Difficult patient care decisions? Consult an ethicist for clarity

ETHICS CONSULTATION IS A service that provides clarity, guidance, and support based on solid ethical principles in clinical situations where there are competing perspectives about what should or should not be done for a patient. Anyone — patient, family, or care team — can request an ethics consultation to help improve communication and think through a decision.

Ethics consultation also provides the Church’s gospel message and moral teaching within patient care decision making. Entities like the National Catholic Bioethics Center (visit ncbcenter.org for their free consultation service), the Catholic Health Association, and various Catholic health systems provide reliable ethics consultation services.

The most common reason for seeking a consultation is that there are competing voices about what should be done in a particular patient’s case, especially surrounding end-of-life care decisions. In these high-pressure situations, family members may disagree about what should be done for the patient: for example, to pursue further aggressive interventions or to focus exclusively on comfort goals. Ethics consultation can help a high-stress situation move forward with integrity and clarity.

Catholic health care ethics consultation in the United States commonly utilizes a document called the Ethical and Religious Directives for Catholic Health Care Services, 6th Ed., for moral and ecclesiastical guidance. These ERDs distill key moral principles of Church teaching as they apply to medical care. The document is published by the U.S. Conference of Catholic Bishops, is promulgated by each bishop in his diocese, and is accessible online for your benefit.

Ethics consultation also can influence other “everyday ethics” situations as well.

Let’s say a patient presents to a family physician with a viral upper-respiratory infection and demands an antibiotic. The physician faces an ethical dilemma. Antibiotics do not treat viral infections, provide no direct benefit to the patient, and may pose a risk. However, the risk for serious harm from antibiotics is low, and the physician wants the patient to have a positive experience. Should he prescribe antibiotics?

During the Covid-19 pandemic, a physician works as an outpatient allergy specialist at Wheeze ’n’ Sneeze Care. The mother of a 9-year-old patient, Henry, whom the physician knows well, calls in stating he is having a cough and congestion for the past four days as the pollen count continues to rise. She needs a letter stating he has allergies so he can return to school and not be quarantined for Covid symptoms. Should the physician write the letter, particularly without seeing the patient?

These issues have an ethical dimension because they shape the moral character of the people involved: do they act with integrity based on the truth, or do they make decisions that are more self-serving and self-centered?

If in doubt in a cloudy medical moral situation, request an ethics consultation to bring clarity and peace of mind.

Elliott Louis Bedford, PH.D., serves as the director of ethics integration at Ascension St. Vincent in Indiana and Ascension Via Christi in Kansas. He obtained his doctorate in health care ethics and Catholic tradition from St. Louis University in 2014. He is a member of the Catholic Medical Association.