Consultation > Case Consultation

• Uncertainties in defining a therapeutic goal or a treatment indication, combined with validating the options in the healthcare team
• Difficulties in determining the patient's (presumed) will
• Differring judgments regarding the appropriate treatment
• Regular/standard case consults when it comes to specific procedures (e.g., placing a PEG-tube)
• Systematic analysis of unclear, complex, or otherwise difficult situations together with the team

• All effected persons are included into the decision-making process in an appropriate manner.
• The person in charge of finally authorizing a decision has a back up.
• Clinical (medical, nursing, therapeutic) and non-clinical (patient's will, social context, organizational) factors are considered for the decision making.
• The decision-making process is well documented so that the reasons for a specific decisions are clear.
• The team's communication and collaboration are strengthened.

Ethics case consultations should comply with certain quality standards regarding structures, procedures, and results. These include, among others

• competent persons who can facilitate an ethics case consultation
• compliance with legal, professional, and organizational norms
• a good documentation of the consult for the patient's records

Currently, a common framework for these quality standards has been developed within the international community for clinical ethics. Important documents are:

• American Society for Bioethics and Humanities. Core Competencies in Health Care Ethics Consultation. 2nd ed., 2011.
• Akademie für Ethik in der Medizin. Standards für Ethikberatung in Einrichtungen des Gesundheitswesens. 2010.

The clinical ethics consultation of ethiX is certified by the Akademie für Ethik in der Medizin.