Ethics Committee
The Ethics Committee on Cleveland Clinic's main campus consists of a multidisciplinary group of healthcare professionals and a representative from the community. These individuals bring together knowledge of ethics and ethical analysis, group process skills, and a wide range of backgrounds and expertise.
The Ethics Committee meets monthly on Cleveland Clinic's main campus to discuss and address patient care issues and ethics-related policies and procedures. The Ethics Committee also networks with other institutional committees and organizational leaders in an effort to enhance the understanding of ethical issues throughout the hospital and to promote the ethical care of patients and families. Committee members also serve as ethics consultation resources to help resolve complex ethical issues that have institutional implications.
Ethics Consultation Services
The Ethics Consultation Service (ECS) on Cleveland Clinic's main campus responds to requests for help to resolve ethical conflicts, issues, or questions involving patient care. It functions as a resource when patients, family members or health care professionals have reached the limits of their own personal or professional abilities to address ethical questions; when there is ethical uncertainty; or when individuals need ethical verification or a sounding-board for ethically supportable strategies and action steps.
Ethics consultation is intended to support but not replace usual channels of communication about ethically challenging situations.
The ECS on the main campus is staffed 24 hours a day, 7 days a week by bioethicists and fellows from the Center for Bioethics. Ethics Consultation is advisory. Patients, family members, and health care professionals remain responsible for their own decisions.
Cleveland Clinic offers this service free to patients, family members and health care professionals. A patient or anyone involved in caring for a patient can request an Ethics Consultation without fear of intimidation or reprisal. All discussions are confidential.
When to Request an Ethics Consultation
Examples for appropriately requesting an ethics consultation include:
- Efforts by patient, family and health care providers to resolve an ethical issue have reached an impasse.
- Decisions need to be made about life-sustaining treatment for a patient who lacks decision-making capacity and for whom an appropriate surrogate decision maker cannot be found.
- A patient’s surrogate decision maker is unable or unwilling to provide a substituted judgment as to what the patient would have wanted.
- Health care professionals wish to discuss ethically supportable strategies that could help to prevent an “ethics crisis.”
- The case is ethically challenging, unusual, unprecedented, or complex.
How to Request an Ethics Consultation
Health care professionals, patients and family members can directly request an Ethics Consultation by calling the hospital operator and asking for the ECS. Patients and family members can also inform their nurse or other health care professionals that they want an Ethics Consultation. Staff made aware of a patient or family desire for an Ethics Consultation should convey the request to the ECS.
The Ethics Consultant will notify the Attending Physician or his/her designee about the request for an Ethics Consultation.
The ECS on the main campus can be reached during business hours by calling the Center for Bioethics at 216.444.8720. All other times the Bioethicist on-call can be paged at 14-22512.
Virtual Visits
The Center for Bioethics now offers Cleveland Clinic scheduled virtual visits to help patients, families and healthcare professionals think through complex health care decisions.
Patients experience the flexibility of talking privately with a clinical ethicist through a live video visit from the comfort of their own home, by using a smartphone, tablet or computer. These virtual visits are available to patients and their families at no cost and all discussions are confidential.
Virtual visits also offer an “Invite a Guest” feature, which allows a patient (or provider) to invite another participant, such as a family member, caregiver, or language translator into the virtual visit. Ethics consultations can help when:
- A decision needs to be made when there is not an option that is clearly best or none of the options are good options (for example the treatment options have uncertain benefits, or all have unacceptable risks, such as bad side effects)
- Patients, family members or the medical team disagree about the best choice for a patient and there is uncertainty about how to move forward
- A patient is unable to make a decision for themselves and it is not clear what the patient would want
- There are conflicting values or professional obligations at play with respect to developing a plan of care, making treatment recommendations, or disclosing information to a patient or family
- To help think through a patient care situation or to validate a plan of care with a set amount of designated time through a virtual ethics consult
To schedule a virtual ethics consult, patients can contact the Center for Bioethics at 216.444.8720. Ethics consultations can be requested by any provider or other caregivers involved in the care of the patient. If needed, an ethicist can be present virtually during the visit with the patient, to speak independently with the patient (and/or family) or to speak with the patient or their team virtually (provider to provider).
Regional Hospitals
Each Cleveland Clinic health system regional hospital has its own Ethics Committee. As on the main campus, these committees consist of a multidisciplinary group of health care professionals and community representatives who contribute to the committees’ three primary purposes:
- Staffing and supporting the Ethics Consultation Service (ECS)
- Providing Ethics Education
- Reviewing and developing ethics-related policies
Each Committee’s activities are supported by Staff Bioethicists.
