are available to handle such issues.
What kinds of ethical decisions can we help people with?
The Ethics Review Service will help people with many different kinds of ethical decisions. Examples include:
- Should we turn off the respirator and allow this (terminally ill) patient to die?
- Should we consent to the insertion of a feeding tube?
- Should we tell our loved one that he/she has cancer and only has a short time left to live?
- We want to do what is best for our child, but we don’t know what that is. How do we decide?
How soon can I arrange a review?
Some life and death issues require immediate attention, while other issues allow more time for reflection. The Ethics Review Service will respond to a request in the shortest time possible. In an emergency situation a full review and broad discussion may not be possible, but a member of the service will be available as soon as possible, upon request. A full review and broad discussion can usually be arranged within three days.
What information should I provide when I make a request?
Please provide, where possible, the following information:
- Brief description of the issue/concern.
- Identification of the hospital/facility the issue or concern has arisen.
- Names of other individuals who may be able to provide further information.
- Any deadlines that those arranging the review should be aware of.
What happens to my request?
Your request will be reviewed with you by a member of the Ethics Committee, usually within two to three days, to ensure that you have adequate and appropriate information to explore all options within the Ethics Service.
If you still wish to have your issue/concern addressed by an Ethics Review Group, a meeting will be arranged. The Ethics Review will provide an opportunity to discuss the issue/concern with a group of health care professionals who offer a variety of viewpoints and opinions that may assist with your decision-making. The committee’s purpose is to assist you in your decision-making process – not to make a decision for you.
The Ethics Review provides a safe environment and non-judgmental process for open and honest discussion among interested and involved parties. This process presumes the right to confidentiality and privacy for all participants. The value of this process lies in the openness and free discussion that it fosters. Views put forth in discussion throughout this process are not binding.
Who will be present at an ethics review?
Who attends an ethics review will depend on the issue, and the kind of consultation requested. We encourage open and frank discussion of all ethical concerns, but we recognize a decision can be a very private matter. Only those involved in the particular case will attend. The Ethics Review Group will normally include:
- The person(s) who requests the ethics review, this includes a patient, substitute decision maker, family member or staff member.
- At least one support person for the one who has made the request (if he or she wishes to have a support person).
- A professional ethicist, members of the Ethics Committee & applicable informed people are available from the respective clinical program area.
- The physician responsible for primary care.
- One or two other members of the patient’s care team members (e.g. nurse, pastoral worker, social worker, respiratory therapists, etc.) who are most familiar with the case.
How can I arrange for an ethics consultation?
All patients, family and staff can bring forward an issue for an ethics review by contacting the Patient Safety and Quality Department.
Patient Safety and Quality Department
P.O. Box 7000, Station C
Happy Valley-Goose Bay, NL