Every day healthcare providers and administrative staff make decisions about how to provide the very best care possible for patients/residents/clients and families.

Sometimes, situations arise that present unique challenges – particularly when conflicting expectations, standards of care and value systems are involved.

Ethical Dilemmas

What is an ethical dilemma?

An ethical dilemma arises when competing values or duties pull us in different directions (e.g., you want to be honest but you are worried that the truth may cause harm to someone).

What are the signs that an ethical dilemma may exist?

• A feeling of discomfort about a decision or course of action.
• Being faced with more than one possible course of action and being unclear which is best.
• Disagreement between people about what should be done in a particular situation.
• Concern that someone has been treated unfairly.

Ethical dilemmas may include issues like:

• Access to care or treatment
• Adherence to treatment or living at risk
• Advance care directives
• Beginning-of-life care or end-of-life care
• Capacity (ability to give consent)
• Cardiopulmonary resuscitation (CPR)
• Conflict of interest
• Conscientious objection
• Disclosure
• Diversity and cultural sensitivity
• Duty of care
• Informed consent
• Justice, equity and human rights
• Medical assistance in dying
• Moral distress
• Priority setting and resource allocation
• Privacy and confidentiality
• Respect for autonomy and empowerment
• Substitute healthcare decision maker
• Withholding or withdrawing of treatment

Ethics Consultation

What does an ethics consultant do?

An ethics consultant works with you and those involved, ensuring all options and solutions are carefully considered and understood in order to reach an ethically sound decision.

Who may request an ethics consultation?

Anyone experiencing an ethical dilemma may request an ethics consultation, including patients/ residents/clients, family members and staff. Permission is not required from leadership for staff to request an ethics consult.

When should I request an ethics consult?

• When there are seemingly irresolvable disagreements over ethical questions/concerns.
• When there is a disagreement on whether an ethical dilemma actually exists.
• When you have tried to resolve the dilemma, but have not been successful.

What can I expect from an ethics consultation?

An ethics consultant will help to clarify the nature of the ethical dilemma and identify potential solutions based on ethical values and standards. The ethics consultant will be clear about their ethical viewpoint when providing consultation services, and they will apply the IDEA: Ethical Decision-making Framework (PDF), where appropriate. The recommendations, advice or opinions of the ethics consultants are not binding.

Reference: Ethics Consultation Services policy (PDF)

A consultation may take place over the phone, in-person or through a meeting, which includes all the relevant people. The ethics consultant will disclose any conflict of interest they may have, including issues of conscience.