Effect of ethics consultations in the intensive care unit
ABSTRACT Although evidence-based research is limited, results suggest that ethics consultations are associated with reductions in hospital days and intensive care unit days and in life-sustaining treatments in those patients who ultimately will not survive to discharge. Furthermore, the majority of healthcare providers and patients/surrogates agreed that ethics consultations in the intensive care unit were helpful in addressing treatment conflicts. Ethics consultations also reduce hospital costs without diminishing the quality of care. Hence, ethics consultations seem to be useful in resolving conflicts that may be inappropriately prolonging nonbeneficial or unwanted treatments at the end of life. Further research on whether ethics consultations are beneficial in other settings is needed to establish the optimal scope of this intervention. Also, the benefits described above were achieved by highly skilled and experienced consultants. It is not certain, therefore, how successful other hospitals will be when adopting this intervention.
- SourceAvailable from: Sara L Tobin
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- "The history of " bedside " ethics or clinical ethics consultation shows some of the benefits as well as the pitfalls of such services. There have been several attempts to show the positive value of clinical ethics consultation (DuVal et al. 2004; La Puma et al. 1988; Schneiderman 2006; Yen and Schneiderman 1999) such as reduced intensive care unit times (Schneiderman et al. 2003), and patient and surrogate satisfaction (Orr et al. 1996). Multiple professional organizations have supported the importance of clinical ethics consultation, including the American Hospital Association (1986), and the American Medical Association (1985). "
ABSTRACT: Institutional ethics consultation services for biomedical scientists have begun to proliferate, especially for clinical researchers. We discuss several models of ethics consultation and describe a team-based approach used at Stanford University in the context of these models. As research ethics consultation services expand, there are many unresolved questions that need to be addressed, including what the scope, composition, and purpose of such services should be, whether core competencies for consultants can and should be defined, and how conflicts of interest should be mitigated. We make preliminary recommendations for the structure and process of research ethics consultation, based on our initial experiences in a pilot program.The American Journal of Bioethics 04/2008; 8(3):4-13. DOI:10.1080/15265160802132951 · 2.45 Impact Factor
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ABSTRACT: Die klinische Ethikberatung in Deutschland wurde zunächst v. a. in Krankenhäusern unter konfessioneller Trägerschaft, später auch motiviert durch Verfahren der Krankenhauszertifizierung etabliert. Ihre Aufgaben bestehen in der Regel in der klinischen Ethikberatung, der Mitwirkung an der Erstellung von Leitlinien sowie in der Aus- und Fortbildung des ärztlichen und pflegerischen Personals in Fragen der Ethik. Darüber hinaus gibt es vereinzelt Krankenhäuser, in denen Ethikkomitees im Einzellfall oder in der Regel in das ganze Klinikum betreffende Grundsatzentscheidungen eingebunden sind.12/2007: pages 207-217;