What should be done to ensure that the care for this patient is both right and good? This is the ethical question that should be asked - and answered - in caring for every Geisinger patient. In some circumstances, however, it may be difficult to answer this ethical question. There may be questions or disagreements within the health care team about the most effective treatment. There may be conflicts within a patient's family about the best course of care for their loved one. And sometimes, conflict arises between the patient or the patient's family and the health care team. In situations like these, it may be helpful to seek guidance from individuals with expertise in clinical ethics - individuals who are educated and trained to resolve ethical conflicts and questions in patient care. It may be helpful to contact Geisinger's Ethics Advice and Consultation Service.
What is the Ethics Advice and Consultation Service?
The Ethics Advice and Consultation Service provides help to patients, their families and their clinicians whenever difficult ethical questions or concerns arise or when assistance is needed in improving communication - within families or between clinicians and patients and their families.
The Service can offer informal advice on a confidential basis or it can provide a more formal intervention, including the facilitation of meetings that bring together patients, their families, and their clinicians. The Service's recommendations are intended to advise and facilitate - but not replace - decision making by patients, families and their clinicians.
When is the Ethics Advice and Consultation Service available?
The Ethics Advice and Consultation Service is staffed by individuals with specialized education and training in clinical ethics and in conflict mediation and resolution. The service is staffed 24 hours a day, seven days a week and is available throughout the Geisinger Health System.
Who can contact the Ethics Advice and Consultation Service and how?
Anyone - a patient, a family member, a nurse, social worker, physician, or chaplain - involved in the care of a patient can seek and get help from the Ethics Advice and Consultation Service. To contact the Ethics Advice and Consultation Service:
- At Geisinger Wyoming Valley Medical Center in Wilkes Barre or at Geisinger Community Medical Center in Scranton, call 570-973-0805.
- At Geisinger Medical Center in Danville, Geisinger Bloomsburg Hospital in Bloomsburg, or Geisinger Lewistown Hospital in Lewistown, call 570-988-5033.
Clinicians at any Geisinger hospital may also order an ethics consultation through Epic.
The Ethics Advice and Consultation Service: Help for a range of different needs
We make ethical decisions every day: when we decide whether to help a friend or a family member, when we wonder what to do with the ten dollars we saw someone just drop, or when we are tempted to fudge the truth about our age.
In healthcare, decisions are made every minute and most of them have ethical implications for someone, especially for the patient and the patient's family and friends, but also for clinicians. It is inevitable that, from time to time, a patient or a family member or a clinician will have a question about these implications - or perhaps a concern or a conflict.
A need for advice
When an ethical question or a concern arises, sometimes it is helpful to get the advice of someone who is educated and trained in clinical ethics and who can offer an independent, objective perspective - in a confidential fashion. If you are a patient, a family member or a clinician and you want to speak confidentially with one of Geisinger's clinical ethicists, contact the Ethics Advice and Consultation Service. The on-call clinical ethicist will be happy to listen to your concerns and help you identify potential resolutions or options for action.
A need for consultation
In some situations, ethical questions or concerns are compounded by problems in communication - within a patient's family, within the health care team, or between the team and a patient or family. A more formal intervention-a facilitated clinical ethics consultation - may help to improve communication and resolve the conflict in an ethically principled way. With a clinical ethics consultation, a meeting will be arranged as soon as possible and will bring together the patient (if available and able to participate), family members or friends of the patient, and all relevant members of the health care team. The clinical ethics consultant is responsible for facilitating and leading this meeting, which will clarify:
- The patient's diagnosis, prognosis and treatment
- Realistic goals of care for the patient, along with viable options for treatment in light of those goals
- The patient's own health-related values and preferences
- The ethically and legally appropriate surrogate decision maker if the patient lacks the capacity to make decisions for him or herself
- The concerns and questions of others, including family members, friends, and members of the health care team
- All the clinical and ethical considerations relevant to answering the question, what should be done for this patient?
- Next steps in caring for the patient and family