From the Heart is a space for the reflections of our staff on issues that matter to them, to our network, and most importantly, to those we walk alongside.
This month, our Clinical Ethicist, Katarina Lee-Ameduri, sat down to talk about why ethics matter in health and social services and what a day in the life of an ethicist looks like.
Katarina, let’s start with the basics. What is a Clinical Ethicist and what’s the training required to do so?
The high-level description of a Clinical Ethicist is someone who helps patients, families and health or social services teams identify and work through ethical issues. On the day to day, that could mean consulting with a family who is facing a difficult decision around the care plan of an elderly relative, but we also do a lot of organizational work such as creating or reviewing codes of ethics, helping to launch projects or any number of other tasks. It’s a very diverse role.
As for education, the road to become an ethicist is typically multi-path. There are several roads in, but many of us begin with a Bachelor of Philosophy and/or Ethics, most go on to get a Masters of Ethics and many of us have terminal degrees in law, medicine or the humanities. Additionally new Clinical Ethicist’s typically do a post-doctoral in Clinical Ethics. It’s possible to specialize in the type of ethics you want to work in, which for me, of course was clinical.
You mention being involved in different types of projects, which sounds interesting. What types of things have you been working on lately?
At St. Boniface Hospital, we recently created and launched a video project for patients that explains the Patient Charter of Rights and Responsibilities. There are some very fundamental factors that not every patient or family member is aware of when entering the hospital and we want to provide clarity. For example, everyone has a right to request spiritual care, which might be access to a spiritual leader or just a provider who can listen with a compassionate ear. There are other practical pieces such as knowing that staff must introduce themselves to you, or that you have the right to be actively involved in your care and to properly understand what your care plan is. We’ve created a document and a video that’s available in many different languages to be able to reach the broadest audience.
We’ve also been working on a harm-reduction project in the hospital. We want to ensure that patients or visitors have access to items that will reduce the possibility of harm to them or their loved ones, such as clean needles, safer smoking supplies and other risk-reduction tools.
While you’re a Clinical Ethicist who is assigned to supporting Réseau Compassion Network organisations, you’re only one person and those working in health care and social services must be faced with difficult choices often. How do you help spread information and knowledge to front-line staff?
We provide two larger-scale educational formats. We have something called Grand Rounds, which are learning opportunities that are open to staff, students and the public. These usually are specific “hot topics” in ethics. We also have our Health Care Ethics Educational series, in which we host a session each month that focuses on one particular topic. For example, in long term care, feeding often comes up. Some residents might have restrictions on what they can eat for safety’s sake, but the long-term care facility is still their home. When you and I are in our home, we have the right to eat whatever we want. So how do we find the balance between safety and autonomy?
We encourage staff to attend these sessions when are applicable to their work, as more knowledge or time to reflect is always helpful. But what’s most important for me to say is that the staff who work in our health care and social services organisations are really wonderful people who do everything they can to centre the patient or the client. Sometimes, things can become ethically complex and that’s where I provide support, but for the most part, staff are doing everything they can to provide compassionate, ethical care and they do a great job.