Making decisions amid modern medicine’s complexities is not easy. Ethical questions can arise, for instance, when a patient has lost the capacity to make decisions, when there is uncertainty about who should decide, when it is unclear whether the burdens of a treatment are worth the expected benefits, or when values appear to conflict. Clinical Ethics Consultation is an advisory service designed to assist patients, families, and all health care professionals in identifying, analyzing and resolving ethical dilemmas and issues.
University of Chicago patients, families, doctors, nurses, chaplains, social workers, or anyone involved in the case.
Consults are done by physicians who have trained in clinical medical ethics. At the University of Chicago, more than 20 physicians serve as ethics consultants for one to two months. In addition, current ethics fellows (about 10 each year) train under the supervision of ethics attendings.
An Attending Ethicist will review each request to see if a full consult is warranted. Sometimes the concern may only be a communication problem. A full consult will generally involve a review of the case by the Ethics Attending and Ethics Fellow, and conversations with members of the health care team, the patient, and/or family as appropriate. The consultants help to facilitate a discussion and clarify the ethical issues to assist decision making. A formal consult note is placed in the patient’s chart by the attending ethics consultant. Each week, every case seen during the previous week is reviewed by an interdisciplinary ethics committee that includes physicians, nurses, social workers, medical students, ethicists, and legal scholars.
Sometimes, a University of Chicago faculty member, hospital employee, or trainee has an ethical question that is not necessarily specific to an individual patient but relates to an institutional policy or practice. Any University of Chicago employee may contact the Ethics Consult Service for an informal consult. Together, the employee and ethics team can decide if a more formal consult is necessary.