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Ethics Program

The Ethics Program offers academic and clinical services to faculty and staff at Children’s National Medical Center. Our dedicated staff can help parents and patients with ethical concerns about medical treatment and patient care issues. The program also educates clinicians, staff, residents, and medical students on ethics in pediatrics and provides open and non-judgmental consultation services to patients, families, and staff. We seek to uncover common points of misunderstanding within the child’s care team or between that team and the family.  Our goal is to help those involved in a child’s care gain perspective on the view of others and to find an approach acceptable to all.

Ethics Consult Service:
The ethics team members are available 24 hours. Call the operator at 202-476-5000 and ask to be connected to the ethics team leader on call.
Phone: 202-476-3201 (Do not leave a message, call the operator if no answer)
Fax: 202-476-3630


Announcements
The Annual Sanford L. Leikin, MD Memorial Lecture, Ethics in Pediatrics (January 2013)

Guest speaker: Martha Montello, Ph.D.
Assistant Professor
History & Philosophy of Medicine
University of Kansas School of Medicine
Topic: Should Doctors "Fire" Patients Who Refuse Vaccines for Their Children? Watch the webinar
Download Evaluation Form | CME Credit Claim Form







Ethics Consultation

Anyone can call and request an ethics consultation. In an ethics consult, select members of the ethics committee meet with the patient’s family and health care team. Together the group thinks through what is best for the care of this child in this condition. We respect the dignity of all and ensure that:
• Every person is heard
• Family values are clarified
• The goals of care are discussed
• We arrive at an answer to the question, “What are the best choices we have in the care of this child?”

Some typical concerns that are brought to the Ethics Committee include:
• when family and care team disagree about the best treatment for the child
• when family and care team disagree about how much a child should be told about his or her condition
• when treatment goes against a family’s cultural or religious beliefs
• when the family, or care team, wants to know when to stop doing what no longer helps a child. In other words, “when is enough, enough?”

An ethics consult can be a brief conversation, a case conference, or a case consultation. All levels of ethics consult are discussed at the monthly meeting of the Ethics Committee.

Ethics team members are available 7 days a week, 24 hours a day. To arrange for a consult, please call the hospital operator, 202-476-5000, and ask her to page the ethics team leader on call, or send your questions to EthicsProgram@childrensnational.org. If a meeting is decided, the ethics team leader will set up date, time and place and contact those who need to be involved. At the meeting, most patients are represented by a parent or guardian, although patients 18 years and older are automatically included. Families are encouraged to bring a support person—a relative, close friend, pastor, anyone they trust.

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Publications and resources

Ethics brochure for patients and families

Newsletter: Pediatric Ethicscope:
2012: Volume 25, Issue 1; Issue 2; Double issue
2011: Volume 24, Issue 1 - 2; Issue 3
2010: Volume 23, Issue 1-2Issue 3 - 4
2009: Volume 22, Issue 1 - 2; Issue 3-4
2008: Volume 21, Issue 1; Issue 2
2007: Volume 18, Issue 1 - 2, Issue 3
2006: Volume 17, Issue 1 - 2; Issue 3
2005: Volume 16, Issue 1 - 2; Issue 3 - 4
2004: Volume 15, Issue 1
2003: Volume 14, Issue 2
2002: Volume 13, Issue 1 - 2

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Frequently Asked Questions

What is an ethics consultation?
In an ethics consult, two or three members of the Clinical Ethics Committee meet with the family and the patient’s health care team. The idea is to think through, together, what is the best care for this patient in this condition. Members respect the dignity of all and give special attention to the patient and the family. They do not take sides.

Ethics committee members try to:
• Make sure each person is heard.
• Clarify the patient’s and family's values.
• Discuss the patient’s goals of care.
• Help each person answer this question: “What are the best choices we have in the care of this child?”

Examples of some problems or concerns that have come to the Clinical Ethics Committee:
• When the family and care team disagree about the best treatment for the child
• When the family and care team disagree about how much a child should be told about his or her condition.
• When a recommended treatment goes against a family’s cultural or religious beliefs
• When the family, or the care team, wants to know when to stop doing what no longer helps. In other words, “When is enough, enough?”

When should I request an ethics consultation?
Concerns often arise related to a patient’s values, quality of life, autonomy, confidentiality, or end-of-life care. Sometimes patients, families or health care team disagree about what is best and how to approach or resolve a particular situation. When difficult choices have to be made, it can be painful and frightening. You may feel alone. The Clinical Ethics Committee has an interdisciplinary team that you can turn to for help.

How do I request an ethics consult?
If you think an ethics consult would be helpful, call 202-476-5000 or email us at EthicsProgram@childrensnational.org.  Ask the hospital operator to page the ethics team leader on call. An ethics team member is available 24 hours a day.

What will happen after I make the call?
If, after talking with the ethics team leader you decide to have a meeting, the team leader that person will get in touch with those who need to be involved. A day, time and place to meet will be scheduled, and you will be notified.  If the patient is over 18 years old, he/she will automatically be included in the ethics meeting. (Most patients are under age and the parent or guardian will represent them.)  We encourage  families to bring with them any person they choose for support. This can be a relative, a close friend, or anyone they trust.

Your questions about the care of your child are important to us. When we meet, please let us know how we can help.

What is the Clinical Ethics Committee (CEC)?
Members of the CEC come from the hospital and the community. The committee exists to help improve the communication between patient and family, or between family and health care team. Our goal is to help those involved gain perspective and understanding and find an approach acceptable to all.

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Meet the team

Tomas J. Silber, M.D., M.A.S.S.
Director, Pediatric Ethics Program
Chair, Clinical Ethics Committee
tsilber@childrensnational.org

Kathleen Ennis-Durstine, M.Div.
Vice Chair, Clinical Ethics Committee
Director, Pastoral Care Services
Phone: 202-476-3321
ennis-durstine@childrensnational.org

Kathy DuBois, MSN, RN-BC
Staff Development Specialist, Nursing Education
Chair, Sub-committee on Education
Phone: 202-476-5032
kdubois@childrensnational.org

Mary Keegan
Sr. Administrative Assistant
Phone: 202-476-3201
mkeegan@childrensnational.org

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