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Ethics Nova Scotia Health: Ethics support for policy developers
12/16/2024
Library Staff
Nursing, Physicians, Ethics, Nurse Practitioners

Ethics Nova Scotia Health can provide input at any stage of the policy development process. In this blog post, we outline how we help policy developers and working groups with ethics input at different stages of the process.

Ethics support during the initial policy development stage

It may be useful to reach out for ethics support early in the policy development process if you are developing or revising a ‘high stakes’ policy, e.g.:

  • A policy that affects equity-seeking populations
  • A policy that involves curtailing the liberty of patients, or other kinds of value-based tensions

At this stage, our team can assist with assessing policy options from an ethics lens. We can work with you to identify how well these options align with our organizational principles and values, as well as other relevant principles and values. Depending on the complexity of the policy (or the complexity of the related ethics issues), it may also help to include a member of Organizational Ethics and Policy Support on the policy development group.

Ethics support during the policy writing stage

It is not always easy to identify and weigh the principles and values that should inform a policy. We can assist policy working groups to identify and formulate relevant principles and values specific to the policy they are developing.

We can also support your group to facilitate a discussion if there is disagreement about how different values should be weighted within the policy, especially if some of these values are in tension with each other.

To help you determine the type of ethics support that may be most beneficial for your working group, or when to reach out to Ethics Nova Scotia Health for ethics support with a policy, visit:

How can Ethics Nova Scotia Health help you develop policies?

You can learn more about the role of ethics in health policy development in Nova Scotia Health Ethics Network’s (NSHEN) Fireside chat with Policy Manager, Michelle Helliwell. The video comes with a discussion and resource page, for use in facilitating discussions or for further reflection.

Another useful resource is NSHEN’s Ethics and Health Policy: The Nuts and Bolts. While this guide is written for a general audience and is not specific to Nova Scotia Health’s policy development process, it provides useful guidance around ensuring that the policy process is ethics-informed, including:

  • Addressing power dynamics
  • Managing conflicts
  • Identifying and considering relevant principles and values

Ethics review of a policy

If you are sending out a draft policy for feedback, you may want to include Ethics Nova Scotia Health in the collaborating-partners feedback survey.

Organizational Ethics and Policy Support, a core function group with Ethics Nova Scotia Health, meets on the second Friday of each month. At these meetings, we review draft policies from an ethics lens. We summarize both general and section-specific feedback and highlight any potential ethical implications or concerns that the group may have. We are always happy to answer questions and are available to assist with implementing our feedback.

Please submit your policy review request according to our submission deadlines. Requestors can expect to receive feedback about one week after the meeting date.

For ethics input on a policy:

Complete our Ethics Input on Policy request form

Email: ethicssupport@nshealth.ca

For more information about ethics support:

Visit: Ethics Nova Scotia Health

Phone (toll-free): 1-833-392-1413

Lisbeth Witthoefft Nielsen

Ethics Program Manager, Ethics Nova Scotia Health

Ethics Nova Scotia Health: New structure for ethics support - Part 1
10/28/2024
Library Staff
Nursing, Physicians, Ethics, Nurse Practitioners

In September 2024, Ethics Nova Scotia Health launched its new model for delivery of ethics support. This was done to:

  • better align ethics support with the organization’s movement towards provincial approaches to program delivery and administration.
  • promote greater availability of ethics support across the province.

This post looks at the structure for ethics support and the changes we have made, and the types of ethics support available to health care providers, staff members, volunteers, and patients and families.

Changes to Ethics Nova Scotia Health’s structure

The main change to our structure is the formation of three Core Function Groups:

  • Clinical Ethics Support
  • Organizational Ethics and Policy Support
  • Ethics Education

These groups replace the previous Local Ethics Teams, Zone Ethics Committees, and the Ethics Leads group.

As of October 2024, Ethics Nova Scotia Health's updated structure and community includes about 55 members from all four zones. Each Core Function Group consists of health care providers and staff members from a wide range of programs and services, and community members. These Core Function Groups provide ethics support within Nova Scotia Health, with support from the Ethics Collaborations Team in the Department of Bioethics at Dalhousie University.

