An ethics consultation service in a teaching hospital. Utilization and evaluation

A newly established formal ethics consultation service in a university teaching hospital was prospectively evaluated. A physician-ethicist interviewed and examined patients, interviewed family and others as needed, and entered a formal consultation note in the medical record. The requesting physicia...

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Bibliographic Details
Published inJAMA : the journal of the American Medical Association Vol. 260; no. 6; p. 808
Main Authors La Puma, J, Stocking, C B, Silverstein, M D, DiMartini, A, Siegler, M
Format Journal Article
LanguageEnglish
Published United States 12.08.1988
Subjects
Adult
Bioethical Issues
Bioethics
Chicago
Ethicists
Ethics Consultation
Evaluation Studies as Topic
Family
Female
Hospitals, University
Humans
Life Support Care
Male
Patient Participation
Patient Selection
Prospective Studies
Referral and Consultation - utilization
Resuscitation
Withholding Treatment
Chicago
Professional Patient Relationship
Bioethics and Professional Ethics
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Summary:A newly established formal ethics consultation service in a university teaching hospital was prospectively evaluated. A physician-ethicist interviewed and examined patients, interviewed family and others as needed, and entered a formal consultation note in the medical record. The requesting physician and the consultant independently completed structured questionnaires. Fifty-one consultation requests were received from 45 physicians from seven departments between July 1, 1986, and June 30, 1987. Seventeen (33%) of 51 patients were in the intensive care unit, and 19 patients (37%) were fully oriented at the time of consultation. Overall, 61% of the patients survived to leave the hospital. The requesting physician sought assistance with withholding or withdrawing life-sustaining treatment in 49% of cases, with resuscitation issues in 37%, and with legal issues in 31%. Assistance with more than one issue was sought in 39 cases (76%). In 36 cases (71%), the requesting physician stated that the consultation was "very important" in patient management, in clarifying ethical issues, or in learning about medical ethics. We conclude that ethics consultation performed by physician-ethicists provides useful, clinically acceptable assistance in a teaching hospital.
ISSN:0098-7484
DOI:10.1001/jama.1988.03410060078031