Q & A

Clinical ethicist Barbara Frye counsels individuals facing tough medical decisionsEthics On CallBarbara Frye Guides Families Through Tough Decisions in Times of Medical Crisis

Worst-case scenario: You’re injured in a terrible car accident and are unconscious. Doctors have to make a decision – amputate your legs or risk your life trying to save them. The hospital staff wants to provide you with proper medical treatment, but no one knows the type of treatment you would want. What decision should your family make?

Dr. Barbara Frye, Ph.D., spends her days as a medical ethicist at Tallahassee Memorial Hospital helping families make tough decisions like this one. Family members turn to her for help addressing every possible aspect of the situation before making a decision they may regret.

“Medical ethicists never ever make the decisions,” Frye said. “He or she listens to all the problems involved and helps (the family) get all the information they need, listens to what they have to say and is there to bring in or ask another physician to talk to them and give them as much information as he or she can gather for them or direct them in the right way.”

Sitting down recently with Tallahassee Magazine writer Shanae Brantley, Frye talked about how one becomes a medical ethicist and the steps a person should take to ensure proper medical treatment.

TM: What duties might a medical ethicist perform?
BF:
A medical ethicist doesn’t just walk in to a family – she has to be called in by a physician, a nursing staff, a family or, in fact, sometimes even the patients themselves. The duties basically are discussing all the issues involved, reading the medical records and discussing the situation with a physician.

TM: Is this something that you always wanted to do?
BF:
You know, I can’t answer that question, because when I was growing up there was no such thing. It’s fairly new. It’s only been the last say 15 years that you even heard about bioethics as a discipline or ethicists, and I have been at Tallahassee Memorial for 12 years.

TM: How do you do your job?
BF:
It’s really a matter of listening to what the family has to say – and they are always under great stress. Sometimes families are very divided on what decision is to be made, so the medical ethicist has to find out who the surrogate is. The surrogate is the person that the patient has designated in an advanced directive, a written advanced directive or a health care directive, saying, “If something happens to me and I am not able to make a decision at a particular time, this is the person I want to be my health care surrogate.” It has nothing to do with a regular will. So that person has a big responsibility, because they should know the person who is ill very well and know what their wishes are, either written or nonwritten.
If there is nothing written, then you get into a much more difficult situation, because sometimes you have a father, mother or a spouse, and you have daughters and sons, and people are divided on what should be done for their loved ones. So you have to listen carefully out of respect for all of their opinions and help them. Sometimes this takes a lot of time, which nurses and doctors don’t have.

TM: What are common problems that you face as a medical ethicist?
BF:
One of the common problems is that there is no advanced directive, no written directive telling the family what that person would want. You kind of have to be a detective to find out if that person could be right there to tell you what they would want. Then you have to dwell in that problem with the family and try to see what would be the best decision they could all make.

TM: What are some ethical issues that you deal with most often?
BF:
One of the issues would be removing somebody from life support, not putting in a feeding tube or removing a feeding tube. It’s very important to do what the sick person would want if there were no advanced directive.

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