Potential Delay or Underuse of PME
Although PME clinical consultations sometimes identify unmet PPC needs, and thereby result in a PPC consulta- tion, the opposite does not occur as frequently: PPC consultation rarely results in a subsequent PME consult. While such a chain of events does occur from time to time, PPC staff, given their collaborative communication skills (and for some, their formal training in PME or involvement in PME con- sultations), may be able to manage most of the ethically challenging cases (but not all of them) and thus run a risk of not drawing on the resources and potential benefits of PME consultation in a timely manner. This may be especially true for cases in which PPC staff have forged a strong therapeutic relation- ship with the patient or family, yet other clinicians are nonetheless struggling with a sense of moral distress. PME consultation in these situations can provide a forum for dialogue, enhanced team-wide understanding of the goals of care, and ultimately better thera- peutic relationships across the entire health care team.