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Password: Ethics

Background:
The September Ethics for Lunch (EFL) will review themes arising from the ethics consultation service over the past year. This will be an opportunity for the hospital community to learn about the ethical issues that are faced by patients, families, communities, and members of the healthcare team. We will review the characteristics of the patients for whom consults were requested and the members of the health care team who requested the consult. The panel will review how the ethics consult team leader responds to a consult request. Often these requests were handled with a phone call. Sometimes the ethics consultant recommended involvement of other services such as palliative care, social work, chaplaincy, or the legal department. Sometimes the request required team-based ethics discussions or meeting with the patient or family. In the past year, virtual platforms facilitated these conversations and permitted more ethics team members to participate.

The panel will review the common themes seen in consult requests. Many of the cases involved a disagreement about the care plan. Some of the cases involved surrogate decisions makers who were not easily available for discussions, especially given the visitor restrictions resulting from the COVID-19 pandemic. Some cases involved COVID-19 patients who had prolonged hospitalizations and no clear path to recovery. Sometimes the cases highlighted the moral distress of health care team members. Other times ethics consultation was requested as part of hospital policy, such as when the health care team was concerned about potentially inappropriate or medically ineffective treatment.

Objectives:

1. Describe the characteristics of patients and care teams for whom ethics consultation has been requested.
2. Discuss the ways that the ethics consultation service responds to requests.
3. Highlight themes of the ethics issues encountered in ethics consultation requests.