toh

Who can request an Ethics Consult?

Anyone can request an ethics consult. Ethics consults are a free and confidential resource accessible to all patients, families and staff.

How can I request an Ethics Consultation Service?

• You can request ethics services via email at: ethics@toh.ca or by calling 613-722-7000 and asking to speak to an ethicist.
• We are available Monday to Friday, 9 a.m. to 5 p.m.
• We provide support in-person, by phone or through virtual consultations, ensuring accessibility for everyone.

Do I need to consult an ethicist when making a decision?

It is always up to you to decide whether or not you would like to speak to someone about an ethical issue. You are not required to consult with an ethicist, and you always have the right to work through problems or issues on your own.

At the same time, you should never feel ashamed or embarrassed about speaking with a professional ethicist. We all face ethical dilemmas, and it can be comforting to discuss our concerns with someone, or to ask what research or policies are available to help guide any difficult decisions you need to make.

When should I contact the Ethics Consultation Service?

You can contact the Ethics Consultation Service if you are having trouble making a decision or are not sure if the decision you want to make is one that you can live with.

We all have to make tough choices every day. These can be especially upsetting when they relate to our health, or to the health of a friend or family member. The ethics service can help guide you through the process.

Can you give examples of ethical issues that I might face in the health-care setting?

Since clinical settings vary, it is hard to know what might be felt to be an ethical issue to a particular person. There are many different scenarios that present ethical issues and that come up fairly often in various health-care settings, including:

• End-of-life decision-making.
• Withdrawal of treatment.
• Identifying and working with substitute decision-makers.
• Treatment refusals.
• Conflict of interest.
• Goals of care.
• Living at risk.
• Problems relating to consent and capacity.
• Issues relating to advance directives or power of attorney.
• Distribution of scarce resources.
• Moral distress.

How does a consultation with an ethicist work?

• If you decide to contact the Ethics Consultation Service, a consultant will collect information, provide clarity and help you find solutions. Ethics consultants may suggest a multidisciplinary approach or coordinate family meetings to achieve agreement among all involved, mediate conflicts, or help the decision-making process regarding care plans.
• After gathering information on the situation, the ethics consultant will do an ethical analysis and often leave recommendations for ongoing care. It is important to note that these are recommendations only – the consultant will not make any decisions for you.
• Together you can decide what your next steps might be. You will never be coerced or discriminated against because of your views.

If I have an ethics consultation, will I still be allowed to make my own decision?

The right to make decisions will always rest with the patient, Substitute Decision Maker (also known as SDM) or health-care team. The Ethics Consultation Service can help by listening, offering guidance and showing which options align with your values and wishes.

Is this service confidential?

Privacy is something we take very seriously; we uphold high standards to ensure all information remains confidential within the necessary people involved. Any discussions that you have with the Ethics Consultation Service will remain confidential, to the extent that the law allows. We respect your privacy and prioritize keeping trust throughout the process.

You can make an anonymous request by telephone or email if you are unsure whether you would like to continue.

What is a clinical ethicist?

Clinical ethicists are specially trained in understanding and helping with moral issues in health care. They are able to listen to problems in a non-judgmental way and can help make complex problems easier to understand. They have a lot of experience in the field of medical ethics they will likely have seen cases like yours before. They may even be able to tell you how others have dealt with similar issues.

What is Ethics?

Ethics can be about right and wrong, and the reasons that we give for our choices and actions. Ethical issues are often “should” questions. For example:

• Should we stop life support?
• Should life-sustaining treatment be continued for an individual for whom the treatment is burdensome with minimal benefit?
• Should I accept this treatment, even though it’s not really what I want?

Last updated on: October 19th, 2023