Anonymous ethics consult requests: nameless or nebulous?

The topic, timing and type of anonymous consults arriving to our ethics consultation service over the years compelled consideration of their purpose and function. The service-focused goal and role of ethics consultation is maximised through interactions with consult requesters for clarity and human connection. Ethics consultants should consider means to deidentify requests as part of ethics processes and remain transparent when this is not feasible. Authoritative guidance cautions against leveraging anonymous consults. This paper offers a trifold approach to the topic of anonymous ethics consultations: elucidation of argument and counterarguments; a summation of public-facing description of anonymous consult availability from 20 national healthcare settings; and reflections from our own institutional experiences. We theorise that the nature of anonymous consults risks the inability for the ethics consultation team to engage in a functionally equivalent ethics process as for consults with named requesters. We uphold the good of confidential consultations as an alternative to anonymous consults. As anonymous consults may be fulfilling a health system gap, any decision to remove mechanisms to place anonymous consult should practically identify and connect requesters to the right door for these concerns and proactively engage preventive ethics principles to bolster organisational ethics.