JCB Partners:
North York General Hospital, Ethics Program
People and Roles:
Ethicist: Jonathan Breslin, PhD
Program Description:
The Ethics Program was officially formed in 2005 when North York General Hospital (NYGH) joined the Joint Centre for Bioethics. Prior to that there was no formal ethics support in the organization, though there was a group of staff members who provided ethics consultation. The first five years of the program were devoted to building the infrastructure and raising awareness about ethics and the Ethics Program. The focus for the next period in the lifespan of the Ethics Program will shift towards higher-level ethics in the organization: how to integrate ethics into the strategy of the organization as a whole.
Consultation:
Ethics consultation is provided for clinical, organizational and research ethics issues. The model of ethics consultation at NYGH is the sole-consultant model, with the Ethicist conducting all of the formal ethics consults in the organization. Anyone has the right to request an ethics consult, including patients, family members, staff, physicians, and administrators. Consults often center around such issues as: informed consent, substitute decision making, disagreements over feeding tubes and CPR, and withholding information from patients.
Education:
Education, both formal and informal, is a major component of the Ethics Program at NYGH. The goals of ethics education are to raise awareness about ethical issues in health care and to help staff develop the capacity to recognize and address ethical issues as they arise. We employ a variety of methods to achieve these goals, including:
- unit-based rounds, inservices and lunch ‘n learns as requested
- case debriefings
- annual Ethics Week
- monthly ethics orientation for new staff
- Ethics Program intranet site
- quarterly ethics newsletter
Policy Development and Quality Improvement:
The Ethics Program plays a key role in the development, revision, and implementation of organizational policies, as well as initiatives to improve ethics quality in the organization. Some examples of this work include:
- Revision, educational rollout, and evaluation of the revised Resuscitation Status policy;
- Development of form and implementation process for documenting advance directive and substitute decision maker information;
- Assisting with revision and educational rollout of capacity assessment policies;
- Leadership of working group to address issues related to non-resident patients;
- Leadership of working group to develop guidelines for critical care triage during an influenza pandemic.
Research:
Our current priority is the development and maintenance of the NYGH Ethics Program, so research has not been a major focus. However, areas of recent research include staff moral distress and evaluating a hospital budgeting process.
Website:
Contact Information:
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Ethicist: Jonathan Breslin, PhD Pager: (416) 714-6555 |
