Advances in medical technology have spurred the field of bioethics as healthcare professionals, patients and their families struggle to negotiate the boundaries between what medicine can and should do. Professionals across the spectrum of healthcare delivery settings confront difficult choices in patient care and immediate pressures to reach a decision. Our Department of Bioethics has created a new program, e-Ethics Cleveland Clinic, to help others respond to ethical challenges in patient care.
For more than 25 years, Cleveland Clinic’s Department of Bioethics has supported healthcare professionals with ethics consultation, policy development and education services. Our highly trained and experienced staff conduct more than 300 consultations each year. Our expertise encompasses ethical issues arising in outpatient, inpatient and intensive care settings, and in the design and conduct of clinical trials. In addition to serving on hospital ethics committees and institutional review boards, our consultants have a long history of advising healthcare organizations on ethics-related policy matters and program development. As academic faculty, we conduct hundreds of educational events annually, within Cleveland Clinic and its Lerner College of Medicine, and at national and international conferences.
We are available for case consultation 24 hours a day, 7 days a week. Using state-of-the-art digital resources, we offer expertise to healthcare professionals in real time.
When should I consider a consult?
Ethics consultations may help when:
- Efforts by a patient, family and healthcare providers to resolve an ethical issue have reached an impasse
- Decisions need to be made about life-sustaining treatment for a patient lacking decision-making capacity and an appropriate surrogate decision maker
- Healthcare professionals feel uncertain about their ethical obligations
- Medical researchers confront ethical challenges in designing or conducting studies
How do consultants help?
We assist by:
- Identifying and analyzing value uncertainty or conflict
- Promoting communication and a respectful atmosphere for decision making
- Recommending dispute-resolution strategies
- Facilitating the process of building a principled ethical resolution
Ethics consultation is strictly advisory, meaning that we do not take over decision making. Patients, family members and healthcare professionals retain decision making authority.
We can provide ethics education tailored to meet your healthcare organization’s specific needs, whether to supplement existing ethics education or establish new curricula.
e-Ethics Policy and Program Development
Beyond consultation on specific cases, ethics consultants aim to prevent or reduce ethical conflicts from arising or recurring.
We can assist in developing:
- Effective institutional policies
- Ethics committees
- Consultation services
- Other ethics resources
Remote ethics consultation may have been conceivable prior to video conferencing technology, but incorporating visual elements into distance ethics consultation is critical to the process. Factual information and the products of ethical analysis, primarily advice and supporting justifications, are transmittable via voice or written communications. However, the process of ethics consultation depends on visual elements that help illuminate the dilemma and possible avenues toward their resolution. While the value of in-person connections is indisputable, establishing the consultant’s visual presence is a strong substitute.
Providing faces along with names and voices not only makes it easier to establish rapport but enables the consultant to incorporate insights into interpersonal dynamics, emotional states, body language and other non-verbal behaviors of and among stakeholders in the case. Cleveland Clinic has been using electronic meeting support for internal confidential communications and conferences among remote staff with increasing frequency.
These technologies also enable remote education. Your organization’s employees can access e-Ethics online education materials and afterward engage in a live, remote Q&A or case-based discussion with an e-Ethics consultant. Our consultant(s) might participate in your organization’s ethics committee meeting via video conferencing to review cases or develop organizational policy on ethics-related matters.
To explore the services of e-Ethics Cleveland Clinic, please call the Director:
Anne Lederman Flamm, JD
Department of Bioethics
If you are a Cleveland Clinic patient or are connected with one and would like an ethics consultation, learn more about our Ethics Consultation Service.
If you are not a Cleveland Clinic patient but you have ethical concerns about your healthcare, you may want to inquire with your healthcare provider about what ethics resources are available to you.