When is it appropriate to involve social services or ethics committees?

• A. For routine care decisions
• B. Only after the patient dies
• C. For complex ethical dilemmas, disputes about capacity, advanced directives, or care decisions beyond routine care.
• D. Never; these are not necessary

Answer: (C)

When care decisions involve values, goals of care, or legal/ethical considerations, it’s appropriate to bring in social services or an ethics committee. Social services help address non-medical barriers that affect care, such as arranging housing, community resources, caregiver support, discharge planning, and guardianship or surrogate decision-making when needed. An ethics committee provides a multidisciplinary review to work through ethically charged situations, including assessing a patient’s decision-making capacity, interpreting advanced directives, resolving conflicts among patients, families, and clinicians, and guiding choices about withholding or withdrawing treatments or allocating limited resources.

These resources are most helpful for complex ethical dilemmas, disputes about capacity, advanced directives, or care decisions that go beyond routine, standard care. For routine decisions, the care team can typically proceed without these supports.