When Time is Critical: A Structured Approach to Urgent Consults
Friday, October 24, 2025
2:30 PM - 3:30 PM Pacific Time
Location: C125-126
Charlotte Harrington, MD – The University of Chicago; Sean Wightman – The University of Southern California; Baddr Shakhsheer – The University of Chicago
Resident Physician Northwestern Medicine, Department of Surgery Chicago, Illinois
Abstract: Clinical Ethics Consultations (CEC) are integral to high-quality healthcare and required for hospital accreditation (2). However, important challenges such as urgent ethics consultation remain unaddressed, with a deficiency in the literature despite clinical need. There are no best practice guidelines for approaching urgent ethics requests, despite professional organizations such as the American Medical Association (AMA) encouraging timely access to ethics services. Due to this lack of actionable guidelines, the authors propose a framework for ethics consultants to approach urgent requests. The first step is to work with the clinical team to explicitly identify and agree upon the specific ethics question. Next, the consultant should guide the clinical team through identifying the time-sensitive components of the request. Here, it is crucial to distinguish medical from ethical when understanding the drivers of acuity. If the request is urgent for medical reasons, the decisions to be made are medical. Importantly, this decision-support tool for ethics consultants is not meant to deter clinical teams from calling. Rather, our algorithm aids in determining what questions can be answered from a clinical ethics perspective. Finally, ethics consultants should only address the specific, time-sensitive components in an ethically urgent case. Broader discussion should be postponed to a later time once the situation has stabilized. CEC involve complex value-based deliberations that require time. Nevertheless, clinical ethics consultants are often called with time-sensitive requests and a structured approach is needed to address urgent questions effectively. Our methodical framework aids ethics consultants in providing timely, pragmatic guidance in crucial moments.
After participating in this conference, attendees should be able to:
Recognize the challenges associated with urgent clinical ethics consultations.
Apply a structured framework for addressing urgent ethics requests by systematically identifying the specific ethics question, assessing time-sensitive components, and providing targeted, pragmatic guidance.
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