What is ECHO?
ECHO Dates and Topics
10/05/22 Introduction and overview
10/19/22 Introduction to clinical ethics deliberation
11/02/22 Capacity, competence and informed consent
11/16/22 End of life issues and discussions
11/30/22 End of life part two
* Winter Break *
01/11/23 Difficult discharge
01/25/23 Boundaries and dual relationships
02/08/23 Issues in pediatric practice
02/22/23 Care for non-capacitated adults with intellectual disabilities
03/08/23 Care for members of the LGBTQIA+ population
What exactly is clinical ethics?
Clinical ethics is the practical application of theoretical ethics to the field of medicine and delivery of healthcare. As a discipline, clinical ethics provides a structured, principled way of helping to identify, clarify, analyze, and resolve ethical issues that arise in the clinical context. Some topics within clinical ethics include:
Issues in end-of-life care
The concept of futility
What does a clinical ethicist do?
Clinical ethicists use their training in ethics, hospital policy, and mediation to help resolve conflicts of values that arise in the medical context. Sometimes conflict arises because the healthcare team and the patient (or the patient’s family) disagree about what the most appropriate treatment plan is. At other times, there may be genuine uncertainty about what course of treatment will best respect a patient’s prior wishes, or what course of treatment will best minimize harm to the patient. In these and other instances of values conflict or uncertainty, a clinical ethicist can help to better understand the value positions in play and facilitate discussions to arrive at conflict resolution and a plan forward.
Clinical ethicists never dictate medical care; instead, they help medical professionals, patients, and families reason through conflict or uncertainty and provide recommendations on how to proceed.
Some common reasons for consulting a clinical ethicist include:
- A patient’s family members disagree about what types of treatment an incapacitated patient would want.
- A patient is refusing a treatment that the medical team deems medically necessary.
- A member of the healthcare team is unsure whether a particular intervention meets the hospital’s definition of ‘futility.’
- A patient is not capable of providing consent to a procedure, but no family or friends of the patient can be located.
Is ‘clinical ethicist’ just another name for the ethics police?
Not at all. Like other members of the healthcare team, clinical ethicists work to ensure that patients receive the best possible care and that patients, as well as their families, are supported and informed during the process. This means that clinical ethicists work collaboratively with patients, families, physicians, nurses, and other members of the healthcare team.
How does an ethics case conference work?
Case conferences are collegial and collaborative processes. Good ethics begins with good facts. A case is presented usually detailing:
- The presenting medical problem and course
- The stake holders involved
- The ethical conflict
A discussion then follows in which there is:
- An analysis of the conflict with potential resolutions
- Determination of a path forward that, if at all possible, is reached by consensus of the entire group.
Are case conferences confidential?
Yes, all attendees protect confidentiality by keeping private all discussions.
How could training in clinical ethics help me?
For healthcare professionals in a variety of settings and support staff like chaplains and social workers, training in clinical ethics can help build competency and confidence in managing complex and often emotional situations that impede quality patient care. Participants in ECHO will learn to recognize ethical problems, clarify and define ethical issues, reason through solutions to those problem, and offer principled recommendations to the care team and patient. Training in clinical ethics can reduce stress and anxiety among staff by encouraging perspective-taking, communication, negotiation, and reason-giving in the face of conflicts, disagreements, and uncertainties. The ECHO model also aims to draw professionals together, building networks and supportive communities that may offer resources or advice as difficult situations arise.
Who can participate in ECHO?
Physicians, nurses, hospital administrators, chaplains, clergy members, social workers, current or prospective members of hospital ethics committees, or medical educators.
If you have any questions please email