Ethics Support Service

What is the Ethics Support Service?

The Ethics Support Service (ESS) is a free consultation service that assists patients and families who are dealing with difficult health care decisions, and for clinicians facing an ethical issue related to care.

ESS was established in 1988 and has since provided 24/7 assistance to staff, patients, and families involved in complex patient care decisions. In addition, the team also conducts educational programs and review policies throughout BIDMC.


Patients, families and health care providers frequently face difficult decisions in the course of treatment. These decisions often involve different values and preferences. There may be uncertainty about the right thing to do.

Consultations are collaborative and can be informal over the phone or highly involved with three- to four-person multidisciplinary physician team, patients, families and staff to help resolve conflict.

Interpreters are also available, free of charge, for limited English speaking patients and family members, and can be arranged by the Ethics team upon request.


Please note: The Ethics Support Service has no authority for clinical decisions. The patient and/or family and doctors are the final decision makers.

Who Can Request An Ethics Consult?

Any BIDMC patient, family member, and/or BIDMC staff member can request a consult.

How Can the Ethics Support Service Assist Patients and Families?

The Ethics Support Service helps with questions and emotions that may arise when a patient and loved ones face difficult health care choices. Sometimes patients, family members and staff wonder if they are making the right choices. They appreciate having the opportunity to talk about their values as they consider these decisions.

Examples: Why One Might Request an Ethics Consult

  • Clarify and understand patient/ family preferences and values
  • Assist with resolving patient and family differences that relate to care
  • Address uncertainty or conflict over who “speaks for” the patient
  • Ensure that religious and cultural preferences are respected
  • Understand BIDMC policy and procedures

What Should One Expect from the Consultation Process?

The consultation process is collaborative. Consultation is provided by one or two people from the Ethics Support Service who work with the patient, family, health care providers and other hospital staff when appropriate. The discussion is an opportunity for all parties to share their concerns. This service helps patients and/or families and the clinical team develops the best plan of care.

The ESS often mediates to ensure that information is communicated and issues are addressed. A written account of the consultation usually becomes a part of the patient’s medical record.

How Do I Contact the Ethics Support Service?

We are available for consult:

  • Monday-Friday: 9 am-5 pm
  • Nights, Weekends and Holidays: Administrative Clinical Supervisor Pager 92465.