Making medical decisions is not easy. Medical situations are complex and it is often difficult to know the right or the best thing to do is. This is especially true when a patient is too ill to make decisions for him or herself, when it is unclear what the appropriate treatment for the patient is, or when values between the patient, family, or care-team appear to conflict. There are often no ‘right’ answers in these circumstances and these decisions can be the most difficult ones you will ever have to make.
Everything is important to this decision-making process, including a patient’s and family’s personal and religious beliefs. These decisions are hard, plain and simple. They require moral and medical consideration, and as such, must involve input from the physician, the patient as well as the patient’s family. Careful and thoughtful attention by everyone involved is very important in determining the best direction in care.
When a difficult decision arises, the Ethics Consult Service can help. We are a group of doctors, nurses, social workers, and chaplains. We have broad knowledge of healthcare, spiritual and ethical decision-making, and we are practiced in helping families to reach decisions in these tough circumstances. We are here to help you.
Anyone who has a concern about the care of the patient may request an Ethics Consultation. To reach the Ethics Consult Service, please contact Frank Chessa at (207) 662-3589 or email clinicalethics@mainehealth.org.
A consultation with the Ethics Consult Service offers an opportunity to discuss the difficult decisions surrounding your own or your loved one’s treatment. A member of the Ethics team will talk with you and the healthcare team to gather the information necessary to understand the ethical concerns you are wrestling with. Following this, the Ethics Consultant may also organize a family meeting with your or your loved one’s healthcare team to discuss your questions and concerns and to facilitate dialogue.
Group-discussion styled meetings are often strongly encouraged in these instances, however you do not have to attend such a meeting if do not wish to. In this instance, an ethics team member will meet with the care-team and the patient or family separately.
While Ethics Consult Service members are here to help you and the healthcare team understand each other’s concerns and identify options and possible solutions, the final responsibility for decisions about your loved one’s care belongs to you and the healthcare team. Learn more about who the Ethics Consult Service members are here.
A group decision-making model is often most appropriate in these complex and difficult circumstances; we can help you have your voice heard, and although we may make a recommendation, we serve as a neutral facilitator in the process. Our goal is to help you and/or your family and the healthcare team develop the best care plan for the patient.
Consider the dialogue that took place during the Consultation, and with the healthcare team, work to care for yourself and your loved one. The Ethics Committee will be available for follow-up as needed.
Please call Patient Relations (207) 662-2983 for concerns about the care team or medical treatment.
We are here to help you work through difficult questions, don’t be afraid to ask:
Q: Who gets to make decisions for my loved one?
A: We can help identify who the patient’s appropriate representative is in the instance that a patient is unable to speak for him or herself.
Q: What if I don’t know what the right decision is?
A: We can help work through complex decisions in which there conflicting values and viewpoints.
Q: I don’t agree with the care-team about the appropriate treatment option. What do I do?
A: We can help mediate when you disagree with the healthcare team about the best treatment options for yourself or your loved one.
Q: I don’t agree with my loved one about the appropriate treatment option. What do I do?
A: When you and your loved one disagree about continuing treatment this can be a very difficult situation. However we can help facilitate the necessary dialogue among members of the care-team, you and your loved one, with the hopes of reaching consensus.
Q: How do I decide how much my child is prepared to learn about his or her condition?
A: We can help you navigate the difficult questions and concerns that arise when you have child with a serious condition and you disagree with the physician or other family members about how much the child should be told. We will include your child’s pediatrician, and care providers from psychiatry and palliative care if necessary.
Q: What do I do if a treatment plan conflicts with my cultural or spiritual beliefs?
A: We can help you, your physicians, and an appropriate religious leader if you choose, as you work to find common ground and shape a treatment plan that is suitable to your cultural or spiritual beliefs when medically appropriate.
Q: Is the ethics consultation process documented?
A: A written account of the consultation becomes a part of the patient’s medical record.
