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Case Consultation

     The Consultancy is prepared to offer capable ethics case consultation for health care teams, patients and their loved ones in the acute care, psychiatric or long-term care settings. This includes review of the medical record, participation in staff case conferences, and debriefings with physicians and other caregivers as well as with the patient and loved ones. It may include our participation in the ethics committee's formal case consultation process.

     Our consultation will always result in our written ethical analysis and recommendations for the specific case. These encompass a recapitulation of the case dynamics including the medical indications, diagnosis, prognosis, and current and proposed treatment course. To this standard record we will endeavor to develop and add a patient narrative providing a more comprehensive presentation of the person including a broader biographical summary and an account of the person's values, beliefs, expressed or known wishes, present decisional capacity, and other vital information.

     Our report will address the ethical issues at hand, framing these in the light of a carefully articulated moral analysis, with reference to widely held values and principles. We typically present several alternative courses of action, stating the apparent ethical implications and further questions raised by each. We will offer to assist in facilitating dialogue among the stakeholders toward morally acceptable resolution of the issues. We will be prepared to offer a comprehensive case presentation and discussion during the regular meeting of the ethics committee, assisting the group with its review and appreciation of the issues raised. These are important educational opportunities.

     Involvement in case consultation requires the extension of privileges for review of the confidential medical record and discussion of patient information. This is usually accomplished by appointment of one of our staff to the institution's clinical ethics committee and its ethics consultation team.

     Consultation is usually arranged by retainer or by hourly consultation fee, and may be negotiated for particular needs and circumstances.

 

© Clinical Ethics Consultancy, 2008

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