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The Institute of Catholic Bioethics has organized an Ethics Consult Service on behalf of the Mercy Health System. Institute faculty consult regularly on clinical cases that staff, patients, family and/or surrogates find morally troubling. Consultants are available by pager, 24 hours a day, seven days per week. Small Faculty from the Institute of Catholic Bioethics meet with the clinical staff, patients, and/or family to clarify the ethical issues and options and to facilitate the decision making process.
What is an ethics consult?
Making decisions amid all the complexities of modern medicine is not easy. Ethical questions can arise when a patient has lost the capacity to make decisions, when it is not clear whether the burdens of a treatment are worth the expected benefits, or when values appear to conflict. The Ethics Consult is an advisory service that is designed to assist patients, families and all health care professionals in identifying, analyzing and resolving ethical dilemmas.
No fees are charged for this service and all consults are kept strictly confidential.
How does one request a consult?
Each Hospital Ethics Committee and its sub-committee may be accessed 24 hours a day by calling the Hospital’s page operator and asking the page operator to page the designated team leader (or alternate) of the on-call case review team.
Every member welcomes any questions or requests for informal discussion of clinical ethics at any time. A number of members of these committees have formal training in clinical ethics and most have served for several years on these committees. A roster of current members can be obtained from the Chairs of the Ethics Committees.
A clinical ethicist is on-call each week. Upon receiving a request for a consult, the ethicist, in conjunction with the consult team, will make initial inquiries and along with the clinical staff arrange for a consult meeting that is appropriate to the needs of the parties involved in the case.
Who can request an initial consult?
Anyone may request a consult. Patients, families, doctors, nurses, social workers, chaplains, and any member of the medical team are encouraged to call us for assistance.
What happens in a consult?
An ethicist and consult team reviews each request to see what type of consultation is best suited to a particular situation. Sometimes, for instance, the concern may only represent a communication problem. A full consult will generally involve a meeting of the full ethics committee, the health care team, the patient, and/or the patient's family as appropriate. The consultants do not judge the quality of patient care or make decisions. They help to facilitate a discussion of the situation and clarify the issues from an ethical perspective.
Ethics Teaching Rounds
In 2003, the Mercy Health System in Philadelphia developed a new type of interdisciplinary teaching rounds. The purpose of Ethics Teaching Rounds is threefold: first, to better enable healthcare providers in supplying excellent care to their patients; second, to reduce the number of ethics consultations present within the hospital system; and third, to aid medical students, residents, interns, and fellows in their bioethical education in hopes of helping them focus on the best intentions of their patients. Ethics Teaching Rounds accomplish these goals by addressing patients' specific ethical issues. An interdisciplinary team, assembled by the hospital's ethics committee, takes part in these discussions and makes recommendations pertaining to patients' future care plans. Numerous legal and bioethical issues are discussed, such as informed consent, medical futility, competency, incompetency, quality-of-life, proper use of resources, end-of-life care, surrogate consent, distributive justice, confidentiality, etc. The ethical principles of respect for persons, beneficence, nonmaleficence, justice, fidelity, confidentiality, and privacy are explained in hopes of their utilization by the young physicians when dealing with patients. A holistic approach to care is stressed, that is, Ethics Teaching Rounds emphasize the need to address patients as whole persons. All aspects of personhood (body, mind, spirit) ought to be considered with these rounds. It is the goal of Ethics Teaching Rounds to help young physicians define their patients as more than persons with illnesses. Instead, patients are defined as persons who are in an unfortunate state of bad health. Because of their condition, patients must be cared for with compassion and understanding. All pertinent aspects of patients' lives should be addressed when attempting to provide excellent medical care. In other words, a patient's medical history, personal attitudes, religious beliefs, financial situation, intellectual capacity, spirituality, social tendencies, etc. should all play a role in his/her care plan.
Schedule of Rounds
- Mercy Fitzgerald Hospital - Friday every week at 10:00 a.m.
- Mercy Hospital of Philadelphia - Friday every week at 1:00 p.m.
- Mercy Suburban Hospital - 2nd and 4th Thursday of the month at 1:00 p.m.
- Nazareth Hospital - 1st and 3rd Monday of the month at 1:00 p.m.
Bioethics Case Study Rounds
Two Bioethics Case Studies are presented every other month by medical interns and residents in the areas of Internal Medicine, Surgery, Family Practice and Ob/Gyn. After each case is presented there is a discussion on the medical, ethical and legal aspects of the case led by an interdisciplinary group that consists of a Bioethicist, Attending Physician, Nurse Manager, Legal Counsel, Vice President of Mission, Pharmacist, etc.
Schedule of Rounds
- Mercy Suburban Hospital - every other month 8 a.m.