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Ethics Consultation and Advisement

The Australian Health Ethics Committee (one of the principal committees of the National Health and Medical Research Council) is Australia’s health ethics peak body. In 2014, AHEC issued a Consensus Statement which highlighted “the importance of clinical ethical services for the delivery of quality healthcare in Australia.”

Sometimes, there is uncertainty about what to do for a patient. Or there may be disagreement, perhaps within the treating team, or within the family, or between the patient and the treating team. In these circumstances, either the patient or the treating team may wish to speak to a clinical ethics service. The clinical ethics service may offer the following:

Explanation: If a patient does not understand the reason why some treatments are not being offered, a clinical ethics service might be able to provide an explanation. For example, even if a patient wants to try a novel treatment, the clinical ethics service might explain that clinicians cannot be forced to provide treatments which they do not consider to be beneficial.

Recommendation: When there is uncertainty about what to do, because of their training in ethics the staff at a clinical ethics service may be able to recommend a possible way forward. They might make these recommendations either to a patient or to the treating team.

Decision: Sometimes, it is the role of a clinical ethics service to decide whether or not a proposed treatment is consistent with the hospital’s ethical standards, and therefore whether or not this proposed treatment may be offered in this hospital. Important decisions like these should never be made lightly.

Verification: In these cases, the treating team seeks confirmation from the ethics service that a proposed course of treatment is both appropriate and consistent with the ethical standards of the hospital. Clinicians appreciate the opportunity to speak about their ethical concerns. They often find support from a clinical ethics service very reassuring.

Mediation: If there is disagreement, a clinical ethics service might be able to broker a way forward that everyone can agree on. For example, if there is disagreement about withdrawing life-sustaining treatment, the clinical ethics service might broker agreement that the treatment will continue for another two days, but if there is no improvement in the patient it will then be withdrawn.

All the above are services which may be offered for a current active case. A clinical ethics service may also offer:

Prospective consultation: While a case is still on the horizon, the treating team may seek an opinion from a clinical ethics service. The ethics service might be asked to offer a recommendation about possible treatments, or to consider whether a proposed treatment is consistent with the ethical standards of the hospital.

Retrospective case analysis: Sometimes, a clinical ethics service is asked to review a past case or cases so that the findings of this review might inform future treatments, quality assurance and improvement, staff education, or the development of better policies and procedures within the hospital.

Development of policies and procedures: A clinical ethics service might also contribute to the development of policies and procedures either leading or contributing to the process of policy development. 

The Caroline Chisholm Centre for Health Ethics strives to be always available for ethics consultation and advisement. While we cannot promise to respond immediately, we always try to respond to inquiries as quickly as possible