KHSC Ethics Framework

Kingston Health Sciences Centre (KHSC) is dedicated to providing excellent healthcare and adhering to best practices in all areas of healthcare. As healthcare is fundamentally an ethical enterprise, KHSC is committed to principled, values-based decision-making and following best practices regarding providing ethical care and promoting ethical awareness throughout the organization.

Therefore KHSC has developed an ethics framework that will help guide leaders, clinicians and staff in identifying, clarifying and resolving ethical dilemmas and questions. The ethics framework will help promote ethical awareness and ensure that the values KHSC are incorporated at all levels of its operations and through principled, values-based decision-making.

What is an ethics framework?

An ethics framework is a structure that provides a standardized approach to working through ethics issues and making decisions.  The framework is more than just a document that proclaims the importance of ethics within an organization. It is a means to ensure the integration of ethics into health care processes, policies and practices, and it emphasizes that everyone in our organization has a role to play in fostering an ethical environment in health care.

An ethics framework helps ensure that the organization is truly “living its values” and engaging in principled decision making. By providing ethics resources, education, and ethical decision making tools, a framework helps ensure that organizational decisions and processes will be filtered through an ethical lens and that leaders, clinicians, staff, patients and families have access to ethics support when they are confronted by ethical dilemmas or questions.

The Four Domains of Health Ethics at KHSC

Clinical Ethics – issues related directly to patient and family care, which involve the majority of ethical dilemmas within health care organizations. Common ethical issues include substitute decision making, challenging patients and/or family members, consent and capacity, informed decision making, difficult discharges, end of life issues, truth telling, privacy, cultural issues, etc.

Organizational Ethics – issues related to organizational decisions, procedures and policies. Common ethical issues include resource allocation, privacy, ensuring just and fair processes, inter-professional scope of practice and obligations, inter-organizational agreements and obligations, etc.

Governance Ethics – issues related to promoting ethical leadership and values-based principled decision making at the Board and Partnership levels of the organization.  In the KHSC context, ethics issues include involvements with the LHIN and the Ministry of Health and Long Term Care, fulfilling the mandate within the resources available for the acute sector of the health care system, partnerships with other sectors within the health care system, respecting the terms, principles and commitments of the Operating Agreement between KGH and HDH, and affirming the unique history and guiding values of each organization.

Research Ethics – issues related to research involving human participants. Common ethical concerns include informed consent, privacy, benefits and burdens of research, etc. Queen’s University Health Sciences & Affiliated Teaching Hospitals Research Ethics Board is responsible for all ethical review of medical research at KHSC.