Navigating the complexities of patient care can be a daunting task for healthcare providers. Between the myriad of treatment options and variety of patient preferences, it’s no wonder that clinicians may find themselves unsure of the best course of action. Fortunately, clinical ethicists specialize in providing guidance through these difficult situations. The following will depict how ethicists add value to clinicians.
Clinical ethicists work with patients, families, healthcare providers, and even hospital administrators to identify and resolve ethical dilemmas that arise during patient care. Their services promote good communication, understanding, and decision-making among all parties involved, while also respecting the values, needs, and interests of patients. From conflicts over treatment options to concerns about privacy and confidentiality, clinical ethicists provide expertise and educational resources on ethical issues that arise in healthcare settings.
It’s important to note that clinical ethicists don’t make decisions for patients or other parties, nor do they impose their own values on others. Instead, they act as third-party mediators, balancing the concerns of all stakeholders to do what’s best for the patient. By enhancing ethical awareness and supporting the clinical team’s desire to promote the dignity of the patient, clinical ethicists play a vital role in ensuring the best possible outcomes for patients and their families.
Clinical Ethicists Enhance Ethical Awareness
Clinical ethicists play a crucial role in enhancing the ethical awareness of clinicians in complex and uncertain situations. They provide a framework and process for identifying and analyzing ethical issues that arise and offer guidance based on relevant ethical principles, standards, and codes of conduct. Let’s explore the four main roles of clinical ethicists in more detail.
Ethicists Help Identify and Analyze Ethical Issues
One of the main roles of clinical ethicists is to help clinicians identify and clarify the ethical issues involved in a particular case. They assist in determining the patient’s preferences and values, the benefits and burdens of different treatment options, institutional policies that apply, and the moral obligations and responsibilities of clinicians. Ethicists analyze these issues by applying ethical frameworks, such as the four principles of autonomy, beneficence, nonmaleficence, and justice, or the four topics of medical indications, patient preferences, quality of life, and contextual features.
Ethicists Offer Guidance and Recommendations
Clinical ethicists provide guidance and support clinicians as they navigate complex ethical situations. Ethicists are the coach that recommends guiding principles to be applied by the clinician. This looks like asking wondering questions to ensure proper understanding and enlighten a path forward based on relevant ethical principles, standards, and codes of conduct. Sometimes, clinicians talk through cases to ensure that they are acting appropriately. Ethicists can serve as a coach to make sure that the principles have been applied appropriately. For example, they may help clinicians respect a patient’s autonomy by informing them of their right to consent or refuse treatment or by involving them in shared decision-making.
Ethicists support clinicians as they balance the principles of beneficence and nonmaleficence, weighing the risks and benefits of different interventions and considering the patient’s quality of life and goals of care. Clinical ethicists ensure that the principle of justice is upheld by ensuring the fair allocation of resources and addressing issues of discrimination or disparity.
Ethicists Facilitate Dialogue and Deliberation
Clinical ethicists are experts at facilitating dialogue and deliberation among different perspectives and values in a given case. They foster collaboration and communication among interdisciplinary team members who may have different roles or expertise in a specific case. By facilitating dialogue and deliberation, clinical ethicists can help promote respect for diversity, tolerance for ambiguity, empathy for others, and mutual understanding among all participants. This is an important skill they apply to resolve conflicts or disagreements between patients, families, and clinicians over treatment goals or options.
Educating Clinicians on Ethical Theories, Concepts, and Methods
A fourth role of clinical ethicists is to educate clinicians on ethical theories, concepts, and methods that can inform their practice. For example, ethicists can introduce clinicians to different ethical theories or approaches that can provide a foundation for ethical reasoning or decision-making. It is often helpful to explain how key ethical concepts or terms may be relevant to a case, such as informed consent, surrogate decision-making, advance directives, futility, or palliative care. The greatest takeaway from clinical ethics consults is often clinicians learning how to use different ethical methods or tools that can assist them in analyzing or resolving ethical issues, such as case analysis, ethical principles, ethical frameworks, or clinical algorithms. By educating clinicians on ethical theories, concepts, and methods, ethicists can help enhance the practitioner’s knowledge, skills, and confidence in dealing with ethical aspects of their practice.
