For Physicians

The Clinical Ethics Consultation Service and Bioethics Committee
Assisting With the Most Difficult Ethical Dilemmas

What is a clinical ethics consultation?

Modern health care presents issues that are often complex and troubling for patients, families and caregivers. This can result in uncertainty about the most appropriate course of action. Members of the Montefiore-Einstein Center for Bioethics, who comprise the Clinical Ethics Consultation Service, are available to meet with patients, families or designated representatives, and care giving staff to help clarify and resolve these ethical dilemmas. Some of these questions include:

• Who should make health care decisions for patients who cannot decide for themselves or communicate their wishes?
• What should a patient do if he or she cannot understand what caregivers are saying about the need for certain tests or treatments?
• What should happen when there is strong disagreement or uncertainty among the patient, family and/or caregivers regarding what is best for the patient?
• What should a patient do if caregivers' treatment recommendation conflict with the patient's ethical, cultural or religious beliefs or traditions?
• When should life-prolonging treatments (such as feeding tubes or ventilators) be started, continued or stopped?

How can a clinical ethics consultation be requested?

Anyone involved in patient care — patient, family member or proxy agent, caregiver or other staff member — with an ethical concern or problem can directly access the Clinical Ethics Consultation Service.

Clinical ethics consultations can be requested by calling The Montefiore-Einstein Center for Bioethics at 718-920-4630. This service is normally available Monday through Friday, from 9:00 am to 5:00 pm. Outside of regular hours, if the patient care issue does not require immediate attention, a message can be left at the offices of the Montefiore-Einstein Center for Bioethics and will be responded to during the next working day.

Urgent consultations outside of regular business hours are handled by the appropriate Administration-on-Call, who can be contacted through the Department of Nursing.

What does the Bioethics Committee do?

The Bioethics committee at Montefiore Medical Center includes ethicists, physicians, nurses, social workers, patient representatives, clergy, risk managers and hospital legal counsel. The Committee is not a decision-making body, but rather a forum for study, review and advice. It meets on a regular and as-needed basis to:

• Explore different approaches to health care decision making and provide recommendation for resolving ethical issues in patient care;
• Assist in consultations when requested by the bioethics consultation Service;
• Participate in developing and reviewing Montefiore Medical Center policy when matters of ethics are involved; and
• Provide educational programs about bioethics issues, both within the Montefiore Medical Center and for the wider community.

Confidentiality

All deliberations of the Clinical Ethics Consultation Service and the Bioethics committee are confidential, and all information and records are protected. There is no charge for this service.