November 7, 2024
By: Locky Butcher, Clinical Research Ethicist Fellow
Ethics at LHSC
Ethics at LHSC provides support for complex ethical issues in patient care, health-care management, and research. The ethics team offers values-based decision-making, education, and analysis to patients, families, staff, trainees, leaders, and researchers to promote ethical practices and decision-making across the organization.
Becoming an Ethicist
I was submersed in the ethics world at a young age as both of my parents work in ethics; my mother in ethics in sport and my father as a health ethics consultant. Standard dinner table discussions growing up could include anything from minor ethical dilemmas, such as whether to lie to someone to protect their feelings from the truth to health ethics issues my father encountered (without any identifying details of course). These conversations sparked my interest in philosophy and led me to pursue it further in secondary school, with the goal of becoming a bioethicist.
My post-graduate journey included a degree in philosophy with a minor in psychology and a master's in philosophy. I am currently a PhD candidate at Carleton University in the Ethics and Public Affairs program, where I am writing my dissertation on the ethical implications of expanding Medical Assistance in Dying (MAiD) to include mental disorders as the sole diagnosis.
Now that I have almost completed my education, working as an ethics fellow at LHSC is the perfect opportunity for me to learn how to practice ethics. Up until this point all of my knowledge had been theoretical, and being an ethics fellow is the perfect stepping stone to being a practicing clinical ethicist. The ethics team here has done an amazing job challenging me to succeed and providing support when I need it. While my position as a fellow only exists for a year, I would be happy to continue if an opportunity exists.
Continuing education, skills and opportunities
Being a clinical ethicist requires skills that can only be developed through experience, such as those gained during a fellowship. While my interest in philosophy and ethics was inspired by my parents, much of what’s needed in practice—like communicating with staff and patients, handling difficult discussions, and addressing complex cases—can’t be learned from books alone. Although I have solid theoretical knowledge and some experience as a teaching assistant, the hands-on practice offered by this fellowship is essential for honing these critical skills.
Becoming a clinical ethicist is a unique career path, and I find it interesting that people find themselves entering the field in a variety of ways. My path has been through a PhD and fellowship opportunity, though others may enter the role with a master's degree or extensive clinical experience. Regardless of how you enter the role, it is important to have a deep understanding of moral philosophy, relevant laws and policies, and strong interpersonal skills to address the root of people's concerns.
Daily Impact on Lives
Ethical decisions are part of everyday life, and clinical ethics consultations help guide the toughest choices for patients, families, and staff. As an ethics fellow, I want to help create an environment where patient values are respected, staff get the support they need to make tough decisions, and health-care resources are used wisely. While ethicists don’t make the decisions, we ask the tough questions, speak up for those who aren’t present, and guide important conversations. No day is ever the same, and it requires a broad skillset so I am always learning.
Clinical ethics fellowships are increasingly essential for becoming a clinical ethicist, yet there are fewer than 10 available annually in Ontario. As a teaching hospital, LHSC is committed to supporting all learners and offers a valuable opportunity to develop the next generation of ethicists. I’ve been fortunate to work with such a supportive team that fosters learning and growth, will challenge me when appropriate and provide guidance when needed.