Resources & Publications - Covenant Health

Resources & Publications

The Ethics & Discernment Centre's Resources & Publications page is a knowledge and resource hub for patients, families, anyone in the organization or externally looking for ethics resources. While the Ethics & Discernment Centre creates space to encourage conversations that guide you when you are struggling to decide on the right thing to do, our Centre has made available a range of tools and resources that can be accessed anytime to help your decision-making.

Tools, frameworks and policies

Ethical Decision-Making Framework Policy

Mission Discernment Tool

Just Workplace Framework

Outsourcing Services Framework

III-95 Patient / Resident Concerns Resolution Process policy

III-95.PROC.1 Patient / Resident concerns Resolution Procedures

Our Commitment to Ethical Integrity - This is our code of conduct. It sets the standard and reinforces that as members of the Covenant Health team, we are each

Accountable to uphold these standards of behaviour &
Create the ethical culture by which our organization will be widely known.

Creating our Covenant Health culture begins with the Board of Directors policy outlining their commitment to ethical integrity. The Board’s commitment is our commitment. The expectation of the Board as instituted in this statement applies to all who work, practice, or volunteer, in Covenant Health facilities.

The commitment made by the Covenant Health Board, in setting the highest standards of ethical conduct, and abiding by and modelling those standards in everything they do, belongs in turn to each of us.

Our Commitment to Ethical Integrity has been translated into 7 additional languages, available below:

Health Ethics Guide

The Health Ethics Guide is the foundational ethics resource used by Covenant Health. Key clinical and organizational policies, ethics consultations, and ethics education at Covenant Health are based on the principles contained in the Health Ethics Guide. It is also a defining document of our organizational identity referenced in the Cooperation and Service Agreement with Alberta Health Services.

The guide is intended to help providers navigate the complex ethical issues encountered while providing service to the people in our care. The guide is also a key component of board orientation, leadership development programs for staff and the privileging process with physicians.

Moreover, our organization’s code of conduct, Our Commitment to Ethical Integrity, is aligned with and based on the guide. Therefore it is important that people understand the content of the guide and its role in supporting both clinical and organizational decision-making.

The Health Ethics Guide has been provided to every director, manager and department, with additional copies available upon request. Please take time to familiarize yourself with the guide as a practical educational, policy development and decision-making resource.

The table of contents for the Health Ethics Guide may be viewed on-line on the Catholic Health Association of Canada's website.

Download HEG Missioning Prayer

Download HEG

Download HEG Orientation Presentation

Codes of ethics

Click here to download the Health Information Act

Nursing Ethics

CNA's Code of Ethics for Registered Nurses

Medical Ethics

Code of Ethics for physicians, residents, and medical students

Pharmacy Ethics

CACP's Code of Ethics

Social Work Ethics

View or download the CASW Code of Ethics

Spiritual Care Ethics

View the CASC's Ethics resources

Ethics & Discernment Centre annual report

2021-2022 Summary of Activities Report

2020-2021 Summary of Activities Report

2019-2020 Summary of Activities Report

2018-2019 Summary of Activities Report

2016-2017 Summary of Activities Report

2014-2015 Summary of Activities Report

Ethics & Discernment Centre newsletter archive

The Ethics & Discernment Centre publishes a monthly newsletter with links to interesting articles related to health care ethics, as well as a listing of upcoming ethics events. Have a tip for the next edition? Email us.

To subscribe to the newsletter, click here.

2023

July - Artificial womb, AI Code of Conduct, Unethical Disconnect, Phage Therapy and Surgery Complications
April - Place in medicine, Overdoses, Race Correction, Mental Health Services and 8 Glasses A Day
March - Healthcare training, Medical bills and Border closures, COVID-19 booster and Unexpected mechanism
February - Physician stress, COVID surveillance and Eugenics facts
January - Finding health, Kinless Canadians and Successful aging

