Consult Service

Why Request an Ethics Consult?

Ethics consults aid decision making in complex situations; they are most often not a sign of "failure" or moral lapses.

Most cases involve one of the following.

Unclear treatment goals:

  1. How to decide among several reasonable treatments?
  2. Is the treatment offered against the patient values?
  3. Is treatment requested not usual medical practice?
  4. Is there a difference of opinion which treatment is most desirable for this patient at this time?

Uncertainty regarding decision-making roles:

  1. Who is the rightful decision maker?
  2. How should the person make the decision?
  3. Does the patient have the capacity to make this decision?
  4. What if there is disagreement about the best decision?

Assistance in conflict resolution:

  1. Between providers and family/ patient.
  2. Within a family.
  3. Within or between treatment teams.
  4. Within a person (who is ambivalent or in denial).

Who May Call for an Ethics Consult?

Any member of the healthcare team, patient, or family can request an ethics consultation.

Attending physicians, residents and fellows, nurses, technicians, therapists, social workers, and others involved in a patient’s care may request an ethics consultation.

The requestor’s name can be kept confidential, but the medical attending of record will be notified that an ethics consultation has been called about his patient.

How to Contact Us

Clinical ethics consults are available 24 hours a day, 7 days a week. Call the Strong Memorial Hospital Operator/Paging Service at (585) 275-2222 and ask them to page the Clinical Ethics Consultant on call. Urgent consults are possible.

Who We Are

Ethics Consultants include:
Richard Demme, M.D.
David Kaufman, M.D.
Bernard Sussman, M.D.

What We Do

When an ethics consult is requested, we notify the patient’s attending physician that a consult has been requested, if he/she did not request the consult themselves. As the person responsible for the patient’s medical care, the attending needs to be informed of the questions raised, and to sum up the medical course, as well as review possible therapeutic options offered to the patient.

Depending on the nature of the consultation (question asked), one or more ethics consultant may interview the patient, housestaff and other trainees, nurses, social workers, other consultants, chaplains, hospital counsel (legal office), or other interested persons. Not all cases need interviews from all of the above. If indicated, we request a patient’s permission to discuss their care with their family members.

In some instances, interviews with those involved leads to a clarification of options. In other instances, we may facilitate a team meeting or family conference to assist in selection of a plan of action or resolution.

When necessary, we may draw on expertise from other members of the ethics committee to assist in these activities.

The ethics consultation note is placed in the patient’s record, if appropriate.