The goal of the Clinical & Organizational Ethics program at Hamilton Health Sciences is to build ethics capacity and nurture a culture that makes it easy to "do the right thing". This site has information about our program to help patients, families, and health care professionals who may be dealing with a difficult ethical issue related to clinical care.

The ethics program at HHS is growing, click here for details

Key Terms:

Ethics is the systematic examination of facts, beliefs, standards and values in determining the rightness or wrongness of decisions and actions. Ethics involves expanding our focus from what is good for me, to consider "the greater good." Ethics is not merely opinion or gut reaction, but involves reasoned deliberation to address the question: "What is the best thing to do, all things considered?"

Ethical decision-making involves reflection on how to make decisions about what should be done in a particular situation. Ethical decision-making usually involves four related questions:

What should we do? (What options are good or right in this context?)
Why should we do it? (Exploring the values and reasons that support each option.)
How should we do it? (What plan of action best aligns with these values and reasons?)
Who should do it? (Who is responsible for making the final decision and enacting and communicating it?)

Clinical Ethics addresses ethical issues and dilemmas that arise in the care or treatment of individual patients. Health care professionals should consider the specific duties they have to these patients, such as those related to confidentiality, disclosure, consent, etc. Some examples of clinical ethics issues include:

whether to withdraw or withhold treatments for a patient at end of life
conflict between a team and family regarding the perceived safety of a discharge plan for a patient
conflict between members of a healthcare team regarding whether to offer a fragile patient an innovative therapy
uncertainty regarding whether a patient is competent to refuse needed treatment

Organizational Ethics addresses the ethical dimensions of decisions affecting groups of patients, as well as non-patient related issues such as human resources, policies and processes, and resource allocation decisions. Examples of organizational ethics issues include:

the development of a policy to support organ donation after cardiac death
the disclosure of a health risk to a cohort of affected patients
the review of a perceived conflict of interest of a Board member
the identification of reasonable criteria to inform resource allocation decisions
the realignment of staff roles to support a new patient care process