Clinical Ethics
Institutional Ethics Committee Members:
Maria Basile, MD, MBA
Phyllis Migdal, MD, MA
Stephen G. Post, PhD
The antiquity of the Hippocratic Oath—which enjoins the practitioners of medicine to “never do harm” and to act “for the good of the patient”—makes clear that the professional practice of medicine has always been an ethically motivated endeavor. The great strides in both science and technology that have come since this oath was first sworn, along with the ever-changing legal environment in which medicine is practiced, have only increased the ethical complexity of the medical situations our patients (and their families), physicians, and other health care staff face on a daily basis. In response to the increasing complexity of situations (for example, surrounding the end of life) as well as clear abuses of medical authority in the past (such as the experiments performed by Dr. Mengele on behalf of the Nazi regime), bioethicists, philosophers, theologians and others have developed a number of ethical principles (such as respect for patient autonomy, non-¬ maleficence, beneficence, and justice) while lawyers, advocates, and legislatures (at both the state and national level) have developed a number of laws to ensure appropriate adherence to these principles. The ethical and legal complexity of even the most routine medical care can often be staggering for a patient and his family confronting these situations for the first time, as well as the health care provider who wants nothing more than to care for her patient. The Institutional Ethics Committee (IEC) at Stony Brook University Hospital aims to help both health care providers and their patients (and family and friends) work through these complexities and ensure that both legal and ethical conflicts are addressed proficiently and to everyone’s satisfaction.
The Institutional Ethics Committee has a tripartite mission in serving Stony Brook University Hospital and the community through Education, Policy advisement and Consultative Service. The IEC provides prospective study and education as well as timely ethics consultation to ensure that the Stony Brook University Hospital is able to meet all of the ethical and legal questions that its staff faces each day with compassion and beneficence in order to ensure the best experience possible for all of our patients.
The IEC is on call 24 hours a day, 7 days a week for consultation. A consultation may be requested by anyone involved in the case—patient, family member, friend, a health care provider, physician, nurse, or any staff member. Ethics consultations are handled by a team comprised of multiple disciplines, including, physicians, nurses, legal advisors, social workers, clergy, religious advisors, ethicists, and others. The Consultation service both helps advise those involved in the case and also helps build consensus among the affected parties so that all feel satisfied and comfortable with the outcome. The IEC keeps careful records of consultations and offers followup on a regular basis.
The IEC also maintains an Ethics Review Committee that regularly reviews the current laws, attends to changes as they are made, and revisits hospital policies and forms to ensure they are up to date and comply with all new laws. Educational opportunities are then provided to all hospital staff including orientations, ethics sessions, conferences, and Ethics Rounds.