The goal of ethics consultation is to support informed, deliberative decision making on the part of patients, families, physicians, and the health care team. By helping to clarify ethical issues and values, facilitating discussion, and providing expertise and educational resources, ethics consultants promote respect for the values, needs, and interests of all participants, especially when there is disagreement or uncertainty about treatment decisions.
Whether they serve independently or through an institutional ethics committee or similar mechanism, physicians who provide ethics consultation services should:
- Seek to balance the concerns of all stakeholders, focusing on protecting the patient’s needs and values.
- Serve as advisors and educators rather than decision makers. Patients, physicians, and other members of the care team, health care administrators, and other stakeholders should not be required to accept the consultant’s recommendations. Physicians and other institutional stakeholders should explain their reasoning when they choose not to follow the consultant’s recommendations in an individual case.
- Inform the patients when an ethics consultation has been requested (if the request was not made by the patient or family) and seek patients’ agreement to participate. Ethics consultants should respect the decision of a patient or family not to participate, whether that decision is indicated formally through explicit refusal or informally by not taking part in discussions.
- Respect the rights and privacy of all participants and ensure that appropriate steps are taken to protect the confidentiality of information disclosed in the consultation.
- Have appropriate expertise or training—for example, familiarity with the relevant professional literature, training in clinical/philosophical ethics, or competence in conflict resolution—and relevant experience to fulfill their role effectively.
- Adopt and adhere to policies and procedures governing ethics consultation activities in keeping with medical staff bylaws, including accountability and standards for documenting the consultation in the patient’s medical record.
- Ensure that all stakeholders have timely access to consultation services in nonemergent situations and as feasible for urgent consultations.
AMA Principles of Medical Ethics: IV, V
Visit the Ethics main page to access additional Opinions, the Principles of Medical Ethics and more information about the Code of Medical Ethics.