The University of Missouri Health Care Ethics Consult Service is staffed by ethics committee members with specific training in the area of ethics who are on call 24 hours a day, 7 days a week. These members provide quick consultations to patients, their families, surrogates, or health care providers who need assistance in difficult decision making.
When to Call the Ethics Consult Service
Questions such as, "What is the right thing to do?" are very real in these times of increasingly high-tech medical care. Dilemmas and conflicts may arise when a patient, family member, health care professional, or the hospital has different ideas about values, responsibilities and loyalties.
The Consultation Process
Following a request for consultation, a representative of the ethics consult service will communicate with the individual requesting assistance. If further discussion is needed, a meeting will be scheduled to include the patient and/or family or representative(s), the health care provider(s) involved in the case and other members of the health care team.
During this private meeting, open and honest discussion will be encouraged about the clinical circumstances and the ethical concerns, and an attempt will be made to resolve conflict. The ethics consultant will assist by facilitating the discussion, helping outline the ethical issues and offering suggestions for reasonable action. Final decisions are to be made by the patient and his or her representative(s) in conjunction with the patient's physician and other members of the health care team.
Making Informed Decisions
University of Missouri Health Care believes in the rights of patients to make informed treatment decisions and provides a caring environment to support an informed choice. To discuss any questions or concerns with an ethics consultant, ask your doctor, nurse, social worker or chaplain to contact the hospital switchboard at 573-882-4141, and ask for the ethics consultant on call to be paged.
Tele-Ethics Consultation Services
The development and expansion of the hospital clinical ethics committee, along with the ethics consult service, in University of Missouri Hospital and Clinics has officially been in force since January 2004, and has had a profound effect on healthcare in this institution. We are presently averaging three to four ethics consults a month in various venues. We also provide consultation to institutions and clinicians outside of our institution and throughout the state through any communication means possible, including phone, email, and the new and innovative means of telehealth video conferencing (tele-ethics).
The Missouri Telehealth Network (MTN) exists to increase access to health care to underserved Missourians, to provide specialty care to Missourians in state facilities, to further homeland security efforts related to bioterrorism, disaster and pandemic preparedness and response, to serve as a resource (consultant) for health care institutions and providers who are embarking on their own telehealth program, to provide a mechanism for clinical research and to provide continuing educational opportunities for health care providers.
MTN began in 1994 as one of the nation's first public-private partnerships in telehealth. Today, MTN has 150 sites in 49 Missouri counties and the City of St. Louis and will add more than 30 sites to the network in the near future.
MTN has provided services in 40 different medical specialties, with a majority of the work coming from radiology, mental health, dermatology and cardiology. From 1996 to 2008, more than 18,000 interactive video encounters and nearly 100,000 teleradiology exams have been conducted.
University of Missouri Health Care's ethics consult service is available 24 hours a day, seven days a week, and will work to provide timely and efficient responses to providers, patients, and families who need assistance with making difficult treatment decisions, or when other ethical dilemmas occur. Tele-ethics is just one more means by which this service can be provided in an efficient and user-friendly fashion for those in need outside of the University of Missouri system. To inquire about tele-ethics consultation, please call 573-882-2738 or email healthethics@missouri.edu.
1. Jerant T, Azari R, Nesbit T. Medical Care 2001
2. Johnson B, Wheeler L, Dueser J, Sousa K, Arch of Fam Med 2000