Ethics Committee Membership rosters are available upon request. Please contact the appropriate Bioethicist:
- Joshua Crites, PhD
Avon Hospital, Fairview Hospital, Lutheran Hospital, and Medina Hospital - Laura Guidry-Grimes, PhD
Lutheran Hospital and Marymount Hospital - Cristie Horsburgh, JD
Euclid Hospital, Hillcrest Hospital, Marymount Hospital, and South Pointe Hospital - Jamie Watson, PhD
Akron General, Union Hospital and Mercy Hospital
Ethics Consultation at Regional Hospitals
The ECS at each hospital responds to requests for help to resolve ethical conflicts, issues, or questions involving patient care. Each ECS functions as a resource for patients, family members or health care professionals when there is ethical uncertainty or the need for ethical validation. Ethics consultation is intended to support but not replace usual channels of communication about ethically challenging situations.
Ethics Consultation is advisory. Patients, family members, and health care professionals remain responsible for their own decisions.
Cleveland Clinic regional hospitals offer this service free to patients, family members and health care professionals. A patient or anyone involved in caring for a patient can request an Ethics Consultation without fear of intimidation or reprisal. All discussions are confidential.
Examples for appropriately requesting an ethics consultation include:
- Efforts by patient, family and health care 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 cannot be found.
- A patient’s surrogate decision maker is unable or unwilling to provide a substituted judgment as to what the patient would have wanted.
- The medical team has concerns about the best interests of a patient unable to make his or her own decisions.
- The case is ethically challenging, unusual, unprecedented, or complex.
- Families need additional support thinking about what factors to consider and how to apply the standard of “substituted judgment” to decisions for a patient.
Health Professionals, patients and family members can directly request an Ethics Consultation by calling the specific hospital’s operator and asking for the ECS. Because each hospital has its own process for ECS requests, callers may be directed to Pastoral/Spiritual Care, the Ombudsman, another department, or directly to the Bioethicist. Patients and family members can also inform their nurse or other health care professionals that they want an Ethics Consultation. Staff made aware of a patient or family desire for an Ethics Consultation should convey the request to the ECS.
The Ethics Consultant will notify the Attending Physician or his/her designee about the request for an Ethics Consultation.
The ECS can also be reached during business hours directly. Please see below for the contact information for each hospital.
Euclid Hospital
216.531.9000, ext. 65404
Fairview Hospital
Pastoral Care: 216.476.7067
Hillcrest Hospital
Spiritual Care/Healing Services: 440.312.3739
Ombudsman: 440.312.9140
Lutheran Hospital
Pastoral Care: 216.363.2158
Marymount Hospital
Pastoral Care or Medical Staff: 216.581.0500
Medina Hospital
Ombudsman: 330.721.5330
Pastoral Care: 330.721.5188
South Pointe Hospital
Ethics Referral Line: 216.491.7886
The ECS on the main campus can be reached during business hours by calling the Center of Bioethics at 216.444.8720. All other times the Bioethicist on-call can be paged at 14-22512.
Cleveland Clinic Florida
Each Cleveland Clinic health system hospital including Cleveland Clinic Florida has its own Ethics Committee. As on the main campus, this committee consists of a multidisciplinary group of people who contribute to the committees’ three primary purposes:
- Staffing and supporting the Ethics Consultation Service (ECS)
- Providing Ethics Education, and
- Reviewing and developing ethics-related policies.
The Ethics Committee Membership rosters are available upon request.
Ethics Consultation at Cleveland Clinic Florida
The ECS at each Cleveland Clinic hospital responds to requests for help to resolve ethical conflicts, issues, or questions involving patient care. Each ECS functions as a resource for patients, family members or multidisciplinary groups when there is ethical uncertainty or the need for ethical validation. Ethics consultation is intended to support but not replace usual channels of communication about ethically challenging situations.
Ethics Consultation is advisory. Patients, family members, and health care professionals remain responsible for their own decisions.
Cleveland Clinic hospitals offer this service free to patients, family members and health care professionals. A patient or anyone involved in caring for a patient can request an Ethics Consultation without fear of intimidation or reprisal. All discussions are confidential.
Examples for appropriately requesting an ethics consultation include:
- Efforts by patient, family and health care 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 cannot be found.
- A patient’s surrogate decision maker is unable or unwilling to provide a substituted judgment as to what the patient would have wanted.
- The medical team has concerns about the best interests of a patient unable to make his or her own decisions.
- The case is ethically challenging, unusual, unprecedented, or complex.
- Families need additional support thinking about what factors to consider and how to apply the standard of “substituted judgment” to decisions for a patient.
Health Professionals, patients and family members can directly request an Ethics Consultation by calling the hospital operator and asking for the ECS. Staff made aware of a patient or family desire for an Ethics Consultation should convey the request to the ECS.
The Ethics Consultant will notify the Attending Physician or his/her designee about the request for an Ethics Consultation.
