Innovation in Collaborative Clinical Ethics Consultation

Dramatic changes transformed life in the last century. People moved from close families in rural small towns to far-flung locations with populations clustered in big cities. Simultaneously, medical technologies developed rapidly. The combination of these radical developments spurred the need for clinical ethics consultation in hospitals to address the complex issues that arose with new technology often involving patients living without support from an extended family network.

The clinical ethics consultation model that evolved in response to those needs often provides service from a single Bioethics expert (sometimes two). When summoned, the clinical ethicist arrives at the bedside, and to varying degrees, takes on an active role in communicating with the patient or family. This prevailing structure meets immediate needs with limited staff.

At our hospital, we recognized an additional need, and therefore took a turn in the opposite direction. We became acutely aware of the need for clinical ethics education. Given pressure for curriculum time in medical education, medical professionals typically receive minimal, cursory medical ethics education. We therefore designed our ethics consultation service to both meet the requesting clinical service’s need for guidance, while addressing the unfortunate educational deficit we identified.

We created a broadly inclusive, interdisciplinary ethics consultation service of 45 members, including medical students, residents, and fellows. This panel will describe what we developed and report on how we conduct ethics consultations. Our presentation will include data on cases we encounter, services requesting consults, participants involved, and our distinctive educational consult notes.