Bioethics for Medical Professionals

The Center for Bioethics team focuses on the unique ethical issues that arise in pediatrics. We are working to advance the field of pediatric bioethics by providing education, sharing expertise and collaborating on scholarly efforts.

Our specific areas of interest include ethical issues related to:

• Allocation of scarce resources and public health crises
• Health disparities, particularly those related to racism, language differences, health literacy and other forms of discrimination
• Moral distress and burnout among health care providers
• Personalized medicine and genomic sequencing
• Preventive models of ethics consultation
• Shared decision-making in serious childhood illness and at end-of-life

Clinical Ethics Consultation

Our ethics consultants follow the American Society for Bioethics and Humanities Code of Ethics and Professional Responsibilities for Healthcare Ethics Consultation. We support patients, families and health care providers grappling with ethical questions.

These questions may include:

• Conflicts between medical teams and patient families (for example, about using life-sustaining therapies)
• Uncertainty or disagreements among members of the medical team about the right course of action (for example, whether to offer certain treatments)
• Staff experiencing moral distress (knowing what the right choice is, but being unable to make it due to things beyond your control)
• Questions about ethical research conduct (for example, weighing the risks and benefits of research participation)

Goals of a clinical ethics consult

Our main goals during a consultation include:

• Facilitating communication among those involved in the ethical issue
• Fostering understanding between those involved
• Clarifying and analyzing ethical issues
• Providing recommendations and justifications for a plan moving forward

Sometimes people have misconceptions regarding clinical ethics consults. These consults DO NOT mean that:

• Someone has done something "unethical"
• Consultants are “moral experts”
• The ethics consultant will decide who is right or wrong
• The ethics consultant will end up “siding with” the family or with the medical team

Who can request a clinical ethics consult?

We encourage health care team members to request help even when they are uncertain if the matter concerns ethics. Our ethics consultants can always answer questions and talk through problems.

Anyone involved in the care of a patient at CHLA can request an ethics consult, including CHLA providers, referring doctors, patients and their families. An attending physician does not have to approve an ethics consult. We don’t accept anonymous requests, but we will do our best to maintain confidentiality within the constraints of the consult process. It is also possible for a group—rather than an individual—to consult with our team.

Preventive Ethics

We visit clinical areas throughout the hospital weekly. These informal ethics rounds give health care team members an opportunity to talk with the bioethics team.

We can discuss ethical issues related to particular patients or general ethics questions. We also support team members coping with moral distress. In addition, our team can provide education on related ethics principles and hospital policies.

Bioethics Scholarship and Advocacy

At the Center for Bioethics, we work to spread bioethics knowledge through education, scholarship, leadership and advocacy. We collaborate with researchers, educators, clinicians and bioethicists from across the country. Please contact EthicsSupport@chla.usc.edu for more information.

Ethics education at Children’s Hospital Los Angeles

We provide education throughout Children’s Hospital to equip faculty, staff and trainees with a basic toolkit for understanding pediatric ethical issues. We cover core ethics topics in relation to patient care, research and advocacy. We use an integrated, multimodal approach to give CHLA team members the space to reflect on the moral aspects and ethical impact of their work.

Currently, we provide ethics education for residency and fellowship programs throughout CHLA. We also offer teaching tailored to a team’s specific needs. Some past presentation topics include:

• Controversies Surrounding Diagnosis and Determination of Brain Death
• Finding Purpose in Personhood: Caring for Patients With Medical Complexity, Disability, and/or Life-Limiting Conditions
• The Ethics of Gender-Affirming Care
• The Ethics of Triage and Crisis Care

Bioethics at Children’s Hospital Los Angeles

We offer a range of bioethics services for patients, families, providers and researchers. Learn more about our bioethics services.