There are various resources available to help health care providers and staff work through the ethical issues they encounter as part of their work. In this first part of a two-part post, we start by looking at the structure for ethics support at Nova Scotia Health, and the types of support available to you.

The Nova Scotia Health Ethics Framework outlines the structure for ethics support, including who is responsible for supporting research ethics, and clinical and organizational ethics. The framework also describes the role of Ethics Nova Scotia Health’s Local Ethics Teams, Zone Ethics Committees, and the Ethics Leads Group.

Who to contact for ethics support depends on the nature of your request:

Ethics Support – Four types at Ethics Nova Scotia Health

Clinical ethics consultation relates to a specific patient’s care or to a particular clinical situation that involves questions of professional ethics. This type of consultation may address ethical concerns relating to a current or ongoing situation, or serve as a debrief after an event. Situations are often complex and include more than one ethical concern or question. Themes that regularly come up in clinical ethics consultations include substitute decision-making, informed choice, and disagreement around goals of care.

Organizational ethics consultation relates to broader, systems-level issues that typically affect larger groups of patients and other stakeholders. This type of ethics consultation also includes overall direction for programs, zones, and the Nova Scotia Health organization as a whole; where an ethics perspective can contribute to analysis and strategic choices.

Sometimes, ethical issues related to a specific patient’s care may be the result of organizational structures and processes. If you are not sure what type of consultation would be best for you, please ask us.

Ethics support in health policy development and review is available to people or groups involved with revising or developing new health care policies. Ethics Nova Scotia Health regularly provides stakeholder feedback on draft policies, and offers support in applying the feedback. If you are working on a policy that is contentious, we recommend involving Ethics early in the process. We can help your working group:

  • Identify the principles and values that should guide the policy
  • Analyze tensions between those guiding principles and values

Consult our Quick Reference Guide: Policy Development and Ethics to learn how we can support you.

Ethics education sessions with Ethics Nova Scotia Health provide health care providers with an opportunity to improve their knowledge and skills with respect to the ethics of complex health care situations. We have education modules and presentations on many key topics, including moral distress, informed choice, professional boundaries, and hope in health care. If there is an ethics topic that your team would like to explore, we will tailor an education session(s) to your needs.

In Part 2 of this post, we will cover how you can access ethics support through Ethics Nova Scotia Health.

Lisbeth Witthoefft Nielsen

Ethics Resource Coordinator, Ethics Nova Scotia Health, Central Zone

with the Ethics Collaborations Team
Department of Bioethics, Dalhousie University