Ethics consultants must be flexible and view a case depending on the clinical details given and discovered. Consultants should be persistent in their pursuit of this goal. When they fail, it is often not so much in the analysis of an issue, but in the paucity of details and data gathered. Thus, the importance of a careful search for information has been emphasized throughout this book. Whether the patient needs a proxy decision maker, and, if so, who that might be and whether that person is reliable and well intentioned.
Most analyses are a mix of clinical, ethical, and legal factors.
Examples of case assessments are presented in the Appendix. Ethical analysis should focus on outlining several courses of action and attempting to discern which courses of action are ethically desirable, permissible, or appropriate. The information gathered from the patient, primary attending physician, records, nurses, and family members usually provide the deciding elements of this analysis. In many cases, critical information is missing and must be gathered, analyzed, and integrated before an assessment can be made. While waiting for missing information, or when the case is especially challenging or new, the consultant often does extra reading to gather additional information that may be useful.