The Centre for Clinical Ethics is a joint venture of Providence Healthcare, St. Joseph's Health Centre and St. Michael's Hospital, three Catholic institutions which serve the Toronto area. It was established in 1982 by the Sisters of St. Joseph and was the first ethics service of its kind in Canada.

The mission of the Centre for Clinical Ethics is to enable members of the health care community to identify and resolve ethical issues which arise in the clinical setting. This is done through education, case consultations, policy development, and research. As a faith-based centre, our commitment is to the core values of our three supporting institutions and to broadening the understanding of the role that faith plays in the questions which confront people in their search for healing.

Ethics is about right and wrong and the reasons that we give for our choices and actions. We explore the question: What ought we to do and why?

Clinical ethics promotes reflective practice and the making of "right" choices and decisions in the delivery of health care. It is not always clear what the right decision is in specific cases. Different individuals (healthcare providers, patients, family members) may disagree about what the right decision should be.

We consider should questions, such as:

• Should we get consent for a "No CPR" order?
• When should you report a colleague's error?
• Should we hide medication in a patient's food?
• When should you follow the advance directive of a patient with anorexia?
• Should those who can pay be able to jump the cue?

In seeking answers to these questions, clinical ethicists in collaboration with healthcare team members, patients, and family members examine basic ethical principles such as autonomy (the right for individuals to make choices about what happens to them), beneficence (the desire to do good), non-maleficence (the duty to prevent harm), and justice (fairness).

What do we do?

1. Education
   
   • The Centre for Clinical Ethics offers ethics education sessions for hospital staff, students, volunteers, and the larger community on a broad variety of ethical issues. These sessions are designed to meet the needs of participants and include Interdisciplinary, Discipline-Specific, and Unit Rounds
   • Ethics Grand Rounds
   • Annual Conference: "Affirming an Ethic of Care"
     • 2011 Conference Brochure
   • Workshops
   • Debriefing Sessions
   • Presentations to Community Groups and Hospital Staff , Students, and Volunteers at Other Healthcare Facilities
   • Clinical Ethics Practica for undergraduate, graduate, and post-graduate University of Toronto students and fellows
   • Formal classroom instruction of healthcare students, medical interns, and residents
2. Ethics Consultation
   The Centre for Clinical Ethics provides consultative services to patients, families, non-medical and medical staff, volunteers and students on a wide variety of issues. Such issues include treatment decisions such as withholding or withdrawing treatment, consent and capacity, allocation of resources, hospital restructuring and institutional ethics. The purpose of an ethics consult is to identify, analyze and resolve ethical issues and to facilitate and support the decision-making process and the decision-makers. The goals are to enhance the ethical decision-making process, mediate value conflicts, and ultimately to improve patient care. A request for an ethics consult may be initiated by anyone who has an ethical concern about a particular situation (including patients or family members).
3. Policy Development & Review
   The Centre for Clinical Ethics is a valuable resource for policy development, implementation, evaluation and review both with the supporting institutions and the wider community. We collaborate with a variety of organizations including the Catholic Health Association of Canada, the Catholic Health Association of Ontario and the Anglican Church of Canada.
4. Research Ethics & Ethics Research
   Staff members of the Centre for Clinical Ethics sit as members of the Research Ethics Board at St. Joseph's Health Centre. The primary mandate of this committee is the protection of human research participants from harm. We are also committed to collaborative research in the area of health care ethics and theology and to developing further relationships to foster this.

What Are We Not?

• Arbiters of right and wrong
• The moral police
• The decision-makers
• Legal experts
• The only people who "do" ethics (everyone has a responsibility to act ethically)

Brochures

Advance Care Planning
Capacity Assessment
Centre for Clinical Ethics
CPR: Cardio-Pulmonary Resuscitation
Ethical Decision Making Framework
Informed Consent
Power of Attorney for Personal Care
Substitute Decision-Making

Contact Us

Our office is located on the 6th Floor, Sunnyside East Wing of St. Joseph's Health Centre. You may reach us by phone at 416-530-6750 or fax at 416-530-6621. If you have an urgent matter or it is after regular business hours, we are available by pager 24 hours, seven days a week. The on-call pager number is 416-664-1153.

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Page last updated: November 10, 2011