Clinical Ethics Choices about patient care always involve values, and a discussion of the patient's and doctor's values may help both to make their decisions. The Ethics Consultation Service helps patients, families, and caregivers to explore the issues and choices surrounding difficult decisions. Situations where an ethics consultation might be helpful include, but are not limited to: When there are questions about decision-making authority. For example, the patient seems to lack capacity to make medical decisions for him or herself, but it is not clear who has the authority to make decisions in his or her place. When there are questions about treatment goals. Often these involve treatment goals at the end of life, such as decisions to forgo or withdraw life-sustaining interventions, DNR orders, etc. When family members disagree about the treatment goals of the incapacitated patient. These situations often involve issues of decision-making authority and treatment goals. A consultation is typically arranged by the attending physician or another member of the healthcare team, although patients, family members, or others may contact the Service directly. A formal consultation involves meeting with the patient and family and/or friends, and discussions with the attending physician and other members of the healthcare team. The Ethics Consultation team writes a consult note which assesses the particular ethical issues and makes recommendations for resolution; this note is included in the patient's chart. This service is financed by the hospital at no cost to the patient. Medical students who choose to do an elective in Clinical Ethics will have an opportunity to work on this Service and participate in all its activities.