Areas of Care

Ethics Consultation Service

On this page:

Overview

As patients and families, you are faced with making tough decisions every day. At The Ottawa Hospital, you don’t have to do it alone. 

We are a free, confidential service to help patients, families and health-care professionals work through difficult situations and reach common ground. We can find and clarify problems, explore possible outcomes and consider the different options.

Ethics consultations can happen in person, by phone or virtually. 

Two people sit at a table discussing something; one gestures with their hands while the other listens, holding a tablet. A laptop, documents, and a blue mug are on the table in a modern office setting.

About clinical ethicists

Clinical ethicists are specially trained in understanding and helping with moral issues in health care. They are able to listen to problems in a non-judgmental way and can help make complex problems easier to understand. They have a lot of experience in the field of medical ethics and they will likely have seen cases like yours before. They may even be able to tell you how others have dealt with similar issues. 

Team

Placeholder image for a user profile.

Michael Kekewich

Director, CCHCE, Clinical and Organizational Ethics, IPAC and MAID
Placeholder image for a user profile.

Dr. Saumil Dholakia

Medical Director of Ethics
Placeholder image for a user profile.

Ali Ladak

Ethicist
Placeholder image for a user profile.

Bridie Hamilton

Ethicist

How we can help

Ethics consultations aim to help patients, families, staff and other stakeholders resolve ethical concerns in order to improve health-care quality.

Conflicts can arise based on differences in values, difficulties in communication or due to the stress of illness. The ethics service works to provide support and guidance by being non-judgmental and offering action-oriented, clinically appropriate recommendations. 

Guiding, not deciding

While the Ethics Consultation Service may make suggestions or offer guidance, final decisions always remain in the hands of patients, families and the health-care team. 

Mike Kekewich, Director, CCHCE

When to use the service

You can contact the Ethics Consultation Service if you are having trouble making a decision or are not sure if the decision you want to make is one that you can live with.

It is hard to know what might feel like an ethical issue to a particular person. There are many different scenarios that present ethical issues and that come up fairly often in various health-care settings, including:

  • End-of-life decision-making.
  • Withdrawal of treatment.
  • Identifying and working with substitute decision makers.
  • Treatment refusals.
  • Conflict of interest.
  • Goals of care.
  • Living at risk.
  • Problems relating to consent and capacity.
  • Issues relating to advance directives or power of attorney.
  • Distribution of scarce resources.
  • Moral distress. 

Not sure if you need an ethicist?

There is never a wrong reason to seek a consultation.

The ethics consultation process

Contact the Ethics Consultation Service

You or a member of your care team can reach out to request a consultation. 

Gather information

An ethics consultant will speak with those involved to understand the situation and gather relevant details.

Clarify the issues

The ethics consultant helps identify the ethical concerns and clarify values, goals and perspectives.

Facilitate dialogue

If needed, the ethics consultant may suggest a team-based approach, coordinate a family meeting or help mediate disagreements.

Give ethical analysis and recommendations

After reviewing the situation, the ethics consultant will provide an ethical analysis and offer recommendations to support decision-making. These are recommendations only—the ethics consultant does not make decisions for you. 

Next steps

You and your care team decide how to move forward. Your views will be respected, and you will not be pressured or judged.

Frequently asked questions (FAQs)

Anyone. Ethics consults are a free and confidential resource accessible to all patients, families and staff.

Privacy is something we take very seriously; we uphold high standards to ensure all information remains confidential within the necessary people involved. Any discussions that you have with the Ethics Consultation Service will remain confidential to the extent that the law allows. We respect your privacy and prioritize keeping trust throughout the process.

You can make an anonymous request by telephone or email if you are unsure whether you would like to continue. 

It is always up to you to decide whether or not you would like to speak to someone about an ethical issue. You are not required to consult with an ethicist, and you always have the right to work through problems or issues on your own. 

You should never feel ashamed or embarrassed about speaking with a professional ethicist. We all face ethical dilemmas, and it can be comforting to discuss our concerns with someone, or to ask what research or policies are available to help guide any difficult decisions you need to make. 

The right to make decisions will always rest with the patient, substitute decision maker (also known as SDM) or health-care team. The Ethics Consultation Service can help by listening, offering guidance and showing which options align with your values and wishes. 

Ethics can be about right and wrong, and the reasons that we give for our choices and actions. Ethical issues are often “should” questions. For example:

  • Should we stop life support?
  • Should life-sustaining treatment be continued for an individual for whom the treatment is burdensome with minimal benefit?
  • Should I accept this treatment, even though it’s not really what I want?
Ethics brochure(88.38 KB)

Contact us

Ethics Consultation Service

613-722-7000 (Ask to speak to an ethicist)

ethics@toh.ca

Monday to Friday 9 a.m. to 5 p.m.