2022

December - Euthanasia, Doctor scarcity, Pediatric hospitals chaos and Frozen embryos
November - Humanoid robot, Chronic homelessness, Anything healthy and Food prices
October - Questioning police, Covid & period timing, Decision making in Surgery and Covid-19 deaths
September - Racisim, After Roe, Canadian Health care and Vaccine-preventable illnesses
August - Omicron underreported, Omicron study, ArriveCan, Understaffed Toronto Hospital and Stabilizing health-care system
July - Oncology, Public Health Threat, Roe v. Wade, Roe and Pig-Heart transplant
May - Human remains, Against abortion, Lifesaving drug and Readmission risk
April - Revoke doctrine, Pope's apology, Second cold war and Workforce Crisis
March - Cyber reporting, International Women's Day, Provincial fuel tax and B.C. gas prices
February - Post-pandemic future, Children protesters and Misrepresentation
January - Public Health decision, Off-Label Covid Vaccination, PCR testing, Covid-19 questions answered and Building resilience

2021

November - Conflict of Interest, Vaccine Mandates, Covid-19 Resurgence, Pfizer Covid-19 Vaccine for Kids
October - No more Nurses, Vaccine stories, Vaccine Imperialism, Vaccination & Triage Decisions
September - Health communications, The Delta variant, Building community, Vaccinated and COVID positive
August - Vaccine passport, Concerns of COVID-19, COVID vaccines failing and Doctors in crisis
July - Tsunami of cancer, ICU Catastrophe, Residential schools and Kidney donors
June - Living, COVID-19 Conscience tracing, Bad day for science, Aducanumab and Vaccine distribution
May - Measuring Burnout, Polyamorous parents, Controversial science, Genetically engineered babies
April - Dr. Google, Covid Vaccine Passports, Vaccine prioritization, Surrogate mothers' vaccinations
March - Machine morality, Demanding justice, Mortal coil, Caregivers and End-of-life care
February - Dying process, Right to die, Dying with dignity, Sedation until death and Disability not a burden
January - Stopping Covid, Effects of COVID-19, Africa Vaccination and Vaccine-doubters

2020

December - Covi-19 triage, Covid-19 homeless choices, Ethical principles and Hard lockdowns
November - Health Ethics Week 2020 Special
October - Covid-scepticism, COVID-19 in Italy, Flu shot, Death of autonomy and Racial disparities during COVID
September - DNR orders, Rethinking nursing homes, Body-snatching and Force-feeding
August - Patient matters, Small actions, Moral injury, School reopening
July - Patient capacity, Primary care dying, Medical research, health care disparities and Anger transformation
June - Coronavirus, Police brutality and Medical care
April - Coronavirus
March - Coronavirus
February - Coronavirus, Patient experience and Pelvic exams confusion
January - Free IVF, Testicle transplant, Modified genome and Genetic study

2019

December - Conscience rule, Conscientious objection, Pulling the plug and Euthanasia for children
October - Primary care, Patients and Medical records
September - Bioethicists, Specialist burnout and Fixing Physician burnout
August - Surrogacy ban, Contraceptive revolution, Stem inflation, IVF error and Research
July - Opioids, Falls, Isolation, Ethical challenges, Brains, Gender and Gender transition
May - Death, Brain Dead, Euthanasia ,Youth Suicide, Body Farm and Dead Donor Rule
April - Treatments for the elderly, Conscientious objection and withdrawing and withholding
March - IVF and Sterilization
February - Gene editing, Birth and more
January - Cancer and AIDS

2018

December - Gene editing
November - Conscientious objection, Social prescribing and Prescribed museum visits
October - Birth Experiences, Vaccination, CRISPR gene editing
September - Suicidal Navy Veteran and advocate against fat shaming
June - Tightrope Walking, Tagging a Killer, and Testing it out on Inmates
May - The Golden Girls, A Film Faux Pas, and IVF to Intervention
April - Should doctors disclose, risks be revealed at home, or peculiar pleas pursued?
Health Ethics Week 2018 Special Edition
March - Testing your tots, drug kits on the spot, a clinical trial it was not, and husband needs a mug shot
February - Instagram Ultrasounds, Donor-conceived curiosity & Storytelling Success
January - What to do with a tattoo, relationships that are taboo and worker treatment needs review

