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Hub and Spoke Strategy

Our Model for the Delivery of Ethics Services at Sunnybrook Health Sciences Centre

The purpose of the Hub and Spoke Strategy is to emphasize integration of services throughout the various service areas of Sunnybrook to ensure sustainability of ethics activities, and to promote accountability for these services. The “hub and spoke” model builds on a core capacity of ethics leadership (the hub) while building capacity and strengths through opinion leaders and ethics integration teams in each of the Programs at Sunnybrook (the spokes).

The core functions of the Hub are to provide leadership, ethics resources, clinical ethics oversight, strategic planning, quality assurance and accountability to the opinion leaders and ethics advisory groups. The Hub also supports bioethics activities, in general, across Sunnybrook. The Spoke component of this model builds on strategically placed opinion leaders in all of the programs at Sunnybrook.

All of the opinion leaders will be strong clinician leaders with demonstrated interest in bioethics. Recruitment and training to fill ethics needs within the organization is a key part of building bioethics capacity at Sunnybrook. Each opinion leader will form and oversee multi-disciplinary ethics advisory groups in their own program or service area. The goal of the ethics advisory groups is to implement multidisciplinary ethics education and research initiatives in their area as well as to participate in clinical ethics consultation. The focus of the clinical bioethics service is on policy development, education, consultation, and research.


The full-time ethicists, the Ethics Consultant, and the administration assistant, who all work to support and provide imperative resources to members of the ethics advisory groups.

Ethics Advisory Group (Spokes)

Ethics Centre staff and clinicians from the seven program areas who help to integrate ethics awareness, knowledge and skills in their local area of service as well as throughout the entire organization.