Hospitals are places of incredible hope and healing, but they are also where some of life’s toughest decisions are made. When families and medical teams find themselves at a crossroads with no obvious right answer, trained experts can quietly help evaluate the options.

Hospital ethics consultants don’t perform surgery or prescribe medication. Instead, they wield a different kind of superpower: the rare ability to bring insight and clarity to moments of deep uncertainty. When the best path forward isn’t on a medical chart, these guides step up to support families and healthcare teams.

Jennifer McCurdy is an assistant professor of bioethics and social justice in MSU’s College of Human Medicine. She’s a hospital ethics consultant and here, she explains when, why and how families, patients and healthcare professionals can benefit from help like hers.

What does a hospital ethics consultant do?

Healthcare ethics consultants are trained to help patients, families and clinicians navigate difficult medical decisions.

They could be called in situations where members of the healthcare staff struggle with providing procedures, such as cardiac resuscitation, that are unlikely to benefit the patient and might even cause more pain and suffering. The consultant could also be called when it is unclear who has authority to consent for a patient’s care or when end-of-life decisions are complicated and resources are limited — such as intensive care unit beds and ventilators during COVID-19.

Ethics consultants come from a range of disciplines: physicians, nurses, social workers, chaplains, lawyers and philosophers who have specialized training and experience in clinical ethics. Since 2018, ethics consultants have been pursuing formal certification through the American Society for Bioethics and Humanities.

Why are they important?

Ethics consultants are trained to help people work through the medical facts as well as the deeply human questions beneath them:

• What counts as an acceptable quality of life?
• How do we weigh hope against suffering?
• How can we know what a patient would want if they cannot speak for themselves?

These decisions can feel urgent and heavy, causing communication to break down. Ethics consultants don’t take decisions away from patients or families, nor do they replace clinicians. Instead, they help ensure a shared understanding of the situation, giving space for different perspectives to be heard and keeping the conversation grounded in the patient’s values and goals.

They also bring something families often don’t realize they need until tensions rise: a calm, measured presence. By clarifying misunderstandings, naming sources of conflict and guiding difficult conversations, they help families and care teams find a way forward together.

Today, most hospitals have a formal process for addressing ethical concerns in complex patient care situations.

What happens when an ethics consultant joins the conversation?

A member of the healthcare team usually requests an ethics consult when they face conflict or uncertainty about the care of a patient. Patients and families can also request an ethics consultation, and more people should know they have this option.

The ethics consultant’s first task is to gather as much information as possible from everyone involved to understand the full context of the case. Ethics consultants do not make treatment decisions; they assist the people who do.

Imagine a loved one with advanced dementia who is in the intensive care unit with respiratory failure and is on a ventilator. The physician believes further treatment will prolong suffering; the family is not willing to let the patient go.

An ethics consultant could be called by the family or healthcare team to slow things down, provide space to reflect and help navigate the situation. The ethics consultant will often talk with everyone involved to ensure that all voices are heard and that the patient’s wishes remain central to the discussion.

As part of the situational review, the ethics consultant would draw on their knowledge of policies, laws and ethical precedent surrounding the withdrawal of life-sustaining treatment to help define the legal and ethical boundaries of the situation. In this case, one legal boundary is the physician cannot remove the ventilator without the family’s consent.

The ethics consultant would then outline the available options to assist the patient, family and healthcare team in making informed decisions.

The choices may still be painful — and there may be no perfect answer — but with the right support, those decisions can feel more thoughtful, more shared and more aligned with what matters most.

Excerpts are taken from McCurdy’s article in The Conversation