Consultation > Case Consultation

Fotolia (Andy Dean)
Fotolia (Andy Dean)

An ethics case consultation is an explicitly structured deliberation and decision-making process concerning an individual patient and performed by an interprofessional team.

Occasions for an ethics 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

Benefits of an ethics case consultation

  • 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.

Quality standards for ethics case consultations

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.