In 1982 the Sisters of St. Joseph established a Clinical Ethics Service which was jointly sponsored by Providence Healthcare, St. Joseph’s Health Centre and St. Michael’s Hospital, three Catholic institutions which serve the Toronto area. The first ethics service of its kind in Canada, this service has grown over the years and today is known as the Centre for Clinical Ethics, a legally constituted joint venture of the three founding Catholic hospitals. Currently, we provide ethics services to 12 healthcare organizations in the GTA, Hamilton and Windsor.
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 founding 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 We Do
- 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”
- 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
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).
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 Alliance of Canada, the Catholic Health Association of Ontario and the Catholic Health Sponsors of Ontario.
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)
- Advance Care Planning
- Capacity Assessment
- Centre for Clinical Ethics
- CPR: Cardio-Pulmonary Resuscitation
- A Principle-Based Decision Making Framework: YODA
- Informed Consent
- Power of Attorney for Personal Care
- Substitute Decision-Making
Ethical Decision Making