CBSSM Bioethics Grand Rounds: Assessing Clinical Ethics Consultation at Michigan Medicine



Wednesday, February 22, 2023


12:00pm - 1:30pm




Assessing Clinical Ethics Consultation at Michigan Medicine

Former Clinical Ethics Fellows and trainees, Hannah Fagen, Samantha Lyons, and Yena Kang, will present their research looking at Michigan Medicine ethics consults on improving and developing the consult process in the outpatient setting; exploring differences in reason for ethics consultation between adult and pediatric settings; and reasons for ethics consultation for incarcerated patients.

Zoom webinar ID:94934045283 Join us on Zoom  

“Outpatient Ethics Consultation in the Pediatric Setting”
At Michigan Medicine, clinical ethics consultation is available to any member of the healthcare team (including patients and families!) in any clinical care setting. While the majority of ethics consultation at MM and elsewhere is done for inpatients, outpatient specialty and primary care practices may also request ethics consultation. This talk will summarize a review of ethics consultation in the outpatient setting, with a focus on pediatric cases. We will explore the context and themes for outpatient pediatric ethics consultation, and contrast this with inpatient pediatric ethics consultation. We will also discuss plans for a new way for outpatient clinicians to request ethics consultation using the electronic medical record. 

“In the liminal space: Differences in reason for consult between adult and pediatric care settings for patients aged 18 to 26 years old”
The liminal space between childhood and adulthood is distinctive for medical care as decision-making authority shifts from the parent to the young adult, and the patient’s responsibility shifts from assent to consent. Depending on the health system or clinical issue, patients 18 to 26 years old can be cared for by pediatric or adult clinicians or both. Although this shift is commonplace, little is reported about the specific ethical issues encountered in this age group and whether they differ depending on if care is provided in the adult or pediatric setting. We conducted a retrospective chart review and characterized and compared the primary ethical and contextual issues for patients 18 to 26 years of age seen by either the Adult or Pediatric Ethics Committees at Michigan Medicine. 

“Clinical Ethics Consultations for the Incarcerated Population at Michigan Medicine”
Mass incarceration is incredibly pervasive in the United States and disproportionately impacts already marginalized minority groups. It was only in the last 50 years that prisoners gained the constitutional right to health care and along with it came numerous limitations that force clinicians to navigate unique medical, legal, and ethical issues. Despite the literature encouraging the involvement of ethics committees for this population, there is little known about the frequency and nature of such ethical consultations. We characterized the primary ethical issues and contextual features of ethics consultations for patients at Michigan Medicine to determine the nature of ethical dilemmas of this population to hopefully better care for this vulnerable population.
CBSSM’s Clinical Ethics Service sponsors the monthly Bioethics Grand Rounds. CME credit is available for Michigan Medicine faculty and staff. 

Faculty and Nursing CME Credit 1 AMA PRA Category 1 Credit(s)™ & 1.0 CEU for Social Work Available

For CME and CEU details click HERE.

Please feel free to forward on to others in your department who may be interested.

The following faculty planner(s)/co-planner(s) and presenter(s) have nothing to disclose: Andrew Shuman, Christian Vercler, Hannah Fagen, Samantha Lyons, and Yena Kang.