Toronto Central Local Health Integration Network

JCB Partners:
Toronto Central Local Health Integration Network


People and Roles:

Kevin Reel is the ethicist at the TCLHIN. He has an MSc in Medical Ethics from Imperial College, London, UK and a BSc in occupational therapy from the University of Toronto (UofT). He completed his Fellowship in Clinical and Organizational Ethics at the Joint Centre for Bioethics (JCB), U of T, in 2009.


Kevin is an Assistant Professor and Graduate Faculty Member in the Department of Occupational Science and Occupational Therapy at U of T and a Faculty member of the Global Institute for Psychosocial, Palliative and End-of-Life Care.


Program Description:

In January 2005, the former Toronto Central Community Care Access Centre (TCCCAC) became the first non-hospital organization accepted as a partner of the JCB. Since then, the TCCCAC has worked closely with the JCB to develop a strategic framework for both clinical and organizational ethics. Today, with the conjoining of the TCCCAC and TCLHIN, the TCLHIN ethicist works to improve staff and board education and awareness; support staff in everyday decision-making; provide guidelines for priority setting and decision-making; and provide mechanisms for identifying systemic ethical issues. The TCLHIN ethicist also supports the ongoing work of the Community Ethics Network, a collaborative of home and community care service providers.



Ethics consultations are designed to help staff deal with difficult ethical issues that arise in caring for clients. The purpose of a consult is not to make client care decisions but to seek to offer support to those involved in the decision making process.



Education of staff members is a significant component of the ethics mandate at TCLHIN. Staff at all levels receive basic training in ethics and ethical decision making. The TCLHIN also offers specialized training in areas of consent and capacity, elder abuse, and end of life decision making.


Another major function includes contributing to curriculum development, teaching, and the training of health professionals through partnerships with the University of Toronto, other universities, and community colleges.


Organizational Ethics:

Through the development of organizational infrastructure and accountability mechanisms, the TCLHIN ensures that support is provided to its staff and quality services are offered to its clients.



A priority is placed on the development of policies and guidelines, as well as research ethics reviews, to ensure all research either initiated or in partnership is done in accordance with the Tri Council Guidelines.


Further, the TCLHIN aims to undertake and participate in research initiatives with the goal of becoming a research leader in community health and of using the results of this research to inform policy and best practice.


Hub & Spoke Strategy for Ethics Services at TCLHIN:

At the TCLHIN, the onsite bioethicist acts as the 'hub' for the entire organization, and staff and managers with an interest in ethics are encouraged to engage in further training to become 'hubs' of ethics expertise at the unit level, and 'spokes' to link to the ethics program.


TCLHIN and the Community Ethics Network:

The hub and spoke strategy has also shaped the development of the Community Ethics Network (CEN) and its partner community health and support service agencies. Launched in 2005, this Network provides resources, coordination and support for both clinical and operational ethics GTA-wide, at the Local Health Integration Network level, and beyond.


The CEN supports an exchange of information, a forum for the identification of ethical issues and resources that foster consistent and transparent approaches to their management and resolution.


Accreditation & Ethics:

The TCLHIN is accredited through the Canadian Council on Health Services Accreditation (CCHSA).



Toronto Central LHIN web link
Toronto Central LHIN Home and Community Care web link web link


Contact Information:

Kevin Reel

Kevin Reel, Ethicist
Toronto Central Local Health Integration Network
Phone: (416) 217-3820 ext. 2565
Email: email link