Ethics Support Service (ESS)
About Us
The ESS offers 24/7 real-time assistance to all BIDMC staff, patients, and families grappling with ethics issues. The ESS provided support in over 100 cases in 2006-07, with numbers continuing to grow, making it among the most utilized service of its kind in the nation. ESS support is helpful both in reaching ethnically sound decisions and in dealing with the emotional and other stresses that difficult moral situations involve. Consultations range from informal telephone guidance about early-stage “preventive ethics” approaches, or about BIDMC policy or procedural questions, to participation in family meetings that address difficult clinical decisions, to preparing a formal, written consultation note in the medical record that offers suggestions for resolving an ethical issue within the framework of BIDMC policies and Massachusetts law. The ESS consultation team does not have any authority for any clinical decisions, since that rests with the patient (or surrogate) and the patient’s attending physician.
What Issues Does ESS Address?
Any clinical ethics issue. By definition, an ethics issue exists when two or more important values seem to be in conflict. Examples include:
- A patient’s welfare vs. a patient’s right to make decisions about his/her treatment
- The goal of extending life vs. the goal of ensuring comfort
- The preference of family members that information be withheld from a patient vs. the patient’s right to know
- A patients right to the best available vs. financial pressures to contain costs
Why Request an Ethics Consult?
Ethics involves the concerns people have about what is morally good, right, or fair. An ethics consult should be considered to explore the ethical aspects of a case when morally troubling or complex problems occur, and the usual routes of discussion do not bring resolution. Ethical problems may exist when known facts and information do not make clear what should be done.
Who Can Request an Ethics Consult?
An ethics consult can be initiated by any member of the BIDMC community, including but not limited to the:
How to Contact Us
Any BIDMC staff member, patient, or family member can contact us directly by calling 617-667-7467, or by calling the page operator at 617-667-4700 and asking for the Ethics staff member on call, or (for BIDMC staff only) by entering an electronic request for an ethics consultation online.
Meet Our Team
Lachlan Forrow, MD, Director
Steve O’Neill, LICSW, JD, Assistant Director
Wendy McHugh, RN, MS, Clinical Nurse Ethicist
L. Chanel Bryant-Alexander, Program Coordinator
