Bioethics Services

Dealing with disease can be difficult and emotional. Illness raises concerns that strike at the heart of personal values and goals. Resources are available to help you constructively navigate these challenging issues. Speak with a compassionate and experienced bioethics professional.

Navigating Difficult Healthcare Decisions

When illness strikes, patients, families and healthcare providers often face difficult and complex decisions. It is critical that any discussion about treatment options include a dialogue of one’s personal values and goals. That’s where a Clinical Ethics Consultation can help. The Program in Medicine and Human Values’ professionally trained bioethics consultants respond directly to consultation requests and provide practical recommendations regarding ethically appropriate care.

An ethics consultation can assist when:

• You’re experiencing an ethical dilemma about your care or the care of a loved one.
• You and your family or support network have conflicts around care goals.
• You or a loved one are not able to make medical decisions and have no healthcare decision maker to act on your behalf.
• You need help to identify a healthcare decision-maker proxy.
• You, your loved one or a healthcare decision maker needs support or assistance in deciding about complex treatment choices.
• You are facing a challenging healthcare situation that leads to distress or suffering.

All requests are confidential. Requestors may choose to remain anonymous.

To request a consultation, please email ethics@sutterhealth.org or use our Ethics Hotline 415-600-3991.

Provider Perspective

The Program in Medicine and Human Values helps healthcare providers—and you—by offering support and guidance through challenging medical situations.

"Having served on CPMC’s Ethics Committee for the past 10 years, I have been constantly impressed with the quality of care our Ethics Service provides. In our high tech, fast-paced medical environment, we often lose track of the toll it can take on providers, patients, and families."

Robert Margolin, M.D.

The Program in Medicine and Human Values works closely with Sutter hospitals and administrators to identify systems-level bioethics issues and develops solutions that serve both patients and staff. This includes bioethics policy development.

Ethics for Healthcare Companies

Sometimes ethical questions arise at an institutional level rather than an individual patient level. The team at the Program in Medicine and Human Values have experience to help. PMHV bioethicists work closely with Sutter Health hospitals and administrators to develop solutions and policies to address systemic issues. The goal is to help close institutional ethics gaps to improve healthcare quality.

Addressing Moral Distress

PMHV strives to address staff distress when dealing with complex patient situations. Our team members find early intervention options, answer questions and help hospital personnel decompress in the face of troubling circumstances.

We offer:

• Staff debriefing sessions to discuss complex cases.
• Involvement in hospital team rounds.
• Initiatives to reduce doctor, nurse and staff distress.

Improving Healthcare Quality

Enhancing healthcare means improving not only scientific, technical and service quality, but also ethics quality. It requires assuring that clinical and management practices consistently adhere to widely accepted ethics standards, norms and expectations. PMHV works with organizations to identify ethics gaps at the system level and develop solutions for quality improvement.

For information on policies and organizational ethics initiatives, email ethics@sutterhealth.org.

New and extensive scholarship in modern bioethics must be translated into useful information and advice for people navigating difficult medical decisions. This requires skilled scholars and bioethicists, professionals who can communicate with patients and doctors and provide ongoing education to those who work in community hospitals.

PMHV staff continue to contribute to scholarly literature. Dr. Jonsen is the author of numerous books in the bioethics field, including the popular Clinical Ethics. Dr. Kushner serves as editor for the Cambridge Quarterly of Healthcare Ethics. Dr. Andereck is widely published in medical and bioethics journals. Dr. Mishra is the department editor for “Ethics Committees and Consultants at Work” for the Cambridge Quarterly of Healthcare Ethics.

Kelsey Gipe, Ph.D.
“Heartbeats, Burdens, and Biofixtures”
Cambridge Quarterly of Healthcare Ethics 30 (2):285-296 (2021)

Shashidhara, S. and Kirk, S. (2020) Moral Distress: Framework for Offering Relief Through
Debrief. Journal of Clinical Ethics. Vol 31 (4): 364-371.

Morely, G and Shashidhara, S. Debriefing as a Response to Moral Distress. (2020).
Journal of Clinical Ethics. Vol 31 (3): 283-289.

William S. Andereck, M.D., FACP
“Rational Rationing: Developing Guidelines for Tough Ethical Choices in the Covid Era”
San Francisco Marin Medicine,
Vol. 93, No. 3, May/June/July, 2020.
https://issuu.com/sfmedsociety/docs/1sfmm-may-june2020

William S. Andereck, M.D., FACP and Ruchika Mishra, Ph.D. served on the CMA Ethics Task Force that authored
“Ethical Allocation of Scarce Health Care Resources in the COVID-19 Pandemic.”
California Medical Association, April 2020.