BUMC Basics.pdf - Anesthesia Home

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PALLIATIVE CARE AND CLINICAL
ETHICS
The Palliative Care Consultation Service (PCCS) and the
Clinical Ethics Committee are a vital element of patient care at
BUMC. The services are closely linked, but not identical.
The Clinical Ethics Committee is a multidisciplinary committee
of the medical staff responsible for developing and maintaining
clinical ethics policies/guidelines, ethics education, and clinical
ethics consultation. Baylor house staff typically interact with the
ethics committee when an ethics consult is requested. Ethics
consultation may be requested for moral guidance in
circumstances of ethical uncertainty. A consult may be as brief
as a several minute conversation with one of the ethics
committee consultants or may involve the consultant seeing
the patient, reviewing the chart, and actively engaging the
treatment team, patient, and or family to bring resolution to
ethical dilemmas. Ethics consultants are advisers only and do
not write orders nor tell any party what they must do (unless it
is a matter of hospital policy). Any member of a treatment team
may request a consult, though it is customary to seek
involvement from the attending physician prior to this as a
courtesy. An ethics consult may be obtained by contacting the
Medical Staff Office (2-2139) or by calling the office of Dr. Fine
and Dr. Casanova (214-828-5090).
The Palliative Care Consultation Service is a multidisciplinary
team composed of staff physicians, nurses, pharmacists,
speech therapists, nutritionists, social workers, physical and
occupational therapists, and chaplains, all with extra skills and
competencies to help manage patients with advanced lifelimiting
illnesses. It is important to realize that palliative care,
although often serving as a bridge to hospice, is not the same
as hospice. Patients seen by the PCCS may continue to
receive all treatments while receiving expert symptom
management and the additional psycho-social-spiritual support
often needed by patients and families facing the most serious
illness. Unlike clinical ethics consults, members of the palliative
care team help actively manage patients and write orders. The
physicians, nurses, and pharmacist team members all have
special expertise in pain and other symptom management.
Circumstances in which to consider asking for a palliative care