Ethics consultation is one of the major ways, along with teaching, serving on advisory committees, and making suggestions related to institutional policies, that bioethicists serve health care organizations.
Purpose
The purpose of the service is to improve the process and outcomes of clinical care and research by helping those involved address ethical challenges and questions that may arise.
Philosophy
The Consultation Service commits itself to providing an opportunity for people to talk through ethical challenges in research and clinical care with a supportive group that understands the nature of the practical issues. The belief that ethics consultation should provide an open space for deliberation about ethical issues guides the Consultation Service. Fundamental to this philosophy is the view that all who come to the table deserve to be heard, regardless of their knowledge of the bioethics literature or their position in the institutional hierarchy.
Process
Most of the senior staff and fellows of the Department of Bioethics organize and staff the Clinical Center's Bioethics Consultation Service. The Service works with and reports to the Clinical Center Ethics Committee.
Bioethics consults can be requested by anyone who works at the NIH or who is connected to the NIH Clinical Center (patients, patients’ families, investigators, physicians, nurses, administrators, social workers, and pastoral care providers).
Many, though not all, of our consults focus on:
- Ethical questions relating to how to best design or conduct research (e.g. how to appropriately protect vulnerable populations in research studies)
- Ethical questions that arise in the care of individual research participants
- Questions about whether a research participant is capable of providing informed consent to research. (The Bioethics Consultation Service is part of the Clinical Center’s Ability to Consent Assessment Team (ACAT)).
Consultations can take various forms, including a phone call, an in-person discussion, or when needed, a full ethics committee meeting. The requestor is encouraged to bring all who might have a stake in the issue at hand to consult meetings unless there are good reasons to do otherwise.
- Information gathered in ethics consultations is kept confidential, unless consultants are required by law or institutional policy to break confidentiality. Individuals who feel uncomfortable with requesting a consultation may ask for an anonymous consultation although such a consult is limited since the consulting staff is hearing only one point of view about the situation at hand.
- Consult requestors will generally receive a consultation report. If a consultation is requested regarding an individual research participant at the NIH Clinical Center, a report will be in the electronic medical record unless there is a compelling reason not to.
Contact Information
The service is available 24 hours a day and seven days a week.
To request a bioethics consultation, use any of the following approaches;
- Call the Clinical Center paging operator (301-496-1211) and ask to be directed to the Bioethics Consult Service;
- Call the Department of Bioethics directly (301-496-2429) during business hours; or
- (For clinicians) put an order for a Bioethics Consult into the Clinical Research Information System (CRIS).
We recommend not to request consultations by email, as we may not be able to respond in a timely fashion. Research subjects and their families can ask someone on the research team to contact the consultation service, if they do not want to call directly.