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National Center for Ethics in Health Care


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Preventive Ethics



Addressing Ethics Quality Gaps on a Systems Level

The Preventive Ethics component of IntegratedEthics®(IE) tackles recurring ethical concerns by applying quality improvement methods to identify and address ethics gaps on a systems level.

The IE model address chronic and recurrent ethical issues systemically, using a step-by-step quality improvement approach called ISSUES that includes the following:

Social worker and patient

Identify an Issue 
Study the Issue
Select a Strategy
Undertake a Plan
Evaluate and Adjust
Sustain and Spread  



Preventive Ethics: Addressing Ethics Quality Gaps on a Systems Level (Second Edition) - The primer provides an introduction to preventive ethics and outlines a step-by-step approach to improving systems and processes that influence ethics practices in a health care organization

Preventive Ethics: Addressing Ethics Quality Gaps on a Systems Level. Joint Commission Journal on Quality and Patient Safety. 

IntegratedEthics Policy - VHA Handbook 1004.06 


Preventive Ethics: Addressing Ethics Quality Gaps on a Systems Level Video - 45-minute, interactive video to teach viewers how to apply principles of quality improvement to proactively address ethics issues on a systems level.


Preventive Ethics core tools:

Document a completed improvement cycle:

Tools for Informed Consent for Long-Term Opioid Therapy for Pain:

PE ISSUES Summary: Informed Consent for Long-Term Opioid Therapy for Pain

VISN Cross-Cutting Ethics Issues Tool: Improving Adherence to Informed Consent for Long-term Opioid Therapy for Non-cancer Pain

Policy and Guidance Documents (under "Informed Consent for Long-Term Opioid Therapy for Pain")

 Six advanced training modules on key PE concepts for Preventive Ethics Coordinators and team members:

Tools to explain the role and responsibilities of the Preventive Ethics Coordinator:


IE Archive: Materials used in the initial launch of the VA IE program



What's New

New! Applications are being accepted through June 10, 2016 for the FY 2017 Health Care Ethics Fellowship Program. Click here for details and an application.

New! The IE Council Member Orientation Guide located on the IE Program Management web page is designed to assist IE council members with the transition into their new role.

The second edition of Ethics Consultation: Responding to Ethics Questions in Health Care is now available. This primer establishes VA standards for health care ethics consultation, one of the three core functions of IntegratedEthics.