2017

November - Donation Deception, Twin Separation, and C-Section Selection
October - Forced Transfusion, DNR Confusion & Privacy Intrusion
September - Doughnuts, Robots and Driverless Cars
August - Sterilizations, Donations, Vacations and Adaptations
July - Discrimination, Resignations, Illumination and Explanation
June - Desperate Times, Desperate Measures and Conflicts of Interest
May - Mental Health Week Edition
April - Quackery", Quality of Life, and Quality Improvement
National Health Ethics Week Special Edition
March - Patients Help Choose, Docs Who Refuse, and Fake Reviews
February - Compassion, Conflict, Chimeras and Contraptions
January - New and Used Organs, the Power of Checklists, and more

2016

Holiday Special Edition
December - Tidings of Comfort and Joy! (And some opportunities for improvement.)
November - MAID, Marijuana, Mistreatment, Murders and Myths
October - Ethics Centre October 2016 Newsletter
May - Ethics Centre May 2016 Newsletter
April - Ethics Centre April 2016 Newsletter
National Health Ethics Week Special
March - Ethics Centre March 2016 Newsletter
February - Ethics Centre February 2016 Newsletter
January - Ethics Centre January 2016 Newsletter

2015

December - Ethics Centre December 2015 Newsletter
November - Ethics Centre November 2015 Newsletter
October - Ethics Centre October 2015 Newsletter
September - Ethics Centre September 2015 Newsletter
August - Ethics Centre August 2015 Newsletter
July - Ethics Centre July 2015 Newsletter
June - Ethics Centre June 2015 Newsletter

Glossary of terms

If you've ever found yourself thinking "I don't understand what those 'ethics people' are talking about" this is a good place to come. With concise definitions and poignant case descriptions to help clarify, this 'Glossary of Terms' will help you to participate in the ethics conversations around you with a greater sense of confidence and understanding.

Clinical Ethicist (or “Ethicist”)

A staff member of the Covenant Health Ethics & Discernment Centre. Ethicists have at least one of an advanced professional clinical degree with specialized ethics training and experience, or a Master's or PhD in other relevant disciplines with practical clinical ethics training and experience. Clinical Ethics, Patient-Specific

Ethical issues and dilemmas that arise in the care or treatment of individual, identified patients. In addressing clinical ethics issues, healthcare professionals should consider the specific duties they have to identified patients, such as those related to confidentiality, disclosure, consent, and fidelity. Some examples of clinical ethics issues include:

Whether to withdraw or withhold treatments for a patient at end of life
Conflict between a team and family regarding the perceived safety of a discharge plan for a patient
Conflict between members of a healthcare team regarding whether to offer a fragile patient an innovative therapy
Uncertainty regarding whether a patient with a severe eating disorder is competent to refuse treatment

Healthcare workers should be alert to any systemic contributors to a clinical ethics issue or dilemma.

Ethical Issue

Ethical issues arise when we strive to do good. Ethical issues are linked to our aspirations and to our beliefs about the goals of life; they often involve competing visions of what is good or right in a given situation.
Ethical issues involve personal, professional, organizational, and cultural values and norms.

Ethics Consultants

Ethics Consultants facilitate the ethics consultation process. They are members of an inter-professional Ethics Committee, or sub-group of an Ethics Committee. Ethics Consultants are healthcare professionals and community members with training and experience in clinical ethics consultation.

Patient

Patient means all individuals including clients, residents and members of the public who receive or have requested healthcare or services from Covenant Health and its healthcare providers.

Stakeholder

In the context of ethics consultation, a stakeholder is anyone with a legitimate interest in clinical and ethical decisions made about a patient's care or about an organizational systemic ethics issue. In clinical cases, the primary stakeholders will vary depending on the ethics issue, but are generally the patient, his/her family, and the healthcare professionals providing care. Other stakeholders may include: the clinical manager, learners, administrators, or appropriate external agencies directly involved in the patient's care.

Requestor

The stakeholder who initiates or requests an Ethics Consultation.

Conflict of Interest

A "Conflict of Interest" for an Ethicist and Ethics Consultant is any situation in which the Ethicist or Ethics Consultant has or may be perceived to have (by a reasonable person in all the circumstances) a private or personal interest that results in the following:

the objective exercise of his/her duties as an Ethicist and Ethics Consultant being influenced to the detriment of one of the stakeholders;
giving an advantage or showing preference to one stakeholder over others

Moral Distress

Moral distress is the experience of knowing what the "right" thing to do is, but encountering barriers or challenges to acting in an ethical manner. These challenges might be internal to the individual experiencing the distress (e.g. anxiety, exhaustion) or external (e.g. difficult working conditions, conflict within a team).