Clinical Ethicists Support the Clinician’s Professional Integrity
Clinical ethicists play a crucial role in supporting professional integrity for clinicians. They assist clinicians in making ethical decisions by respecting their autonomy and conscience, helping them balance their duties and obligations, encouraging self-reflection, and assisting them in resolving conflicts of interest or role. Let’s take a closer look at how clinical ethicists perform these functions.
Respecting the Conscience of Clinicians
Clinical ethicists respect the autonomy and conscience of clinicians by acknowledging their moral agency and responsibility in making decisions that affect their patients’ well-being. Rather than imposing their own values or opinions, clinical ethicists serve as advisors and educators. They facilitate dialogue and deliberation among all stakeholders involved in a case. They help clinicians identify and articulate the ethical issues and values at stake, explore the relevant facts and evidence, consider the perspectives and preferences of patients and families, and apply ethical principles and frameworks to guide their reasoning. This approach empowers clinicians to make informed and consistent decisions that align with their professional standards and personal convictions.
Balancing Duties and Obligations
Clinical ethics consultation helps clinicians balance their duties and obligations to patients, colleagues, institutions, and society by providing a structured and systematic process for addressing ethical conflicts and dilemmas. Clinicians often face competing or conflicting demands from different sources, such as patient autonomy versus beneficence, individual rights versus public health, professional loyalty versus institutional policy, or personal interest versus social justice. These situations can create moral distress or uncertainty for clinicians, who may feel torn between different courses of action or unsure about what is right or wrong. Clinical ethicists help clinicians navigate these complex situations by clarifying the nature and scope of their obligations, weighing the benefits and harms of different options, evaluating the feasibility and acceptability of different solutions, and seeking consensus or compromise among different parties.
Encouraging Self-Reflection
Clinical ethics consultation encourages clinicians to reflect on their own values, beliefs, and assumptions by providing a safe and supportive space for moral inquiry and learning. Clinicians may have implicit or explicit biases or prejudices that affect their judgment or behavior towards patients or colleagues who are different from them in terms of culture, religion, race, gender, sexuality, disability, or other factors. They may also have unexamined or uncritical assumptions about certain ethical issues or principles that may limit their understanding or appreciation of alternative viewpoints or arguments. Clinical ethicists help clinicians examine their own moral frameworks and perspectives by challenging them to question their assumptions, consider other possibilities, acknowledge their limitations, and appreciate diversity.
Assisting in Resolving Conflicts of Interest in Role
Clinical ethics consultation assists clinicians in resolving conflicts of interest or role by providing guidance and support for managing competing or incompatible interests or expectations. Clinicians may have personal or professional interests that conflict with their duties or responsibilities to patients or institutions. For example, they may have financial ties to a drug company that influences their prescribing practices; religious beliefs that prevent them from providing certain services; family relationships that affect their involvement in a case; or dual roles as researchers and caregivers that create ethical tensions. Clinical ethicists help clinicians identify and disclose potential or actual conflicts of interest or role, evaluate the impact of such conflicts on patient care, seek ways to minimize or eliminate such conflicts and ensure accountability and transparency in their actions.
Conclusion
In the healthcare industry, clinical ethicists are an essential resource for clinicians. They help clinicians navigate complex ethical situations, ensuring that they make ethical decisions by respecting their autonomy and conscience, balancing their duties and obligations, and assisting them in resolving conflicts of interest or role. By doing so, clinical ethicists contribute to the quality of patient care, the well-being of clinicians, and the ethical culture of healthcare organizations. Ethicists are a valuable resource to ensure we are doing what is best for the patient.