Clinical ethics

Within the context of health care, ethics is referred to as clinical ethics. Its goal is to improve patient care and health professionals’ work by proposing solutions to ethical dilemmas arising in clinical practice.

Structure

To resolve ethical issues that may affect patients, their families and caregivers and to guide often difficult choices and decisions, the Network has a Clinical Ethics Board and a Regional Ethics Consultant in place.

Clinical Ethics Board

The Clinical Ethics Board is an interdisciplinary advisory committee whose job is to:

  • Coordinate clinical ethics issues throughout the Network;
  • Raise awareness of ethical issues within the health care setting and among employees by communicating information and delivering training;
  • Provide support when consultation requests are made.

Regional Ethics Consultant

The Regional Ethics Consultant is responsible for handling all consultation requests received from the Network. The consultant facilitates complex clinical ethics decision-making by recommending and suggesting solutions.

Clinical Ethics Board membership

The Regional Clinical Ethics Board is multidisciplinary, with representation from all zones. It is made up of the following members:

  • General practitioner;
  • Medical specialist;
  • Nurses (2);
  • Spiritual Care representative;
  • Social worker;
  • Health professional representing another profession;
  • Lawyer;
  • Community representative;
  • Ethicist or member with expertise in ethics;
  • Ethics Office Regional Manager;
  • Clinical services / nursing administration representative;
  • Director of Planning and Decision Support;
  • Vice-President of Performance, Quality and Corporate Services (ex officio member).

Who can request a consultation?

  • The patient;
  • A loved one or immediate family member of the patient;
  • The patient’s substitute decision-maker;
  • The attending physician, the nursing staff or an advisor involved in the patient’s care;
  • A member of the care team or a health professional (e.g. nursing staff member, psychologist, physiotherapist, social worker, etc.) involved in the patient’s care.

When to consult?

Anyone facing a difficult decision can request a clinical ethics consultation.

The following are examples of situations where a consultation can be requested:

  • Continuing or discontinuing treatment
    • When to discontinue treatment in the terminal phase?
    • Must treatments such as chemotherapy, dialysis or tube feeding always be proposed?
    • What decisions must be made when a patient is incompetent?
  • Disagreement on a patient’s care
    • What to do if the care team members cannot agree?
    • What to do if the patient refuses a treatment that the medical team advises?
  • Levels of care and do-not-resuscitate orders
    • Must efforts be made to treat the patient or only to provide pain relief?
    • Must a patient with reduced quality of life be resuscitated?

If the decision-making process is a difficult one, this may indicate that an ethical issue exists. The Ethics Consultant is available to support and advise you based on values, professional ethics and legislation.

Please refer to the Guide to Reflection
Around Ethical Conflicts.

How to request a consultation?

Contact Vitalité Health Network’s Ethics Consultant or Ethics Office.

Vitalité Health Network Ethics Consultant
Pierrette Fortin
Phone: 506-737-5233
E-mail: pierrette.fortin@vitalitenb.ca

Vitalité Health Network Ethics Office
Phone: 506-394-3368
E-mail: ethique.ethics@vitalitenb.ca