Bernard W. Freedman, JD, MPH
Benefits of getting assistance from an Independent Clinical Bioethicist
It is the job of the clinical bioethicist to assist patients and physicians with the application of consistent ethical standards and legal obligations during the course of medical care and treatment. This process must be guided by principles of respect for the patient and distributive justice.
Discussions regarding treatment decisions should not be limited to meeting with a treating physician on one occasion. When feasible, there should be ongoing discussions at appropriate intervals of time as required by the trajectory of the specific disease process.
Frequent issues that arise include:
- Advance care planning: Creating clear and effective advance health directives
- Rights and limitations of decision makers
- Informed consent: getting all the information needed to understand risks and benefits.
- Critical care treatment decisions
- Withholding or withdrawing life sustaining treatment
- Threats to terminate treatment unless the patient is removed from the hospital
- Obtaining an independent second opinion – making decisions with clarity and confidence
Physicians must understand that they are ethically and legally required to explain, in understandable terms to each individual patient or decision maker, the diagnosis, prognosis and the risks of alternative methods of treatments or decisions not to treat. This is an ongoing process. Just as there is a need for continuity of care there must also be continuity in providing timely information. Timely means at a time when thoughtful consideration of the information is possible, not at a time of panic.