Effect of ethics consultations in the intensive care unit

Department of Family and Preventive Medicine and Department of Medicine, University of California School of Medicine, San Diego, California, USA.
Critical Care Medicine (Impact Factor: 6.31). 12/2006; 34(11 Suppl):S359-63. DOI: 10.1097/01.CCM.0000237078.54456.33
Source: PubMed


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.

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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). "
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