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         Patients, families, surrogates, health care providers, and other involved parties may request an ethical consult without fear of reprisal.

         If the ethics consultation request is deemed appropriate, the Lead consultant will gather information and proceed with any or all of the following measures:

o   reviewing the patient's medical record

o   interviewing involved parties, either individually or in groups

o   discussing the case with other members of the consult service

o   discussing the matter with appropriate interested parties (e.g. chaplaincy, risk management, legal counsel)

o   gathering any other information or opinions thought to be helpful, being careful at all times to respect the privacy of the patient

         Strict attention to confidentiality will be maintained during the entire process.

         Any member of the consult service should decline to participate in a consultation should a conflict of interest arise. If the consultation involves a patient within one of the member's area of patient responsibility, that member should decline, to avoid any appearance of conflict.

         Following the gathering of information, a consultation meeting of most or all persons involved may be indicated, especially if there is a difference of opinion about ethically acceptable options. A good-faith effort will be made to involve all parties.

         The meeting shall proceed along the following guidelines. The team leader shall:

o   set the length of the meeting, the issues to be discussed and the goals of the meeting in the beginning.

o   assure that the appropriate decision-makers are present.

o   explain the purpose and parameters of the meeting.

o   emphasize the goals of maintaining confidentiality, and

o   allow time for each person present to express his or her thoughts concerning the case.