CHIRS is a community-based service provider supporting individuals with acquired brain injury (ABI) and their families. There are many unique everyday ethical challenges in working with this population, due to the complexity of issues.
The Leading Practice includes ethical decision-making resources as well as an agency process that has successfully integrated principle-based ethical decision-making into everyday practice across the agency.
The Ethical Decision-Making Worksheet and Resource Kit, adapted for use in brain injury services, are accessible tools for ethical decision-making for staff in all roles and for use with a variety of everyday issues. The agency’s process is such that front-line staff are trained to identify ethical issues in their daily work and to bring them forward for support with resolution. This process is useful for addressing the moral distress that staff occasionally experience, for bringing teams with polarized perspectives together, and for managing the balance between the various ethical perspectives and values, including those of the client and family.
The agency has established an Ethics Team with representation from all the client service teams across the agency, and includes clinicians and management. These representatives provide support to their teams in the ethical decision-making process and, through regular discussions at team meetings, promote ethical practice across the agency. The Ethics Team provides ongoing training, promotion activities, monitoring of ethics activities and data collection for quality monitoring purposes.
The CHIRS Ethics Framework encompasses the following: Policy/Procedures; Code of Ethics; Worksheet and Resource Kit; Staff Training; and the Ethics Team.

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