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Presentation at a training program at
ARAMCO ‘Applying the Principles of Ethics to Clinical Practice’ April 6,
2015 by Professor Omar Hasan Kasule Sr. MB ChB (MUK). MPH (Harvard), DrPH
(Harvard) Chairman of the Ethics Committee King Fahad Medical City.
Purposes of clinical
ethical consultation
·
An Ethics consultation service is a special
consultation process related to ethical Issues. It covers hospitals/centers and
all referral cases related to medical ethics policy making and forms.
·
Ethics Clinical Consultation is a service that
helps to ensure the quality of ethical practices and patient care. By providing
the services in the hospital, the quality of health care will improve.
·
An Ethics Clinical Consultation is a process by
which trained consultants or an Ethics Consultation Sub-Committee of the Ethics
Committee responds to requests for help to resolve ethical conflicts, issues,
or questions involving patient care.
·
An Ethics Consultation is advisory. Patients,
family members, and health care providers remain responsible for their own
decisions.
·
Clarification of the ethically accepted course
of action can help the health care providers and patients navigate difficult
clinical circumstances.
How it works
·
The Ethicist-On-Duty is an individual allocated
through the ethics consultant duty schedule to provide ethics consultations.
·
Any staff member may elevate an ethical issue to
the Ethics Committee.
·
Clinical Ethics Consultation is available and is
treated like any other form of clinical consultation according to the
regulations.
·
An ethical problem exists when it is not clear
what the ethically sound action is or course of action or when people disagree
about what is best for a patient.
Case
scenario #1
The
ethicist on duty was called to deal with a case in which a 60-year diabetic
with foot ulcers that were getting gangrenous refused below knee amputation and
he told the doctors that he understood the consequences of his refusal because
his elder sister had the same conditions and died after refusing surgery. How
should the ethicist proceed? What arguments will be use? What ethical
principles can support his arguments?
Case
scenario #2
Physicians
wrote a DNA order for a conscious terminal patient with disseminated cancer and
multi-organ failure. When they informed the family some agreed and some
refused. The ethicist was called to deal with the matter. How will he approach
the issue? What ethical principles will guide him/her?