July 13, 2001

In an environment as complex as that at the MGH, situations sometimes arise that present challenging ethical dilemmas – often without straightforward, clear-cut solutions. For example: With whom can a nurse discuss a dying patient's family who wishes to remove the patient from life support? What can a doctor do if a seriously ill patient refuses treatment and leaves the hospital? Where can patients find more information about obtaining an advance directive for their care?

The MGH has many resources for ethical questions – various committees, consult services, administrative resources and educational opportunities that exist to help staff. But for some MGH clinicians, especially those who are new to the hospital, finding the right resource to help with a particular issue might be challenging.

Beginning July 16, a subcommittee of the MGH Ethics Task Force is introducing an ethics support program, which will provide support to employees who encounter ethical questions or concerns. Those who need to access the service can page the Ethics Support Program through the hospital's page operator or through the Partners directory.

A group of volunteers from the various hospital ethics committees will respond to the paging system to help staff work through ethically problematic situations and direct them to the best resources. In the pilot stage of the program – which will run from July 16 to Sept. 15 – pager coverage will be available Monday through Friday, 8 am to 5 pm. Employees are encouraged to leave a message on the program's voicemail if situations arise after hours, and a response will be given the next business morning.

According to Alex Cist, MD, of the MGH Pulmonary and Critical Care Unit and a member of the ethics subcommittee, the aim of the new program is to provide centralization and coordination to the hospital's many ethical resources. "We hope to provide immediate support for employees who face ethical dilemmas," she says. "We have a gold mine of ethics resources at this hospital, more so than most institutions this size, and this program will help our employees utilize these resources."

Regina Doherty, MS, OTR/L, of MGH Occupational Therapy Services and also of the subcommittee, adds that the program will allow the committee to collect data to help the MGH Ethics Task Force target education for areas that are needed.

"Sometimes people get frustrated because they don't know who to call when they need help," she says. "This program will help triage calls to the right place, such as the Pediatric Bioethics Committee or the Optimum Care Committee. It also will help the committee see where the gaps in resources are, so that we can continue to develop our own expertise and provide further education in certain areas of the institution."