Types of ethics support available

While the delivery of ethics support has changed, the types of ethics support available remain the same and include:

  • Clinical Ethics Support offers ethics support pertaining to a specific patient’s care or to a particular clinical situation involving questions of professional ethics.
  • Ethics Education is available for education days or if there is an ethics topic that your team would like to explore. We can tailor the education session(s) to your needs. Some recent topics we have worked on include “ethics issues in health care documentation” and “moral distress.” We also develop ethics education resources, such as a guide for patients and families about Making Health Care Decisions for Someone Else: Acting as a Substitute Decision-Maker (SDM), and our Ethics Tool: Help with Ethical Issues.
  • Organizational Ethics and Policy Support addresses broader, systems-level issues that typically affect larger groups of patients and other stakeholders. Organizational ethics may involve overall direction for programs, zones, and Nova Scotia Health as a whole, where an ethics perspective can contribute to analysis and strategic choices. This can also include support with policy development and/or ethics review of policies. This Core Function Group is available to review draft policies through an ethics lens, as well as offer support in applying our feedback.
    For upcoming deadlines and details on how to submit policies for an ethics review, see our Ethics Review of Nova Scotia Health Policies – Submission Deadlines.

In part 2 of this post, we will take a closer look at ethics support available for policy developers and the process for requesting and obtaining stakeholder feedback on draft policies from Ethics Nova Scotia Health.

If you need ethics support, you can:

Lisbeth Witthoefft Nielsen

Ethics Program Manager, Ethics Nova Scotia Health

Part 2: Ethics support at Nova Scotia Health
09/19/2022
Library Staff
Nursing, Physicians, Ethics

In part 1 of our post about ethics support at Nova Scotia Health, you learned about the structure for ethics support and the types of support available to staff and physicians. Now, in part 2, we will cover how you access ethics support through Ethics Nova Scotia Health.

Ethics support is available to all staff, health care providers, volunteers, patients, and families at Nova Scotia Health. Our hours are Monday to Friday, 8:30 -4:30pm.

To request ethics support:

  1. Visit our corporate website.
  2. On the website, click on the appropriate link to access a request form. Download the form and fill it in.
  3. Submit the completed form by email to the relevant zone ethics contact.

OR

What to expect when you request an ethics consultation

Ethics requests are confidential. Health care team members, patients, and families do not need permission from the treating physician to request an ethics consultation.

Once you have submitted your request, an ethics administrator or a member of the ethics consultation team will contact you. If you have not filled in a request form, you may be asked to provide more information about the situation. We will then triage your request. If we determine that another service may be better able to address the issue, we will do our best to direct you to the relevant service.

Ethics consultation support can take different forms, depending on the issue and the situation:

  • In some cases, an informal conversation with a health care ethicist may help clarify the ethical concerns and the tensions between values.
  • In other cases, it may be useful to involve several team members in a meeting (online or in-person) with Ethics, to discuss the team's concerns.
  • You may choose to involve Ethics in a more formal meeting with the medical team, patients, and family members.

During your ethics consultation, we can help you:

  • Work through complex decisions
  • Identify tensions between the values in the situation
  • Explore possible options and the consequences of those options

NOTE Ethics does not take over the decision-making authority.

Online ethics resources and tools

Ethics Nova Scotia Health resources: https://www.cdha.nshealth.ca/ethics-support/ethics-resources

Nova Scotia Health Ethics Network (NSHEN): www.nshen.ca

Clinical ethics resources:

Resources for health policy developers and reviewers:

  • Ethics and Health Policy: The Nuts & Bolts is a general guide on developing health policies. It guides you through the various stages of health policy development. NOTE This guide is written for a general audience. It does not speak to the specifics of Nova Scotia Health's policy development and approval processes.

Ethics education resources:

If you have any general inquiries about Ethics Nova Scotia Health, please contact czethics@nshealth.ca. To request ethics support, please reach out to Ethics Support for your health zone: https://www.cdha.nshealth.ca/ethics-support/contact.

Lisbeth Witthoefft Nielsen

Ethics Resource Coordinator, Ethics Nova Scotia Health, Central Zone

with the Ethics Collaborations Team
Department of Bioethics, Dalhousie University

 

Part 1: Ethics support at Nova Scotia Health
09/06/2022
Library Staff
Nursing, Physicians, Ethics

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

 

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