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Conflicts of interest in clinical ethics consults
  1. Elliott Mark Weiss1,2,
  2. Aaron Wightman1,2,
  3. Laura Webster3,4,
  4. Douglas Diekema1,2
  1. 1 Department of Pediatrics, University of Washington School of Medicine, Seattle, Washington, USA
  2. 2 Treuman Katz Center for Pediatric Bioethics, Seattle Children's Research Institute, Seattle, Washington, USA
  3. 3 Department of Hospital Consultative Services, Virginia Mason Medical Center, Seattle, Washington, USA
  4. 4 Department of Bioethics and Humanities, University of Washington School of Medicine, Seattle, WA, USA
  1. Correspondence to Dr Elliott Mark Weiss, Pediatrics, University of Washington School of Medicine, Seattle, WA 98195, USA; emweiss{at}


Although there is wide agreement that ethics consults are at risk for conflicts of interest (COIs), ethics consultants (ECs) have limited guidance with regard to how to identify and approach COIs. We aim to address these concerns and provide practical guidance. We will define and consider four categories of COIs: consult type, team composition, dual clinical roles and other concerns. We will define and consider six actions available for ECs to take in response to COIs: no action, disclosure only, obtaining a second opinion, referring to another EC, referring to an institutional ethics committee or seeking an outside consult. We will then propose a points-based algorithm for ECs to use to determine the appropriate response to COI. Finally, we will discuss the strengths and limitations of our proposed algorithm.

  • ethics committees/consultation
  • clinical ethics

Data availability statement

There are no data in this work.

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Data availability statement

There are no data in this work.

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  • Contributors This project was initially conceptualised by EMW, AW and DD. LW helped develop the framework. EMW drafted the initial manuscript. All authors verify the final version as submitted.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.