Frank Chessa
Dr. Chessa is the Director of Clinical Ethics at Maine Medical Center. Additionally, he serves as the Assistant Professor of Medicine at Tufts University School of Medicine, where he serves as Associate Course Director of Ethics and Professionalism and Co-Course Director for Scientific Foundations of Social and Behavioral Medicine in the Maine Track. He previously worked as an Assistant Professor at both Bates College and the University of Nevada. He attended Dickinson College, where he received a Bachelor of Arts degree in Philosophy and Environmental Studies. He received a Master of Arts in philosophy at the University of South Florida, followed by a Doctorate in Philosophy at Georgetown University. At Georgetown, he focused on ethical theory and medical ethics. In 2012 and 2016, he was awarded “Outstanding Lecturer” from Tufts University School of Medicine. He regularly presents at national conferences and has numerous publications on medical ethics. At MMC, he is a member of the Institutional Review Board and Directs the Living Donor Advocacy Program. His topics of interest include Clinical Ethics (e.g., End-of-Life Care, Organ Transplantation, Reproductive Health), Medical Ethics (e.g., Methodology, Just Distribution of Health Care Resources, Managing Relationships with Industry, Research Ethics), and General Ethical Theory.
Laura Madigan-McCown, MSW, MTS
Laura Madigan-McCown is a clinical ethicist at Maine Medical Center where she conducts ethics consultations, helps to coordinate the clinical ethics committee and participates in ethics education and training for staff and organizations. Laura has a Masters in Social Work from Boston University and a Masters in Theological Ethics from Boston College. She has also completed coursework and training at Harvard Medical School’s Center for Bioethics.
Isabella N. Stumpf, D.O.
Isabella N. Stumpf, D.O. practices Palliative Medicine at Maine Medical Center. Dr. Stumpf is board certified in Hospice in Palliative Medicine. She attended the University of New England College of Osteopathic Medicine and completed her internal medicine residency and pulmonary and critical care fellowship at Maine Medical Center. Her primary practice is at Maine Medical Center where she serves as the Division Director of Palliative Medicine and as Clinical Assistant Professor Faculty. Dr. Stumpf serves as the chair of the clinical ethics committee since 2015. Dr. Stumpf is the Medical Director for Palliative Care at MaineHealth and also holds a per diem faculty position at the Massachusetts General Hospital. Her interest in palliative medicine involves patient and family centered care and a system based approach to health care delivery to improve the access and value of palliative care across settings.
Janet P. Maguire
Interim Co-chair: Janet Maguire RN, BSN, MBA. Current MMC position: Clinical Risk/Safety Coordinator. Member of Ethics Comm since 2010. Completed Harvard Bio-Ethics course 2011. Co-chair of Ethics Comm from: 2012-2014.
Marjorie Nickerson-Smith, RNC
Marge has worked as a staff nurse and charge nurse at MMC for 33 years. She currently practices on R-7, a 46 bed medical cardiac unit and she is a Certified Cardiovascular nurse. She has a Bachelor of Science degree in English from Springfield College, Springfield, Mass. and a diploma in nursing from Mercy Hospital School of Nursing. She was a delegate to the MMC values in action caucus and has helped to facilitate focus groups for the hospital in stress and burnout, and performance reviews. She is a member of R-7s practice committee.
Jonathan Archibald
Director of Nursing for R1/CTICU. I oversee the Cardiothoracic Surgical units at MMC. I’ve worked here for 7 years and my clinical background is Cardiothoracic ICU nursing. Nursing is a second career for me. I was a Firefighter/Paramedic for 10 years before going to Nursing School.
Catherine F. Garlid, MDiv, BCC, ACPE: Supervisor
Kitty’s position at MMC is Director of Spiritual Care and Clinical Pastoral Education. She is a graduate of Yale Divinity School and did her chaplain residency at Memorial Sloan Kettering in NYC. She worked as Director of Spiritual Care at Greenwich Hospital, Yale New Haven Health System, where she was a co-founder and co-chair of the Ethics Committee for 25 years. She chaired the MMC Clinical Ethics Consultation Task Force in 2014 and is now a member of the Ethics Committee.