Clinical Ethics Consult Services
At Mount Sinai, clinical ethics consultation services are available to hospitals and Mount Sinai Doctors outpatient practices to help resolve ethical questions that arise in the care of patients. The Clinical Ethics Consult Service is comprised of a multidisciplinary team of ethics consultants who provide analysis of and recommendations about ethical issues related to patient care. The goals of clinical ethics consultations are to promote the ethical delivery of patient care, resolve conflicts, and ensure everyone’s voice is heard. Any health care professional—including nurses, residents, advanced practice providers, attending or consulting physicians, genetics counselors, social workers, and patient representatives—may request an ethics consultation.
Mount Sinai patients, family members, and legally authorized representatives may also request an ethics consultation. When appropriate, the ethics consultants can meet with patients and families and facilitate meetings with care teams.
Hospital ethics committees oversee the consult service within each hospital and affiliated Mount Sinai Doctors outpatient practices, provide education, and collaborate on ethics-related policy development. In addition, the Mount Sinai Health System Ethics Committee ensures common operations and ethical standards as well as quality improvement across hospital ethics committees and consult services.
When to Request an Ethics Consultation
Ethics consultations offer guidance in ethically challenging situations, promote effective communication, and support decisions grounded in compassion, professionalism, and respect for patient values.
Ethics consultants make recommendations that can help patients, families, and health care professionals navigate ethically complex situations in patient care. Consultations are confidential, non-judgmental, and focused on supporting respectful, values-based decision-making and building consensus.
Consider requesting an ethics consultation (and/or legal consultation) when there are:
- End-of-life decisions, such as uncertainty about whether to withhold or withdraw life-sustaining treatment particularly in patients with no one to speak for them
- Questions about decision-making capacity, especially when a patient’s capacity is unclear, contested, or fluctuating
- Refusal of treatment. When a patient declines care that may be beneficial or life-sustaining or wishes to leave against medical advice
- Concerns about decision-making by the legally authorized representative (proxy, surrogate under the Family Health Care Decisions Act or guardian), including determining an appropriate decision maker, disagreements among family members, or questionable decision making
- Patients without capacity and without anyone to speak for them particularly in end of life situations
- Conflicts over the plan of care, including disagreements between the clinical team and the patient or family, among clinicians, and among patients and family members
- Concerns about providing potentially non-beneficial or medically inappropriate treatment
- Questions about advance directives, such as how to interpret or apply a living will, medical orders for life-sustaining treatment, or a health care proxy
- Informed consent issues Concerns about understanding, voluntariness, or potential coercion
- Confidentiality dilemmas, including appropriate disclosure of sensitive information
- Safe discharge planning When there are ethical concerns about sending a patient home or to another facility
- Allocation of limited medical resources, including making fair decisions during scarcity (such as ICU beds, dialysis, transplant)
- Clinician conscientious objection When a clinician raises moral or religious objections to aspects of care
- Questions about hospital policy and ethical standards When clarification is needed on how institutional policies apply to a specific case
Legal and Ethics work closely together. Questions that are directed to Legal that are appropriate for an ethics consultation will be referred to Ethics and questions that come to Ethics of a more legal nature will be referred to Legal.
Initiating an Ethics Consultation
Please contact the appropriate clinical ethics consult team below. Mount Sinai health care professionals may also contact the on-call ethics consultant listed in Amion.
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For patients at The Mount Sinai Hospital, Mount Sinai Queens, Mount Sinai Brooklyn, New York Eye and Ear Infirmary of Mount Sinai, Mount Sinai-Behavioral Health Center, and affiliated Mount Sinai Doctors outpatient practices, please contact The Mount Sinai Hospital Ethics Consult Service: mshethics@mountsinai.org
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For patients at Mount Sinai Morningside, Mount Sinai West, and affiliated Mount Sinai Doctors outpatient practices, please contact: ethicsMSSLW@mountsinai.org.
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For patients at Mount Sinai South Nassau and affiliated Mount Sinai Doctors outpatient practices, please contact: ethics.committee@snch.org
Hospital Ethics Committees and Ethics Consult Service
The Mount Sinai Hospital Ethics Committee and Consult Service
Krishna Chokshi, MD, MS
Ethics Committee Chair, The Mount Sinai Hospital
Director, Clinical Ethics Consultation Service, The Mount Sinai Hospital
krishna.chokshi@mountsinai.org
Mount Sinai Morningside and Mount Sinai West Ethics Committee and Consult Service
Mirna Mohanraj, MD
Ethics Committee Chair, Mount Sinai Morningside and Mount Sinai West
edwardinemirna.mohanraj@mountsinai.org
Mount Sinai South Nassau Ethics Committee and Consult Service
John Altus, MD, MA
Ethics Committee Co-Chair, Mount Sinai South Nassau
jonathan.altus@mountsinai.org
James Murphy, DNP, ACNPC-AG, CCRN
Ethics Committee Co-Chair, Mount Sinai South Nassau
james.murphy2@mountsinai.org
Health System Ethics Committee
The Mount Sinai Health System Ethics Committee consists of the hospital ethics committee chairs and other leaders throughout the Health System. It ensures standard common operations and ethical standards as well as quality improvement across the hospital ethics committees and consult services and coordinates ethics-related policy development in the Health System.
Jolion McGreevy, MD, MBE, MPH, MBA
Ethics Committee Chair, Mount Sinai Health System
jolion.mcgreevy@mountsinai.org
Contact Info
Clinical Ethics Consult Requests
Please contact the appropriate clinical ethics consult team below. Mount Sinai health care professionals may also contact the on-call ethics consultant listed in Amion.
For Patients at The Mount Sinai Hospital, Mount Sinai Queens, Mount Sinai Brooklyn, New York Eye and Ear Infirmary of Mount Sinai, Mount Sinai-Behavioral Health Center, and affiliated Mount Sinai Doctors outpatient practices
Email: mshethics@mountsinai.org
For Patients at Mount Sinai Morningside, Mount Sinai West, and affiliated Mount Sinai Doctors outpatient practices
Email: ethicsMSSLW@mountsinai.org
For patients at Mount Sinai South Nassau and affiliated Mount Sinai Doctors outpatient practices
Email: ethics.committee@snch.org