Bioethics in Healthcare

Bioethics & Ethical Dilemmas

Sometimes making the right decision in the face of serious illness can be complicated. When there is uncertainty or disagreement, the Bioethics Committee can help.

The Bioethics Committee is a group of physicians, nurses, social workers, chaplains, other staff members and members of the community who are available to help patients, families, doctors and other health care provides when they face difficult ethical decisions.

The Bioethics committee meets free of charge to provide a safe, supportive, confidential forum in which you and others can think through a problem, consider different points of view and sort through options. Every attempt is made to involve key members of the health care team as well as the patient and family, as appropriate, in the process. After discussing the ethical issues at stake, the Bioethics Committee offers advice in the form of a nonbinding recommendation. It is then up to those involved to decide what to do next.

Before you contact the Bioethics committee, it is recommended that you first speak with those involved in your health care situation, and that you use all available resources in the hospital to try to resolve the problem or dilemma.

Often, meeting with the patient, family members, physicians, nurses, social workers, chaplains, patient representatives, and other members of the hospital staff can help those involved come to an agreement. If what should be done is still unclear, you may contact the Bioethics committee. A Bioethics request can be initiated by any hospital staff, patient or patient family member.

What is an Ethical Dilemma?

Ethical dilemmas may arise for patients, family members, medical staff members and physicians alike.

Some of the issues surrounding problems for which ethics consultation may be requested include:

• Advance directives
• Surrogate decision making
• Refusal of treatment
• Conflicts with caregivers
• Foregoing life-sustaining treatment
• Do Not Resuscitation orders
• Futile Care determination
• Other issues perceived as ethical problems

Examples of ethical dilemmas may include the following:

• Your critically ill family member is in the hospital, and the doctors and nurses are turning to you to make medical decisions on the patient's behalf. You don't know how to decide what to do and could use some guidance.
• You are a patient and are concerned that you may become too sick to speak for yourself. You are uneasy about who will make medical decisions on your behalf, and whether your wishes will be followed. You wonder, "What if they disagree about what I would want, or what would be best for me?"
• You are part of the healthcare team, and your patient comes from a culture in which it is considered wrong to tell patients that they are dying. You're unclear how to respond to a family's request to conceal the truth from a dying patient.
• You are a physician, and some may think it is time to withdraw life support and let nature take its course, yet the dying patient's family insists that you "do everything possible" to keep the patient alive. You're unclear how to solve this problem and worry that "doing everything" might cause the patient pain and discomfort without offering any benefit.