Ellen Fox1, Sarah Myers, Robert A Pearlman. 1. National Center for Ethics in Health Care, Department of Veterans Affairs, Washington, DC 20420, USA. ellen.fox@va.gov
Abstract
CONTEXT: Although ethics consultation is commonplace in United States (U.S.) hospitals, descriptive data about this health service are lacking. OBJECTIVE: To describe the prevalence, practitioners, and processes of ethics consultation in U.S. hospitals. DESIGN: A 56-item phone or questionnaire survey of the "best informant" within each hospital. PARTICIPANTS: Random sample of 600 U.S. general hospitals, stratified by bed size. RESULTS: The response rate was 87.4%. Ethics consultation services (ECSs) were found in 81% of all general hospitals in the U.S., and in 100% of hospitals with more than 400 beds. The median number of consults performed by ECSs in the year prior to survey was 3. Most individuals performing ethics consultation were physicians (34%), nurses (31%), social workers (11%), or chaplains (10%). Only 41% had formal supervised training in ethics consultation. Consultation practices varied widely both within and between ECSs. For example, 65% of ECSs always made recommendations, whereas 6% never did. These findings highlight a need to clarify standards for ethics consultation practices.
CONTEXT: Although ethics consultation is commonplace in United States (U.S.) hospitals, descriptive data about this health service are lacking. OBJECTIVE: To describe the prevalence, practitioners, and processes of ethics consultation in U.S. hospitals. DESIGN: A 56-item phone or questionnaire survey of the "best informant" within each hospital. PARTICIPANTS: Random sample of 600 U.S. general hospitals, stratified by bed size. RESULTS: The response rate was 87.4%. Ethics consultation services (ECSs) were found in 81% of all general hospitals in the U.S., and in 100% of hospitals with more than 400 beds. The median number of consults performed by ECSs in the year prior to survey was 3. Most individuals performing ethics consultation were physicians (34%), nurses (31%), social workers (11%), or chaplains (10%). Only 41% had formal supervised training in ethics consultation. Consultation practices varied widely both within and between ECSs. For example, 65% of ECSs always made recommendations, whereas 6% never did. These findings highlight a need to clarify standards for ethics consultation practices.
Authors: Eric Kodish; Joseph J Fins; Clarence Braddock; Felicia Cohn; Nancy Neveloff Dubler; Marion Danis; Arthur R Derse; Robert A Pearlman; Martin Smith; Anita Tarzian; Stuart Youngner; Mark G Kuczewski Journal: Hastings Cent Rep Date: 2013 Sep-Oct Impact factor: 2.683