Resources about whisteblowing

Annual Report FY 2022-23 Covenant Health (2023)

Annual Report FY 2021-22 Covenant Health (2022)

Don't shoot the messenger: the value of whistleblowing (CBC Radio Episode, 54min, September 26, 2017)

Whistle-Blowers Spur Companies to Change Their Ways (The New York Times, December 16, 2016)

Having an Ethics Hotline is a Really, Really Bad Idea. (Really?) (The Compliance and Ethics Blog, December 2015)

Corporate Culture: The second ingredient in a world-class ethics and compliance program (Deloitte 2014)

Pontifical Council for Justice and Peace - Vocation of the Business Leader (2012)

Resources about end of life

Covenant Health Palliative Institute
The Covenant Health Palliative Institute is committed to alleviating suffering for patients and their families through supporting excellence in palliative and end-of-life care.

Palliative Care Matters

Government of Alberta - Personal Directives
Information on personal directives (what they are, how they work)

Canadian Virtual Hospice
The Canadian Virtual Hospice provides support and personalized information about palliative and end-of-life care to patients, family members, health care providers, researchers and educators.

Video: Improving Decision-Making about Feeding Options in Dementia (19:17)

Helpful web links

Catholic Health Alliance of Canada
Inspired by the Gospel and grounded in shared beliefs and values, the Alliance is a forum for Catholic health and social services Sponsors in Canada, to exchange ideas and develop shared strategic initiatives that support their ability to strengthen the healing ministry of Jesus.

John Dossetor Health Ethics Centre
The John Dossetor Health Ethics Centre is the only interdisciplinary, academic health ethics centre in Alberta and one of the first in Canada. The Centre is involved in health ethics education, research and community engagement at the University of Alberta.

Canadian Bioethics Society
The Canadian Bioethics Society (CBS) is a national, member-driven, registered charity serving as a forum for individuals interested in sharing ideas relating to bioethics.

Canadian Catholic Bioethics Institute (YouTube Channel)
The CCBI Video Series 'Catholic Bioethics Moments' covers topics such as: Ethical Issues at the End of Life (Part 1 and 2), Matters of Conscience, and Fundamental Moral Theology. Explore Catholic teaching on death, euthanasia, forgoing treatment, the Principle of Double Effect, Pain Relief at End of Life, Conscientious Objection, and more.

Alberta Seniors
A number of Government of Alberta programs and services to support seniors (and their caregivers) in Alberta.

The Canadian Bioethics Companion
An online book written by Dr. Dave Unger, the Physician Ethicist for Providence Health Care and the Ethicist for both the Providence Health Care Research Ethics Board and the BC Centre for Disease Control.

Health Law Institute - University of Alberta
The Health Law Institute (HLI) conducts health law and science policy research, disseminates scholarly outputs and policy work to a broad interdisciplinary community, facilitates collaborative opportunities with national and internationally based researchers and organizations, and attracts top graduate students to the Faculty.

National Reference Center for Bioethics Literature (U.S.)
Developed and maintained by the library services staff at the Kennedy Institute of Ethics.

Inside the Ethics Committee
This BBC Radio programme explores the workings of clinical ethics committees with a panel of experts that discuss real-life cases (12 episodes).

The Hastings Center Report (U.S.)
A nonpartisan research institution dedicated to bioethics and the public interest since 1969

Informed Consent
(via the College of Physicians and Surgeons of Alberta)

When Patients Cannot Eat or Drink: Understanding Artificial Nutrition and Hydration
Information from www.familydoctor.org about benefits and risks of artificial nutrition and hydration

Ethics Made Real

Ethics Made Real, which was previously found in the Western Catholic Reporter, will now find its permanent home within the Ethics Centre. The column will continue to see perspectives from Gordon Self, Chief Mission & Ethics Officer, but also welcomes Jon Gilchrist and Eleanor Stewart, Clinical Ethicists, as contributors.