Clinical faculty members direct a clinical Ethics Consultation Service at NewYork-Presbyterian Hospital/Weill Cornell Medical Center to assist clinicians, patients and their families in assessing and resolving ethical issues that arise from clinical practice. Since its inception, the Ethics Consultation Service has helped a greatly increasing number of patients and family members to make complex and difficult decisions. In collaboration with Patient Services Administration, the Ethics Consultation Service is one of the busiest ethics consultation services in the country, working with about 250 patients a year. Joseph J. Fins, M.D., M.A.C.P., is Chair of the Ethics Committee and Director of Medical Ethics at NewYork-Presbyterian Hospital/Weill Cornell Medical Center.
Most of the issues with which patients and families ask for help center around end-of-life care, determination of capacity and futility disputes. Sometimes conflicts arise when patients refuse treatment. A percentage of cases involve infants in the neonatal intensive care unit and pediatrics. The Ethics Consultation Service has an excellent track record in transforming irresolvable dilemmas into fixable problems. The Service works with colleagues in the Patient Services Administration to help elucidate the facts and issues, resolve misunderstandings and miscommunications, and resolve conflicts. In the great majority of cases, a consensus can be reached on goals of care. Patients can obtain this service by asking a nurse, physician, social worker, chaplain or a representative from Patient Relations.