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Call to action: empowering patients and families to initiate clinical ethics consultations
  1. Liz Blackler1,
  2. Amy E Scharf1,
  3. Konstantina Matsoukas1,2,
  4. Michelle Colletti1,3,
  5. Louis P Voigt1,4
  1. 1 Ethics Committee, Memorial Sloan Kettering Cancer Center, New York, New York, USA
  2. 2 Technology Division, Library Services, Memorial Sloan Kettering Cancer Center, New York, New York, USA
  3. 3 Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, New York, USA
  4. 4 Department of Anesthesiology, Pain, and Critical Care Medicine, Memorial Sloan Kettering Cancer Center, New York, New York, USA
  1. Correspondence to Liz Blackler, Ethics Committee, Memorial Sloan Kettering Cancer Center, New York, New York, USA; blacklel{at}mskcc.org

Abstract

Clinical ethics consultations exist to support patients, families and clinicians who are facing ethical or moral challenges related to patient care. They provide a forum for open communication, where all stakeholders are encouraged to express their concerns and articulate their viewpoints. Ethics consultations can be requested by patients, caregivers or members of a patient’s clinical or supportive team. Although patients and by extension their families (especially in cases of decisional incapacity) are the common denominators in most ethics consultations, these constituents are the least likely to request them. At many healthcare organisations in the USA, ethics consultations are overwhelmingly requested by physicians and other clinicians. We believe it is vital that healthcare institutions bridge the knowledge gaps and power imbalances over access to ethics consultation services through augmented policies, procedures and infrastructure. With enhanced education and support, patients and families may use ethics consultation to elevate their voices and prioritise their unique characteristics and preferences in the delivery of their healthcare. Empowering patients and families to request ethics consultation can only strengthen the patient/family–clinician relationship, enhance the shared decision-making model of care and ultimately lead to improved patient-centred care.

  • autonomy
  • ethics committees/consultation
  • clinical ethics
  • patient perspective

Data availability statement

All data relevant to the study are included in the article.

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Data availability statement

All data relevant to the study are included in the article.

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Footnotes

  • Contributors LB, AES, KM, MC and LPV provided substantial contributions to the conception, drafting and revisions of the manuscript assuring accurate intellectual content. All authors take responsibility and accountability for all aspects of the work and have ensured that questions related to the accuracy or integrity of any part of the work have been appropriately investigated and resolved. All authors approved the final version of the manuscript for publication. LB is the guarantor and accepts full responsiblity for the decision to publish.

  • Funding This work was supported by the National Institutes of Health grant P30 CA008748 to Memorial Sloan Kettering Cancer Centre and by the Ethics Committee at Memorial Sloan Kettering Cancer Centre.

  • Competing interests None declared.

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