Physicians often face patient-care dilemmas with no easy answers.
The LGH Ethics Committee is here to help.
The term “ethics” often conjures up lofty principles that are difficult to actually apply. Co-chair Andy Probolus, M.D., of Palliative Medicine Consultants, said the committee aims to offer pragmatic, clinically relevant advice and recommendations.
“Many people don’t know about the Ethics Committee and what we do,” he said. “We hope providers think of us when an issue comes up where they want another opinion. We want to help solve difficult clinical problems.”
Dr. Probolus and Chaplain Keith Espenshade co-chair the committee, which includes physicians, nurses, patient care representatives, chaplains, residents and attorneys. (Former long-time chair Dr. Thomas Gates moved to Africa last year.)
The committee reviews cases at the request of a provider, patient or family, during monthly meetings or as needed. Providers can order an ethics consult in Epic. Many requests also come through the LGH patient reps.
Recent cases include a neurosurgeon who requested an ethics consult to determine if a trauma patient had the capacity to refuse surgery. The committee recommended an evaluation, which showed that the patient did not have the capacity to make such a decision.
Another recent case involved a young woman with significant brain damage. At issue was how the case intersected with hospital policy on brain death and how much autonomy the family could have in confirmatory testing for that diagnosis.
“We had a really good discussion about what we can learn from this case, as well as its implications,” Dr. Probolus said. “What are the choices, and how do we communicate them? How do we support patients and their families?”
The committee also regularly reviews hospital policies and procedures, making recommendations for revisions. The growing trend of new mothers consuming their placentas recently led the committee to draft a recommended policy for use at Women & Babies Hospital.
Dr. Probolus hopes to raise the committee’s profile with education and outreach, while fostering more discussion of ethical issues. Like many committee members, he has a long-standing interest in ethics. He chose palliative medicine because of the challenges and rewards of working with patients and families at the end of life.
“We have the ability to support people in difficult situations and help them make big decisions that really have an impact on their lives and their loved ones’ lives going forward,” he said.